Oral Contraceptives and Knee Ligament Damage | Prolotherapy.org

In a new study, doctors say that hormones such as estradiol have an effect on human connective tissue, making women more susceptible to knee injuries.

  • Women have a greater risk for non-contact injuries of anterior cruciate ligament (ACL) compared to men when participating in the same sports.

The study examined the difference in ACL laxity after an eccentric (resistance) exercise in the lower limbs in young healthy women between oral contraceptive pill (OCP) users and non-OCP users to see the effect of OCP on ACL laxity.

Forty young healthy women participated in the experiments (25 with normal menstrual cycle and 15 with taking Oral Contraceptives).

ACL laxity and a visual analog pain scale were measured before and after a bout of squat.

  • OCP users had more pain than non-OCP users after heavy exercise.
  • Health professionals working with young female adults should recognize that OCP users may be at higher risk for having knee injuries.1.

One important aspect of healing chronic pain with Prolotherapy is to ensure that a patient’s lifestyle habits and factors are pro-healing. While this may sound obvious, many patients are surprised to learn that certain lifestyle factors are harmful to joint health. One such factor is the birth control pill. Women who take the birth control pill are at a disadvantage when it comes to healing an injury because estradiol inhibits healing. Estrogen, the female hormone, dramatically inhibits fibroblasts. These fibroblasts are what make the collagen that makes up the ligaments and tendons, which are injured during sports or other chronic pain injuries. The more estrogen a woman has, the more inhibition will occur. This has direct effects for all women taking birth control pills. Birth control pills have pharmacological levels of estrogen, which are far in excess of a woman’s normal production. The simplest way for a female who is on artificial estrogen to overcome injuries is to stop taking them.

In a recent article, researchers showed how oral contraceptives weaken the anterior cruciate ligament (ACL) and its attachments.2

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1. Lee H, Petrofsky JS, Yim J. Do Oral Contraceptives Alter Knee Ligament Damage with Heavy Exercise? Tohoku J Exp Med. 2015;237(1):51-6. doi: 10.1620/tjem.237.51.

2. Woodhouse E, Schmale GA, Simonian P, Tencer A, Huber P, Seidel K. Reproductive hormone effects on strength of the rat anterior cruciate ligament. Knee Surg Sports Traumatol Arthrosc. 2007 Apr;15(4):453-60. Epub 2006 Dec 23.