Oral Contraceptive Use Has Protective Effect Against Ankle Sprains in Women

Area of Science:

• Orthopedics
• Sports Medicine
• Women's Health

Background:

• Ankle sprains (AS) are common musculoskeletal injuries, disproportionately affecting women.
• Hormonal fluctuations may influence ligament laxity and muscle stiffness, contributing to sex disparities in AS.
• Oral contraceptive pills (OCPs) alter hormone levels, but their impact on AS risk is not well-established.

Purpose of the Study:

• To investigate the association between oral contraceptive pill (OCP) use and the risk of ankle sprains (AS) in a large cohort of women.
• To determine if OCP formulation influences the protective effect against AS.

Main Methods:

• A case-control study utilizing the 2010-2023 PearlDiver database.
• Inclusion of female patients aged 15-50 years, with 1:1 matching of ankle sprain cases to controls.
• Stratification by OCP use (prescription within 1 year prior to AS) and formulation, followed by multivariate analysis.

Main Results:

• Over 1.8 million AS cases and 108,000 controls were analyzed.
• OCP use was significantly associated with decreased odds of ankle sprains (OR, 0.47; P < 0.001).
• Nonestrogen OCPs demonstrated a greater protective effect (OR, 0.20; P < 0.001) compared to estrogen-progesterone formulations (OR, 0.47; P < 0.001).

Conclusions:

• OCP users exhibit significantly lower odds of experiencing ankle sprains compared to non-users.
• These findings suggest OCPs may play a role in injury prevention strategies for female athletes.
• Further research into OCP formulation and its specific effects on ligamentous injury risk is warranted.