Inflammation and Oral Contraceptive Use in Female Athletes Before the Rio Olympic Games
Open accessAbstract
Purpose: To investigate the association between synthetic ovarian hormone use (i.e., the oral contraceptive (OC) pill) and basal C-reactive protein (CRP), peripheral blood immune cell subsets, and circulating pro- and anti-inflammatory cytokine concentrations in elite female athletes. Methods: Elite female athletes (n = 53) selected in Rio Summer Olympic squads participated in this study; 25 were taking an OC (AthletesOC) and 28 were naturally hormonally cycling (AthletesNC). Venous blood samples were collected at rest for the determination of sex hormones, cortisol, CRP, peripheral blood mononuclear memory and naïve CD4+ T-cells, CD8+ T-cells and natural killer cells, as well as pro- and anti-inflammatory cytokine concentrations. Results: C-reactive protein concentrations were elevated (p < 0.001) in AthletesOC (median = 2.02, IQR = 3.15) compared to AthletesNC (median = 0.57, IQR = 1.07). No differences were reported for cortisol, cytokines, or PBMC immune cell subsets, although there was a trend (p = 0.062) for higher IL-6 concentrations in AthletesNC. Conclusion: Female Olympians had substantially higher CRP concentrations, a marker of inflammation and tissue damage, before the Rio Olympic Games if they used an OC. Future research should examine the potential consequences for athlete performance/recovery so that, if necessary, practitioners can implement prevention programs.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
COCs with higher concentrations of hormones can decrease glucose tolerance, in turn augmenting insulin resistance in adult premenopausal women.
“Evidence shows that COCs with higher concentrations of hormones can decrease glucose tolerance, in turn augmenting insulin resistance in adult premenopausal women [179].”
From International society of sports nutrition position stand: nutritional concerns of the female athlete (2023) · cites this paper as [179]
The Introduction and Conclusion discuss oral-contraceptive use in relation to CRP and inflammation in elite athletes, not glucose tolerance. Searches for glucose tolerance, insulin resistance, and hormone dose found no passage in the paper stating that higher-hormone COCs reduce glucose tolerance or increase insulin resistance in adult premenopausal women. A reference title mentions impaired insulin sensitivity, but it does not establish the claimed dose-dependent effect. (LLM, conf=0.76)
Experimental — accuracy not yet measuredWomen using COC demonstrate a slightly lower reliance on exogenous CHO oxidation compared to non-COC users.
“Women using COC demonstrate a slightly lower reliance on exogenous CHO oxidation as compared to non-COC users [98,179,201].”
From International society of sports nutrition position stand: nutritional concerns of the female athlete (2023) · cites this paper as [179]
The Materials and Methods describe a blood-sample study of elite athletes, and the Discussion and Conclusion report inflammatory markers rather than exogenous carbohydrate oxidation. Searches for exogenous carbohydrate oxidation and exercise substrate use found no passage stating the claimed difference between contraceptive users and non-users. (LLM, conf=0.76)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Ridker, P. M., Hennekens, C. H., Buring, J. E., & Rifai, N. (2000) · New England Journal of Medicine · doi:10.1056/nejm200003233421202 · Cited by 5,850 · see citing works
C-reactive protein: a critical update
Pepys, M. B., & Hirschfield, G. M. (2003) · Journal of Clinical Investigation · doi:10.1172/jci18921 · Cited by 4,576 · cited 1× · see citing works
“C-reactive protein (CRP) is an acute phase reactant used as a systemic marker of inflammation and tissue damage (Pepys and Hirschfield, 2003).”
BackgroundC-reactive protein: a critical update
Pepys, M. B., & Hirschfield, G. M. (2003) · Journal of Clinical Investigation · doi:10.1172/jci200318921 · Cited by 3,436 · see citing works
The anti-inflammatory effect of exercise
Petersen, A. M. W., & Pedersen, B. K. (2005) · Journal of Applied Physiology · doi:10.1152/japplphysiol.00164.2004 · Cited by 3,100 · see citing works
Black, S., Kushner, I., & Samols, D. (2004) · Journal of Biological Chemistry · doi:10.1074/jbc.r400025200 · Cited by 1,844 · cited 1× · see citing works
“Nevertheless, these findings are interesting given that IL-6 is thought to trigger CRP expression (Black et al., 2004), yet CRP was higher in the AthletesOC group though this group displayed a trend for lower IL-6 concentrations, and there was no difference in CRP between AthletesNC in the follicular and luteal phases…”
BackgroundImmune function in sport and exercise
Gleeson, M. (2007) · Journal of Applied Physiology · doi:10.1152/japplphysiol.00008.2007 · Cited by 1,016 · cited 4× · see citing works
“Regular physical activity promotes an anti-inflammatory immune profile (Petersen and Pedersen, 2005; Gleeson, 2007), and so it is possible that the effects of OC use on inflammation differ in elite sportswomen when compared to the general community.”
