New research suggests that women athletes who use birth control pills are less likely to suffer serious knee injuries.

Published in Medicine & Science in Sports & Exercise, a study revealed that female athletes are 1.5 to 2 times more likely than male athletes to injure their ACL. Proposing that estrogen makes women more vulnerable to ACL injury by weakening this ligament, the investigators designed a case-control study to determine if women undergoing ACL surgical reconstruction were less likely to use birth control pills than matched noninjured population.

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The researchers examined national insurance claims data between 2002 and 2012. In their analysis, they included women between the ages of 15 and 39 who had received surgical reconstruction of the ACL. The investigators defined exposure to oral contraception “as the presence of any prescription fill for oral contraceptives during the previous 12 months to index date.”

“Birth control pills help maintain lower and more consistent levels of estrogen, which may prevent periodic ACL weakness,” lead author Aaron Gray, an MD and a PhD student, said in a statement. “With this in mind, we examined whether oral contraceptive use protected against ACL injuries that require surgery in women.”

Reviewing young women between 15 and 19 years of age, the investigators learned that women with an ACL knee injury who were taking birth control pill were less likely to need corrective surgery than women of the same age with ACL injuries who did not use the not use oral contraception. The researchers found that women undergoing surgical repair of the ACL in this age range were 18% less likely to use oral contraceptives than matched controls.

“Young athletes currently use birth control pills for various reasons including more predictable cycles and lighter periods,” Gray said. “Injury risk reduction could potentially be added to that list with further, prospective investigations.”


Gray AM, Gugala Z, Baillargeon JG. Effects of Oral Contraceptive Use on Anterior Cruciate Ligament Injury Epidemiology. Med. Sci. Sports Exerc. 2015;  doi: 10.1249/MSS.0000000000000806