Understanding the physiological factors that influence performance is paramount in elite sports where fractions of a second can determine careers. For female athletes, hormonal oral contraceptive pills (OCPs) represent a common medical intervention, yet their impact on athletic performance, including strength, endurance, and recovery, remains inadequately understood (Hruby, 2022). This lack of evidence leaves athletes, coaches, and medical professionals with insufficient information to make informed decisions about OCP use. Drawing on existing research and a case study of one elite high school female swimmer, this project explores whether OCPs contribute to performance stagnation or decline, including changes in physical sensation, mood, motivation, and reported declines in competitive results. This research analyzes swim times and anecdotal observations of an elite high school swimmer during a six-month period while on OCPs. By shining a light on this underexplored issue, the study aims to spark meaningful conversations and further scientific inquiry into the nuanced interplay between hormonal contraception and athletic performance. The findings aim to highlight the urgent need for more rigorous, gender-inclusive research to equip female athletes with the knowledge necessary to make informed decisions about their health and athletic careers.