BackgroundInfluentialMuscle damage and inflammation during recovery from exercise
Peake, J. M., Neubauer, O., Gatta, P. A. D., & Nosaka, K. (2016) · Journal of Applied Physiology · doi:10.1152/japplphysiol.00971.2016 · Cited by 829 · see citing works
Sports injuries and illnesses during the London Summer Olympic Games 2012
Engebretsen, L., Soligard, T., Steffen, K., Alonso, J. M., Aubry, M., Budgett, R., Dvořák, J., Jegathesan, M., Meeuwisse, W. H., Mountjoy, M. L., et al. (2013) · British Journal of Sports Medicine · doi:10.1136/bjsports-2013-092380 · Cited by 753 · see citing works
Ridker, P. M., Rifai, N., Cook, N. R., Bradwin, G., & Buring, J. E. (2005) · JAMA · doi:10.1001/jama.294.3.326 · Cited by 744 · see citing works
Freeman, D. J., Norrie, J. D., CASLAKE, M. J., Gaw, A., Ford, I., Lowe, G. D. O., O’Reilly, D. S. J., Packard, C. J., Sattar, N. A., & for the West of Scotland Coronary Prevention Study Group (2002) · Diabetes · doi:10.2337/diabetes.51.5.1596 · Cited by 720 · cited 1× · see citing works
“Elevated CRP concentrations are also associated with an increased risk of developing cardiovascular disease (CVD) (Ridker et al., 2000) and diabetes mellitus (Freeman et al., 2002).”
BackgroundPhysical activity and risk of cardiovascular disease—a meta-analysis of prospective cohort studies
Li, J., & Siegrist, J. (2012) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph9020391 · Cited by 674 · see citing works
Effects of gender and sex steroids on the immune response
Schuurs, A. H. W. M., & Verheul, H. A. M. (1990) · Journal of Steroid Biochemistry · doi:10.1016/0022-4731(90)90270-3 · Cited by 587 · see citing works
Newell, E. W., Sigal, N., Bendall, S. C., Nolan, G. P., & Davis, M. M. (2012) · Immunity · doi:10.1016/j.immuni.2012.01.002 · Cited by 555 · see citing works
The effect of including C-reactive protein in cardiovascular risk prediction models for women
Cook, N. R., Buring, J. E., & Ridker, P. M. (2006) · Annals of Internal Medicine · doi:10.7326/0003-4819-145-1-200607040-00128 · Cited by 504 · cited 2× · see citing works
“L−1 (“very high” CVD risk) (Cook et al., 2006; Cauci et al., 2017), whereas two OC users (8%) fell into this category in the current cohort.”
BackgroundMethodDupuy, O., Douzi, W., Theurot, D., Bosquet, L., & Dugué, B. (2018) · Frontiers in Physiology · doi:10.3389/fphys.2018.00403 · Cited by 472 · see citing works
Melin, A., Tornberg, Å. B., Skouby, S., Faber, J., Ritz, C., Sjödin, A., & Sundgot-Borgen, J. (2014) · British Journal of Sports Medicine · doi:10.1136/bjsports-2013-093240 · Cited by 435 · see citing works
Stricker, R., Eberhart, R., Chevailler, M.-C., Quinn, F. A., Bischof, P., & Stricker, R. (2006) · Clinical Chemistry and Laboratory Medicine (CCLM) · doi:10.1515/cclm.2006.160 · Cited by 392 · cited 1× · see citing works
“…with respect to menstrual cycle, however, hormone concentration data (progesterone and estradiol) were used to stratify AthletesNC according to menstrual cycle phase using established reference values (Stricker et al., 2006; data were converted to relevant units for comparison where necessary).”
