Cohort study reveals lower risks of ACL, meniscus, and bone stress injuries in female athletes using hormonal contraceptives, indicating potential protective effects on joint stability.
Key Points
To assess whether systemic hormonal contraceptive use is associated with a reduced risk of common lower extremity injuries among female athletes.
Retrospective cohort study using the TriNetX United States Collaborative Network identifying female athletes aged 18 to 65 years with sports-related encounters over a 20-year period.
A 1:1 propensity score matching protocol balanced 8,358 systemic hormonal contraceptive users with 8,358 nonusers on demographic factors and medical comorbidities.
Primary outcomes included 5-year incidence of ACL sprains, meniscal tears, lower extremity stress fractures, and other soft tissue injuries analyzed via risk ratios and 95% confidence intervals.
Hormonal contraceptive users had a significantly lower 5-year rate of ACL sprains compared to nonusers (1.7% vs 2.2%; RR 0.78, 95% CI 0.62–0.97; P = 0.03).
Meniscal tears occurred significantly less often in contraceptive users compared to nonusers over 5 years (2.0% vs 2.5%; RR 0.78, 95% CI 0.64–0.97; P = 0.02).
Contraceptive users demonstrated a significantly reduced risk of lower extremity stress fractures (0.2% vs 0.4%; RR 0.52, 95% CI 0.29–0.93; P = 0.02).