APPENDIX 12 |
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SEXUAL ACTIVITY & CONTRACEPTION IN ATHLETES
Several medical studies and reports conclude that men and women who are well-conditioned and vigorously engaged in sports and competition have more frequent sexual intercourse--and enjoy it more -- than their sedentary counterparts. The energy drain that results from sexual intercourse is negligible among athletes who are physically fit. The amount of energy expended is estimated to be equal to running a 100-yard dash.
CONTRACEPTIVE CONSIDERATIONS
Athletes use the same contraceptive measures as others, but some forms of birth control may require special considerations for athletes. The use of diaphragms, cervical caps or rubber condoms obviously has no effect on sports ability or performance. However, the following forms of contraception for women merit examination:
Contraceptive creams and jellies sometimes cause vaginal and vulvar irritation that can interfere with athletic performance. These side effects usually disappear readily once the cream or jelly is discontinued. Occasionally, local treatment with topical steroid creams is necessary.
Oral contraceptive pills cause significant physiological changes. At present, we do not know enough to encourage or discourage their use in women athletes. Some women retain excess fluid while on the pill, and this may decrease performance. On the other hand, the pill increases the body's blood volume. Exercise enhances the body's ability to deal with the body's blood volume because the heart functions more efficiently and circulation is better. Both of these factors can enhance endurance and other aspects of performance. The physiological changes experienced with oral contraceptives vary from woman to woman, so the decision to use the pill should be based on factors other than physical activity.
Injections of long-acting progesterone are used in some countries, but they are not approved by the FDA for use in the U.S., so we have few studies on this form of contraception. It has been established, however, that progesterone can cause fluid retention and irregular periods. Fluid retention may decrease athletic performance.
Intrauterine devices (IUDs) have significant negative effects on women athletes and should not be used. Following are some of the reported problems associated with using IUDs:
(1) Higher percentage of pelvic infections in athletes than in sedentary women using IUDs.
(2) Higher degree of unpredictable intervals between menstrual periods in athletes than in sedentary women using IUDs.
(3) Much higher frequency of heavy, prolonged bleeding. Some medical studies have reported that 60% to 75% of IUD users experience excessive flow. This significant increase in bleeding can lead to anemia and decreased oxygen-carrying capacity of the blood, eventually affecting athletic performance.
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