MethodNutrition Knowledge in Athletes: A Systematic Review
Heaney, S. E., O'Connor, H. T., Michael, S., Gifford, J. A., & Naughton, G. A. (2011) · International Journal of Sport Nutrition and Exercise Metabolism · doi:10.1123/ijsnem.21.3.248 · Cited by 324 · see citing works
Effect of four different oral contraceptives on various sex hormones and serum-binding globulins
Wiegratz, I., Kutschera, E., Lee, J. H., Moore, C., Mellinger, U., Winkler, U. H., & Kuhl, H. (2003) · Contraception · doi:10.1016/s0010-7824(02)00436-5 · Cited by 239 · see citing works
Injuries impair the chance of successful performance by sportspeople: a systematic review
Drew, M. K., Raysmith, B. P., & Charlton, P. C. (2017) · British Journal of Sports Medicine · doi:10.1136/bjsports-2016-096731 · Cited by 199 · see citing works
Self-citationCYCLIC PLASMA IL-6 LEVELS DURING NORMAL MENSTRUAL CYCLE
Angstwurm, M., Gärtner, R., & Ziegler‐Heitbrock, H. W. L. (1997) · Cytokine · doi:10.1006/cyto.1996.0178 · Cited by 147 · see citing works
Substrate and hormonal responses to exercise in women using oral contraceptives
Bonen, A., Haynes, F. W., & Graham, T. E. (1991) · Journal of Applied Physiology · doi:10.1152/jappl.1991.70.5.1917 · Cited by 126 · cited 1× · see citing works
“, 2013), others showing no difference (Bonen et al., 1991; Kirschbaum et al., 1996), and one showing a decreased concentration (Reinberg et al.”
BackgroundDrew, M. K., Vlahovich, N., Hughes, D. C., Appaneal, R., Peterson, K. M., Burke, L. M., Lundy, B., Toomey, M., Watts, D., Lovell, G. A., et al. (2017) · Journal of science and medicine in sport · doi:10.1016/j.jsams.2017.02.010 · Cited by 122 · see citing works
Self-citationEffects of Oral Contraceptives on Body Composition and Physical Performance in Female Athletes
Rickenlund, A. M., Carlström, K., Ekblom, B. T., Brismar, T. B., von Schoultz, B., & Hirschberg, A. L. (2004) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2003-031334 · Cited by 120 · see citing works
Timmons, B. W., Hamadeh, M. J., Devries, M. C., & Tarnopolsky, M. A. (2005) · Journal of Applied Physiology · doi:10.1152/japplphysiol.00171.2005 · Cited by 114 · see citing works
Tam, R., Beck, K. L., Manore, M. M., Gifford, J. A., Flood, V. M., & O'Connor, H. T. (2019) · Sports Medicine · doi:10.1007/s40279-019-01157-y · Cited by 114 · see citing works
Oral Contraceptives Suppress Ovarian Hormone Production
Fleischman, D. S., Navarrete, C. D., & Fessler, D. M. T. (2010) · Psychological Science · doi:10.1177/0956797610368062 · Cited by 112 · cited 2× · see citing works
“As expected, estradiol, progesterone, and testosterone were lower in the AthletesOC group when compared to AthletesNC (Wiegratz et al., 2003; Fleischman et al., 2010).”
BackgroundResultExercising in Environmental Extremes
Walsh, N. P., & Whitham, M. (2006) · Sports Medicine · doi:10.2165/00007256-200636110-00003 · Cited by 110 · cited 2× · see citing works
“It is not immediately clear as to why this occurred, however, periods of intensified training can have an immunosuppressive effect (Walsh and Whitham, 2006; Gleeson, 2007).”
