Among the major categories of contraceptive methods including “time selection”, “mechanical and chemical contraception in males and females,” hormonal contraception has found its solid grounds and is still the most frequently applied technology in 2024. Hormonal contraception is based on three principles: Combined oral contraceptive pills (COCs) are commonly used in adolescent females, including athletes. COCs provide a moderate dose of estrogen and progesterone which prevents ovulation and, therefore, pregnancy. Other effects include reduced androgen production by the ovaries, which can be considered as positive in a girl with polycystic ovary syndrome (PCOS), but some athletes may notice a performance decrement with lower androgen levels. Therefore, it remains debatable if oral contraceptive pills (OCPs) are very popular in female athletes not only for contraceptive effects but also due to the possibility of cycle manipulation. However, any manipulation of the menstrual cycle may also have a beneficial effect on exercise performance. The discussed three principles form the intersection and platform for all possibilities of hormonal contraception in the female.