This
was no armchair athlete talking, no envious wanna-be who spends race day
handing out cups of water. A veteran of five triathlons — including
the prestigious Ironman Hawaii — K leaned forward and dropped her
voice before continuing.
“You know, the pros all use birth control to regulate their hormones. You know how you have more energy at some points during your cycle, less at others? Well, they time things so that they’re at peak on race day.”
“Do you do that?” A reasonable question. We’re talking to a woman so dedicated to the sport that she once had her sweat analyzed to measure mineral retention.
A self-depreciating laugh. “No, I’m not a pro.”
According to Mona Terrell, of Ortho-McNeil, manufacturer of Ortho-Tri-Cyclin, by far one of the most popular birth control pills on the market, “Our products are not indicated for any use other than the prevention of pregnancy. Any other use is off-label, and we have nothing to say about that.”
Official commentary aside, we all know women who use contraception for non-traditional purposes. The bride planning the perfect wedding day, the accountant who doesn’t need the extra stress during tax season. There’s even a name for it. It’s called menstrual suppression.
The pharmaceutical industry, ever quick to notice a dollar-laden phenomenon, sent scientists scurrying into the lab to develop medicines like Seasonale. Extended-use oral contraceptives are taken for 84 days in a row, resulting in 4 periods a year. This could be a good or bad thing, depending on where you fall in the medical, social, and ethical debate surrounding long-term menstrual suppression.
Some athletes — especially younger, college-aged women — don’t need any medical intervention to stop their periods. Dedicated to their sport, these women subject themselves to long hours of intense physical activity. Anything in excess is a bad idea, and exercise is no exception. When limits are ignored, athletes may fall prone to what is known as the Female Triad. First described in the early ‘90s, this combination of stress fractures, eating disorders, and skipped or stopped menstrual periods (known as premenopausal amenorrhea) can wreak havoc on one’s system. Birth control pills are sometimes prescribed to help regulate hormonal balance and ironically, re-start menstrual periods.
But will they make you run faster?
No two athletes are alike. The sports drink that perks up one runner can leave the next one puking on the side of the road. Enter the complicated world of female hormones, and things become even more complex.
Oral contraceptive pills cause significant physiological changes. Use of the pill may cause some women to retain excess fluid, adding weight and negatively impacting overall performance.
There’s another type of fluid increase that athletes may look at more warmly. Taking oral contraceptives can increase the body’s blood volume. Extremely fit women, who have the benefit of efficient hearts and excellent circulation, take advantage of the extra oxygen available. The enhanced endurance that can result is very valuable to athletes in distance events like triathlons.
So we’re left with a class of drugs that may enhance performance in some athletes, hinder it in others. Oral contraceptives do effectively prevent pregnancy, which gives doctors a legitimate reason to prescribe them and women a legitimate reason to take them.
Routine drug testing takes place after all sanctioned sporting events, according to the International Triathlon Union. One test measures the proportion of testosterone to epitestosterone (T/E), and is used to determine the presence of performance-enhancing drugs. “We have investigated several cases of reported high ‘T/E’ ratios,” they report. But in the cases in question, however, the ITU found in favor of the athletes, since they were taking prescription birth control pills. In each instance, rigorous additional testing protocol was applied to ensure that a doping violation had not been committed.
At this time, it appears that the regulatory authorities consider the possible performance-enhancing qualities of birth control to be inconsequential. Among the athletes, things are different. K isn’t the only athlete to harbor suspicions about her competitors.
Athletics is plagued by the persistent specter of cheating. By the very nature of the field, only the smallest percentage of competitors can succeed. Athletes do everything to gain an edge — countless hours of training, special diets, and mental preparation. When someone else captures first place, a competitor is left asking, “What did she do that I didn’t?”
Sometimes the answers are too terrible to contemplate. At the Ottawa World Anti-Doping conference in 1988, Prince Alexandre de Merode of Belgium — who was also the international Olympic Committee Vice President — was among those claiming that female athletes inside the Communist block were having themselves artificially inseminated, then aborting the fetuses two or three months later to take advantage of a perceived hormone boost.
The veracity of this information is still under debate. Several women from Eastern Europe have come forward, stating that they were told that they had to terminate their pregnancies during the seventies. Remembering that use of steroids and other performance-enhancing drugs was rampant among Communist athletes at this time, commentators have reasoned that the forced abortions were to prevent children being born with severe birth defects rather than for any extra competitive edge. East Germany’s backstroke champion gave birth to a son with a clubfoot; another bore a blind daughter.
While this story has become a great favorite with anti-choice advocates, we’ve yet to have any verifiable, medically supported proof that it is true.
Perhaps the birth control pills fall into the same category: scientifically plausible, comfortably nebulous, firmly ensconced in the awkward, underexplored territory of female reproductive health — everything is in place to explain longer strides, stronger kicks, faster times.
We’ll never truly know the answer as long as there are athletes who are willing to wholly sacrifice themselves on the altar of victory. Until then, K and her comrades will swim countless hours, bike hundreds of miles, and run as fast as they can. And they will whisper.