BackgroundImpact of Gender and Menstrual Cycle Phase on Plasma Cytokine Concentrations
O’Brien, S. M., Fitzgerald, P., Scully, P., Landers, A., Scott, L. V., & Dinan, T. G. (2007) · NeuroImmunoModulation · doi:10.1159/000107423 · Cited by 107 · see citing works
VAN ROOIJEN, M., HANSSON, L. O., FROSTEGÅRD, J., SILVEIRA, A., HAMSTEN, A., & BREMME, K. (2006) · Journal of Thrombosis and Haemostasis · doi:10.1111/j.1538-7836.2005.01690.x · Cited by 105 · see citing works
Piltonen, T., Puurunen, J., Hedberg, P., Ruokonen, A., Mutt, S. J., Herzig, K. H., Nissinen, A., Morin-Papunen, L., & Tapanainen, J. S. (2012) · Human Reproduction · doi:10.1093/humrep/des225 · Cited by 94 · see citing works
Yeh, S.-H., Chuang, H., Lin, L.-W., Hsiao, C.-Y., Wang, P.-W., Liu, R.-T., & Yang, K. (2008) · British Journal of Sports Medicine · doi:10.1136/bjsm.2007.043562 · Cited by 88 · see citing works
Reinberg, A., Touitou, Y., Soudant, É., Bernard, D., Bazin, R., & Mechkouri, M. (1996) · Chronobiology International · doi:10.3109/07420529609012653 · Cited by 73 · see citing works
Cauci, S., Santolo, M. D., Culhane, J. F., Stel, G., Gonano, F., & Guaschino, S. (2008) · Obstetrics and Gynecology · doi:10.1097/aog.0b013e31816a2476 · Cited by 72 · cited 1× · see citing works
“L−1 (36%) than previously observed in OC users in the general population (31%) (Cauci et al., 2008).”
BackgroundModulation of IL-6 Production during the Menstrual Cycle in Vivo and in Vitro
Konecná, L., Yan, M., Miller, L. E., Schölmerich, J., Falk, W., & Straub, R. H. (2000) · Brain Behavior and Immunity · doi:10.1006/brbi.1999.0570 · Cited by 67 · see citing works
Sørensen, C. J., Pedersen, O. B., Petersen, M. S., Sørensen, E., Kotzé, S., Thørner, L. W., Hjalgrim, H., Rigas, A. S., Møller, B. K., Rostgaard, K., et al. (2014) · PLoS ONE · doi:10.1371/journal.pone.0088196 · Cited by 63 · see citing works
Boisseau, N., Enéa, C., Diaz, V., Dugué, B., Corcuff, J., & Duclos, M. (2013) · PubMed · doi:10.3275/8971 · Cited by 59 · see citing works
Pirkola, J., Vääräsmäki, M., Ala‐Korpela, M., Bloigu, A. H., Canoy, D., Hartikainen, A., Leinonen, M., Miettola, S., Paldanius, M., Tammelin, T., et al. (2009) · American Journal of Epidemiology · doi:10.1093/aje/kwp320 · Cited by 58 · see citing works
Evaluation of Nutritional Intake in Canadian High-Performance Athletes
Lun, V. M. Y., Erdman, K. A., & Reimer, R. A. (2009) · Clinical Journal of Sport Medicine · doi:10.1097/jsm.0b013e3181b5413b · Cited by 54 · see citing works
Giraldo, E., Hinchado, M. D., García, J. J., & Ortega, E. (2008) · Molecular and Cellular Biochemistry · doi:10.1007/s11010-008-9752-2 · Cited by 53 · see citing works
Cauci, S., Francescato, M. P., & Curcio, F. (2016) · Sports Medicine · doi:10.1007/s40279-016-0534-9 · Cited by 49 · cited 8× · see citing works
“C-reactive protein concentrations were threefold higher in AthletesOC compared to AthletesNC, which supports an earlier study (Cauci et al., 2017) that reported a fourfold increase in CRP concentrations in athletic women using an OC when compared to non-users.”
BackgroundResultInfluentialEffect of oral contraceptive cycle phase on performance in team sport players
Rechichi, C., & DAWSON, B. T. (2007) · Journal of science and medicine in sport · doi:10.1016/j.jsams.2007.10.005 · Cited by 39 · see citing works
Auerbach, L., Hafner, T., Huber, J. C., & Panzer, S. (2002) · Fertility and Sterility · doi:10.1016/s0015-0282(02)03173-4 · Cited by 38 · cited 3× · see citing works
“However, re-calculation of our data to be comparable to the previous study (Auerbach et al., 2002) made no difference to our results (data not shown).”
BackgroundResultInfluentialAnthropometric measurements and body composition of selected national athletes.
