Approach to sport-savvy contraceptive counselling for athletes

Objective To provide a practical approach for primary care physicians counselling female athletes on contraception choice. Sources of information A targeted literature search was conducted in PubMed and Google Scholar for articles published until December 2025 and integrated key current research, including a 2024 cross-sectional study on female athletes’ experiences with contraceptive selection and the 2023 International Olympic Committee’s consensus statement on relative energy deficiency in sport (REDs). Main message Athletes frequently report sport-specific concerns are overlooked during contraceptive counselling with their physicians, leading to dissatisfaction and information seeking outside of medical settings. While evidence on the impact of contraceptives on athletic performance is limited, clinicians should address known performance-related factors such as iron status, menstrual symptom management, cycle timing manipulation, body composition concerns, and potential injury risk. Awareness of REDs is also essential, as hormonal contraception can impact menstrual changes that signal low energy availability. Conclusion Contraceptive counselling that incorporates an athlete’s sport and performance-related considerations can enhance confidence in contraceptive choice while helping to optimize both health and performance.