Do Oral Contraceptives Alter Knee Ligament Damage with Heavy Exercise?

Hormones such as estradiol have an effect on human connective tissue, making women more susceptible to knee injuries. Indeed, women have a greater risk for non-contact injuries of anterior cruciate ligament (ACL) compared to men when participating in the same sports. The purpose of the present study was to examine the difference in ACL laxity after an eccentric 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 OCP). 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 (p < 0.001). Both groups showed a significant reduction in ACL laxity on the 2nd day after exercise (p < 0.05). While ACL laxity was always less in the OCP group, when expressed as a percent change from baseline, the ACL laxity change was similar in both groups (p > 0.05). We found that there was no statistically significant difference in ACL laxity recovery over time in response to the delayed onset muscle soreness after a bout of squat between two groups. However, health professionals working with young female adults should recognize that OCP users with less ACL laxity are at higher risk for having knee injuries because of ACL stiffness when doing exercise.