Wan Nudri, W., Ismail, M. N., & Zawiak, H. (1996) · PubMed · Cited by 33 · see citing works
CANADIAN CROSS-CULTURAL COMPARISON OF THE HIGH-RISK PREGNANCY STRESS SCALE
Goulet, C., Polomeno, V., & Harel, F. (1996) · Stress Medicine · doi:10.1002/(sici)1099-1700(199607)12:3 · Cited by 16 · see citing works
Probiotic supplementation has little effect on peripheral blood regulatory T cells
West, N. P., Horn, P. L., Pyne, D. B., Warren, H. S., Asad, S., Cox, A. J., Lahtinen, S. J., Lehtinen, M. J., Fricker, P. A., Cripps, A. W., et al. (2016) · Journal of Allergy and Clinical Immunology · doi:10.1016/j.jaci.2016.06.055 · Cited by 8 · see citing works
Self-citationSTAY HEALTHY: AN AUSTRALIAN INSTITUTE OF SPORT ILLNESS PREVENTION PROJECT
Drew, M. K., Vlahovich, N., Hughes, D. C., Appaneal, R. N., Kirsten, P., Louise, B., Bronwen, L., Mary, T., David, W., Lovell, G., et al. (2017) · British Journal of Sports Medicine · doi:10.1136/bjsports-2016-097372.76 · Cited by 2 · see citing works
Self-citation
Flagged first, then by citations
Cited by
Sorted by citations
Sex differences and considerations for female specific nutritional strategies: a narrative review
Wohlgemuth, K. J., Arieta, L. R., Brewer, G. J., Hoselton, A. L., Gould, L. M., & Smith-Ryan, A. E. (2021) · Journal of the International Society of Sports Nutrition · doi:10.1186/s12970-021-00422-8 · Cited by 111 · see citing works
“Oral contraceptive pills may have a negative influence on inflammatory markers as evidenced in elite Olympic level female athletes who were using oral contraceptives as they displayed higher levels of C-reactive protein, a marker of inflammation, than eumenorrheic peers, potentially suggesting increased muscle damage…”
BackgroundInternational society of sports nutrition position stand: nutritional concerns of the female athlete
Sims, S. T., Kerksick, C. M., Smith-Ryan, A. E., Janse de Jonge, X. A. K., Hirsch, K. R., Arent, S. M., Hewlings, S. J., Kleiner, S. M., Bustillo, E., Tartar, J. L., et al. (2023) · Journal of the International Society of Sports Nutrition · doi:10.1080/15502783.2023.2204066 · Cited by 91 · see citing works
“Additionally, increases in C-reactive protein levels, through glucose tolerance testing of Olympic female athletes on COC, have been observed, indicative of an upregulated inflammatory response [180]; with significantly higher oxi-”
BackgroundOosthuyse, T., Strauss, J. A., & Hackney, A. C. (2022) · European Journal of Applied Physiology · doi:10.1007/s00421-022-05090-3 · Cited by 70 · see citing works
Improving menstrual health literacy in sport
McGawley, K., Sargent, D., Noordhof, D. A., Badenhorst, C. E., Julian, R., & Govus, A. D. (2023) · Journal of science and medicine in sport · doi:10.1016/j.jsams.2023.06.007 · Cited by 74 · see citing works
“In Australia, ~47% of elite female athletes competing in the 2016 Rio Olympics used an oral HC (28), compared to 58% (113 out of 195 athletes) at the Tokyo Olympic or Paralympic games (29).”
BackgroundSex Differences in Stress Susceptibility as a Key Mechanism Underlying Depression Risk
Mengelkoch, S., & Slavich, G. M. (2024) · Current Psychiatry Reports · doi:10.1007/s11920-024-01490-8 · Cited by 63 · see citing works
“This research gap has occurred even though these hormonal influences have been known to impact stress reactivity for the past 30 years (e.g., [35 • , 37, 38, 39 • , 40 •• , 41, 42]).”
