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Sex Hormones and Tendon.

Mette Hansen1, Michael Kjaer2,3

  • 1Department for Public Health, Section for Sport Science, Aarhus University, Dalgas Avenue 4, 8000, Aarhus, Denmark. mhan@ph.au.dk.

Advances in Experimental Medicine and Biology
|August 19, 2016
PubMed
Summary

Sex hormones influence tendon and ligament injury risks differently in men and women. Estrogen may aid recovery in women, but high levels increase injury risk, while testosterone impacts tendon properties in men.

Keywords:
ACL ruptureBiomechanical propertiesCollagenCross-linksEstradiolEstrogenFasciclesGenderInjury riskInsulin-like growth factor I (IGF-I)Joint laxityKnee laxityProgesteroneRelaxinSexSex hormonesTendinopathyTestosterone

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Area of Science:

  • Sports Medicine
  • Endocrinology
  • Orthopedics

Background:

  • Tendon and ligament injuries present different risks for men and women.
  • Sex hormones, particularly during adolescence and young adulthood, likely contribute to these gender-specific injury patterns.
  • The precise roles of estrogen and androgens in tendon health and injury remain incompletely understood.

Purpose of the Study:

  • To explore the sex-based differences in tendon and ligament injury risk.
  • To examine the influence of sex hormones, specifically estrogen and androgens, on tendon morphology and collagen turnover.
  • To elucidate the distinct effects of these hormones on tissue response to loading and injury.

Main Methods:

  • Review of existing literature on sex differences in musculoskeletal injuries.
  • Analysis of hormonal effects on tendon collagen synthesis, crosslinking, and turnover.
  • Examination of hormonal impacts on joint laxity and tissue response to mechanical stress.

Main Results:

  • Estrogen may promote tendon collagen synthesis, aiding recovery, but high physiological levels in female athletes can increase injury risk via reduced crosslinking and increased joint laxity.
  • Testosterone in men may enhance tendon stiffness through increased collagen turnover and content.
  • Testosterone has also been associated with decreased responsiveness to relaxin in men.

Conclusions:

  • Significant sex differences exist in tendon and ligament injury risk, mediated by hormonal variations.
  • Estrogen and androgens play complex, often opposing, roles in tendon health, influencing injury susceptibility in a sex-specific manner.
  • Further research is needed to fully understand these hormonal mechanisms for targeted injury prevention strategies.