The Pill, lean muscle development & fertility awareness: could contraception be impairing your gains?

Muscle mass growth and the Pill: could contraception be impairing your gains?

It’s no secret that hormonal contraception can impact the body in a variety of ways. While some women may experience positive impacts from birth control, others are left with less than desirable side effects.

If you’re on the pill or another form of hormonal birth control, did you know that it could be negatively impacting your muscle growth?

That’s right, your contraception could be impairing your gains!

The Pill and muscle gains

The Pill may affect your muscle gains by affecting fat metabolism. It’s been shown that the Pill can alter energy levels, and this can slow down fat-burning. An insulin-like growth factor (IGF-1) is known to help build muscle, but the Pill can lower its production, as well as lowering estrogen and testosterone production. What’s more, the Pill can also interfere with growth hormone release—one of its main functions is to stimulate muscle growth. All of these factors combined means that the Pill could potentially have a negative impact on your muscle mass development.

The Pill, training and fitness

The Pill is no stranger to controversy. For example, there’s the long-standing speculation that hormones in birth control could lead to weight gain (which we’ve debunked with science). But one of the most common complaints you’ll hear from women who use oral contraception is that they notice a dip in strength, muscle mass, and general fitness levels after starting the pill.

While it can be difficult to separate out the effects of birth control from all the other factors that influence your training—like diet, stress and sleep—we wanted to find out if there’s any truth to this particular claim. We looked at the evidence to find out what kind of impact hormonal contraceptives can have on your fitness levels and how you might be able to minimise them.

If you’re serious about building muscle, some forms of hormonal birth control could be holding you back.

If you’re a female athlete, training with weights can be a crucial part of your fitness routine. Strength training is essential for building muscle mass and optimising your metabolism. Women need to maintain muscle mass as they age to avoid osteoporosis, frailty, and sarcopenia (loss of muscle mass). The ability to build muscle also declines as we age.

Interestingly a study released last year demonstrated the impact of hormonal contraception on lean muscle mass might be more profound than we have previously realised. It compared two groups of women both on and off hormonal contraception over a 10 week strength building program. The women that were taking hormonal contraception had significantly lower lean muscle mass gains, and higher levels of cortisol (the stress hormone), as well as lower levels of IGF-1.

The reason for the impairment of muscle growth appears to be related to the Pill impairing the anabolic and catabolic hormones that regulate muscle development, and possibly the effects of synthetic progestin on androgen receptors.

“Oral contraceptive use impaired lean mass gains in young women after RET and was associated with lower DHEA, DHEAS, and IGF-1 and higher cortisol”

Reichmann & Lee, 2021

The pill or other hormonal contraceptives may not be suitable for all women who want to build lean body mass or get serious about their fitness. The first step is to evaluate your goals and what you are hoping to achieve with exercise and proper nutrition while taking oral contraception or other types of hormonal birth control. Some forms of contraception could affect gains if you have specific fitness or health goals.

Natural birth control

If you’re concerned with how your birth control may be affecting your muscle mass, it’s important to understand the benefits of non-hormonal contraception. These are methods of avoiding pregnancy that don’t require a prescription or implantation, and they can help you understand and embrace your cycle with no side effects. To begin with, there are two primary types of natural birth control: barrier methods, which prevent sperm from entering the woman’s body (such as condoms), and fertility awareness-based methods, which involve tracking fertile biomarkers and ovulation, so that you know when not to have sex, or to use a barrier method.

These options may seem less convenient than popping a pill or having an IUD implanted in your uterus, but for those who want more control over their hormonal health without any added chemicals like estrogen and progestin from synthetic HBCs, these options may be empowering.

To learn more about the Symptothermal Method of Fertility awareness for contraception, check out our free resources or our comprehensive course Contraception: Naturally.


  • Riechman SE, Lee CW. Oral Contraceptive Use Impairs Muscle Gains in Young Women. J Strength Cond Res. 2021 May 14. doi: 10.1519/JSC.0000000000004059. Epub ahead of print. PMID: 33993156.