BackgroundKodama, Y., Masuda, S., Ohmori, T., Kanamaru, A., Tanaka, M., Sakaguchi, T., & Nakagawa, M. (2023) · Bioengineering · doi:10.3390/bioengineering10040474 · Cited by 50 · see citing works
Notbohm, H. L., Moser, F., Goh, J., Feuerbacher, J. F., Bloch, W., & Schumann, M. (2023) · Acta Physiologica · doi:10.1111/apha.14013 · Cited by 45 · see citing works
“…0.63] 0.00 [−0.32, 0.32] 1.24 [−0.11, 2.60] 0.09 [−0.86, 1.04] −0.04 [−0.50, 0.42] −0.43 [−0.99, 0.13] 0.01 [−0.91, 0.93] −0.37 [−1.15, 0.41] 0.02 [−0.69, 0.74] 0.16 [−0.49, 0.82] −0.26 [−1.18, 0.67] 0.14 [−0.48, 0.76] n luteal n follicular Quality OV test E2 & P4 IL−1b Chiu et al. 2000 [94]…”
InfluentialSims, S. T., Ware, L., & Capodilupo, E. R. (2021) · BMJ Open Sport & Exercise Medicine · doi:10.1136/bmjsem-2021-001047 · Cited by 43 · see citing works
The Specificities of Elite Female Athletes: A Multidisciplinary Approach
Castanier, C., Bougault, V., Teulier, C., Jaffré, C., Schiano-Lomoriello, S., Vibarel-Rebot, N., Villemain, A., Rieth, N., Scanff, C. L., Buisson, C., et al. (2021) · Life · doi:10.3390/life11070622 · Cited by 35 · see citing works
Vogel, K., Larsen, B., McLellan, C., & Bird, S. P. (2023) · Sports · doi:10.3390/sports12010004 · Cited by 28 · see citing works
“For instance, hormonal contra-Sports ceptive use has been shown to influence thermoregulatory processes [39], inflammation [40], and perceived exertion [39] when compared to naturally menstruating women.”
BackgroundSelf-citationQuinn, K., Cox, A. J., Roberts, L. A., Pennell, E. N., McKeating, D. R., Fisher, J. J., Perkins, A. V., & MINAHAN, C. L. (2021) · European Journal of Applied Physiology · doi:10.1007/s00421-021-04734-0 · Cited by 26 · see citing works
Self-citationMasama, C., Jarkas, D., Thaw, E., Daneshmend, A., Franklyn, S. I., Beaurepaire, C., & McQuaid, R. J. (2022) · Hormones and Behavior · doi:10.1016/j.yhbeh.2022.105229 · Cited by 25 · see citing works
Power, C. J., Fox, J. L., Elliott-Sale, K. J., Bender, A. M., Dalbo, V. J., & Scanlan, A. T. (2023) · Sports Medicine · doi:10.1007/s40279-023-01963-5 · Cited by 24 · see citing works
“Nevertheless, the use of hormonal contraceptives in athletes has prompted increased research attention regarding their effects on athlete health, performance, and recovery [113, 122, 123].”
Mengelkoch, S., Gassen, J., Slavich, G. M., & Hill, S. E. (2023) · Brain Behavior and Immunity · doi:10.1016/j.bbi.2023.10.033 · Cited by 22 · see citing works
“A growing body of research has found that HC users exhibit more chronic inflammation (Larsen et al., 2020; Masama et al., 2022), oxidative stress (Cauci et al., 2021), and inflammation-related health conditions such as cardiovascular disease (Okoth et al., 2020), autoimmune disorders (Costenbader…”
InfluentialBozzini, B. N., McFadden, B. A., Elliott-Sale, K. J., Swinton, P. A., & Arent, S. M. (2021) · Journal of Applied Physiology · doi:10.1152/japplphysiol.00818.2020 · Cited by 19 · see citing works
Active Women Across the Lifespan: Nutritional Ingredients to Support Health and Wellness
Smith‐Ryan, A. E., Cabre, H. E., & Moore, S. R. (2022) · Sports Medicine · doi:10.1007/s40279-022-01755-3 · Cited by 17 · see citing works
“An increased C-reactive protein response was also observed through glucose tolerance testing of Olympic female athletes taking OCs, illustrating an upregulated inflammatory response, possibly indicating increased muscle damage or insufficient recovery [34].”
BackgroundHormonal Contraceptive Use and Affective Disorders: An Updated Review
Mengelkoch, S., Afshar, K., & Slavich, G. M. (2025) · Open Access Journal of Contraception · doi:10.2147/oajc.s431365 · Cited by 12 · see citing works
“51 Others have found HC users to have elevated chronic inflammation, 78,109 which is itself a risk factor for depression.”
