Oral hormonal contraception (OHC) is a widely used method among women for supporting or regulating menstrual cycles, providing protection against pregnancy, and managing hormonal imbalances. During the menstrual cycle, there is considerable variability in resting metabolic rate (RMR). The intake of OHC, through the introduction of exogenous synthetic sex hormones that disrupt the natural ovarian hormonal profile, could potentially affect RMR. We conducted a narrative literature review to examine the effects of endogenous and exogenous sex hormones on RMR, as well as potential differences in the impact of progestin-only versus combined OHC. The findings from the limited number of studies investigating the effect of OHC on RMR are inconsistent. The interplay of numerous physiological mechanisms, including thermoregulation, appetite regulation, hormonal balance, and changes in body composition, suggests that OHC may influence women's metabolic activity. However, the currently available evidence does not allow for conclusive statements. The potential impact of OHC on RMR remains unclear, highlighting the need for further research to deepen our understanding of female physiology. Given the widespread use of OHC among female athletes and its possible influence on metabolism, it is essential to examine its effects more thoroughly and to strengthen the inclusion of women in metabolic research.
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