Could OCs help protect against ACL tears?


Oral contraceptives (OCs) may have an additional benefit for young athletes.

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Oral contraceptives (OCs) may have an additional benefit for young athletes: protection from tears in the anterior cruciate ligament (ACL). A study published in The Physician and Sportsmedicine shows that the rate of ACL tears was 63% lower in women aged 15 to 19 taking the pills than in those not on the contraceptives.

 According to the authors, their findings confirm results from previous studies. The report, by researchers from Brown University, was based on a review of data from The PearlDiver database on OC users aged 15 to 49. Women undergoing surgery for an ACL tear were compared to a control group having the same procedure who were not on OCs. Chi-squared testing was used to assess for significant differences in the rate of ACL reconstruction for the two groups, with age groups broken down into 5-year intervals.

A total of 82,874 patients were studied. Looking at the 15-to-19 age group, the authors found that 29.35% of ACL surgeries were in women not on OCs versus 13.33% in women on OCs. The odds ratio (OR) for ACL reconstruction while on OCs across all age groups was 0.82 (χ 2 = 0.001, 95% CI 0.72–0.92) compared to not using OCs. In the 15-to-19 age group, the OR was 0.37. The number needed to treat for OC usage in women in that group was six patients.

In previous studies, the likelihood of experiencing an ACL tear was found to be greatest during ovulation, the phase inhibited by OCs. The authors concluded that prescribing OCs to inhibit the elevated levels of estrogen and progesterone during the ovulatory phase can prevent both increased laxity of the ligament and ACL tears. 

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