Moreillon, B., Equey, T., Astolfi, T., Salamin, O., & Faiss, R. (2022) · Drug Testing and Analysis · doi:10.1002/dta.3218 · Cited by 10 · see citing works
“Several hormonal chain reactions are associated with the menstrual cycle and can have an influence on female physical capacity.(41,43,44) Women taking OCPs have less amplitude in their hormonal status and cannot be considered to have ‘normal’ menstrual cycles even though they may have regular bleeding patterns because…”
BackgroundZou, M. Y., Cohen, R. E., Ursomanno, B. L., & Yerke, L. M. (2023) · Dentistry Journal · doi:10.3390/dj11070163 · Cited by 9 · see citing works
“Several clinical studies have shown that patients taking OC exhibit greater concentrations of C-reactive protein (an indicator of inflammation and tissue damage) [15], more pronounced gingival inflammation, increased loss of clinical attachment, and gingival enlargement [14].”
BackgroundNotbohm, H. L., Umlauff, L., Bloch, W., & Schumann, M. (2023) · European Journal of Applied Physiology · doi:10.1007/s00421-023-05275-4 · Cited by 9 · see citing works
“Similarly, Larsen et al. (2020) found no difference in any cytokines, including IL-6, between naturally cycling elite athletes and those using oral contraceptives, although menstrual cycle phases were mixed (Larsen et al. 2020).”
BackgroundBadenhorst, C. E., Govus, A. D., & Mündel, T. (2023) · Physiological Reports · doi:10.14814/phy2.15777 · Cited by 8 · see citing works
“Samples were collected from elite female athletes throughout the day, with athletes either in a rested or post training recovery state (Larsen et al., 2020).”
InfluentialQuinn, K., Roberts, L. A., Cox, A. J., Borg, D. N., Pennell, E. N., McKeating, D. R., Fisher, J. J., Perkins, A. V., & MINAHAN, C. L. (2022) · European Journal of Applied Physiology · doi:10.1007/s00421-022-04964-w · Cited by 6 · see citing works
Self-citationAbdelgawad, L. M., Salem, Y. G. M. I., & Eltayeb, E. A. (2024) · Journal of lasers in medical sciences · doi:10.34172/jlms.2024.39 · Cited by 4 · see citing works
Exercise and Immunity: Beliefs and Facts
López, P., Chamorro-Viña, C., Gómez-García, M., & Fernández-del-Valle, M. (2023) · Springer eBooks · doi:10.1007/978-3-031-15485-0_28 · Cited by 4 · see citing works
Fabunmi, O. A., Dludla, P. V., & Nkambule, B. B. (2024) · PLoS ONE · doi:10.1371/journal.pone.0298429 · Cited by 3 · see citing works
“While in other studies, COC did not alter the levels of IL-6 and other related cytokines during exercise [43, 44].”
ResultMINAHAN, C. L., & Sabapathy, S. (2023) · Springer eBooks · doi:10.1007/978-3-031-21881-1_9 · Cited by 3 · see citing works
Self-citationGilfarb, R. A., Ranade, S., Dybas, E., Biddle, A., Stewart, M., Rajesh, A., Leuner, B., & Lenz, K. M. (2025) · Brain Behavior and Immunity · doi:10.1016/j.bbi.2025.02.016 · Cited by 2 · see citing works
Mikkonen, R., Hackney, A. C., Hulmi, J., Isola, V., Ahtiainen, J., & Ihalainen, J. (2025) · European Journal of Sport Science · doi:10.1002/ejsc.70076 · Cited by 2 · see citing works
“…of cortisol in combined HC users were generally higher than those of progestin‐ only HC users and naturally menstruating females in line with previous research (Hertel et al. 2017; Masama et al. 2022), although this finding is not consistent (Kirschbaum et al. 1996; Larsen et al. 2020).”
Trends in the use of oral contraceptives and progestins in Japanese female Olympic athletes
Nose‐Ogura, S., Kawabe, R., Kashiwagi, Y., Senzaki, Y., Nakamura, Y., Nakamura, M., Tomori, A., Shirai, K., & Nakajima, K. (2025) · The Physician and Sportsmedicine · doi:10.1080/00913847.2025.2597173 · Cited by 1 · see citing works
Kjerulff, B. D., Dinh, K. M., Boldsen, J. K., Kesmodel, U. S., Dowsett, J., Mikkelsen, S., Kogelman, L. J. A., Didriksen, M., Mikkelsen, C., Bay, J., et al. (2026) · Apmis · doi:10.1111/apm.70235 · Cited by 1 · see citing works
Trexler, E. T., Eagle, D. E., & Pontzer, H. (2025) · PLoS ONE · doi:10.1371/journal.pone.0319928 · Cited by 1 · see citing works
“These studies have recruited samples of female athletes who compete at the national level [32], the international level [15], and a wide range of competitive levels [31].”
InfluentialLemii, B. C., Daka, I. R., Gabriel-Brisibe, C. U., Enebeli, S. K., Edward, U. F., Austin-Asomeji, I., Oghenetekevwe, E., Nodi, C. C., & Odinga, T.-B. (2024) · International Journal of Biological Chemistry · doi:10.3923/ijbc.2024.01.10
Mejoramiento del conocimiento sobre salud menstrual en el deporte
McGawley, K., Sargent, D., Noordhof, D. A., Badenhorst, C. E., Julian, R., & Govus, A. D. (2025) · Pensar en Movimiento Revista de Ciencias del Ejercicio y la Salud · doi:10.15517/x43ajy28
Griffiths, M. J., Brown, M. E., Gibson, D. A., Collins, F., Dunlop, C. E., Saunders, P. T. K., & Horne, A. W. (2025) · medRxiv · doi:10.1101/2025.08.25.25334349
Wohlgemuth, K. J., Arieta, L. R., Brewer, G. J., Hoselton, A. L., Gould, L. M., & Smith‐Ryan, A. E. (2021) · Figshare · doi:10.6084/m9.figshare.14431715
McKay, A. K. A., McCormick, R., Pearson, M. A., Tee, N., Harris, R., MINAHAN, C. L., Peeling, P., Ackerman, K. E., & Burke, L. M. (2026) · International Journal of Sport Nutrition and Exercise Metabolism · doi:10.1123/ijsnem.2025-0257
Self-citationFabunmi, O. A., Luthuli, G. P., Dludla, P. V., & Nkambule, B. B. (2026) · Frontiers in Physiology · doi:10.3389/fphys.2026.1728032
“…of 11 cross-sectional studies (Notelovitz et al., 1987; Santos et al., 2008; Rebelo et al., 2010; Schaumberg et al., 2017; Ihalainen et al., 2019; Larsen et al., 2020; Mattu et al., 2020; Schaumberg et al., 2020; Bozzini et al., 2021; Nakamura and Nose-Ogura, 2021; Gomes et al., 2022), four RCTs…”
InfluentialPhysical Training as a Component of Immune Status Maintenance during Long-Term Analog Mission
Kokueva, М. А., Ponomarev, S. A., Петровна, Р. М., Шмаров, В. А., Дмитриевна, О. К., Bakhtereva, V., Валерьевна, К. О., & Fomina, E. V. (2026) · Microgravity Science and Technology · doi:10.1007/s12217-026-10274-z
“Data obtained in female athletes also indicate that hormonal status and the use of hormonal contraception may be associated with specific features of the inflamma - tory profile during regular physical exercise (Larsen et al. 2020).”
- Authors
- Larsen, B., Cox, A., Colbey, C., Drew, M., McGuire, H., Fazekas de St Groth, B., Hughes, D., Vlahovich, N., Waddington, G., Burke, L., Lundy, B., West, N., & Minahan, C.
- Affiliations
- Griffith University (AU)
- Federation University (AU)
- The University of Sydney (AU)
- University of Canberra (AU)
- Corresponding author
- Minahan, Clare
- ORCID
- Venue
- Frontiers in Physiology
- Publisher
- Frontiers Media SA
- Published
- 2020-05-25
- Volume
- 11
- Pages
- 497-497
- ISSN
- 1664-042X (ISSN-L)
- PMC
- PMC7261912
- OpenAlex
- W3032360840
- Cited by
- 38
- References
- 47
- Citations by year
- 2026: 4 · 2025: 7 · 2024: 4 · 2023: 12 · 2022: 5 · 2021: 6
- FWCI
- 3.19
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Physiology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- University of Southern Queensland ePrints (University of Southern Queensland) (acceptedVersion)
- Griffith Research Online (submittedVersion, cc-by)
- FedUni ResearchOnline (Federation University Australia) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Griffith University
- University of Canberra
- International Olympic Committee
- Australian Institute of Sport
- Topics
- Health Sciences › Medicine › Rehabilitation › Exercise and Physiological Responses
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Sports Performance and Training
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Keywords
- oral contraceptives, female athletes, C-reactive protein, inflammation, cytokines, CD4+ T cells, CD8+ T cells, natural killer cells, cortisol, interleukin-6, Olympic athletes, hormonal contraception, immune function
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
