The clinical relevance of this finding is that female athletes may be more predisposed to anterior cruciate ligament injuries during the preovulatory phase of the menstrual cycle .
These findings may lead to potential interventions targeted toward this phase of the menstrual cycle to reduce the incidence of anterior cruciate ligament injury
Several theories have been proposed to explain the 3- to 6-fold gender difference in the incidence of anterior cruciate ligament injuries .
One potential theory for the increased incidence is based on gender-related hormonal differences between men and women , especially after puberty and the onset of menses in the female athlete .
The purpose of this systematic review was to compile and systematic ally analyze the published literature to determine if the menstrual cycle is associated with anterior cruciate ligament injury risk and to provide an objective comparison of the published results .
The Menstrual Cycle, Sex Hormones, and Anterior Cruciate Ligament Injury.
OBJECTIVE : To determine if anterior cruciate ligament ( ACL ) injuries in female athletes occur r and omly or correlate with a specific phase of the menstrual cycle . DESIGN AND SETTING : Female athletes who sustained ACL injuries reported the days of their menstrual cycles and provided saliva sample s for sex-hormone determination . Salivary sex-hormone profiles were assessed to confirm the self-reported menstrual histories . SUBJECTS : A total of 38 female athletes ( 20 college , 15 high school , 1 middle school , 2 recreational ) with recent ACL injuries participated in the study over a 3-year period . MEASUREMENTS : Athletes with recent ACL injuries completed a question naire defining the injury , the last menstrual cycle , prior knee injury , school , and type of birth control used ( if any ) . Each subject provided a 30-cc saliva sample within 72 hours of injury . Saliva sample s were placed into sealed containers and frozen at -20 degrees C. We obtained 13 additional control sample s from uninjured females to test the correlation between saliva and serum sex-hormone levels . Progesterone and estrogen were assayed by radioimmunoassay . Physical examination , magnetic resonance imaging , or surgery confirmed the injury in all subjects . RESULTS : The correlations between saliva and serum estrogen and progesterone were 0.73 ( alpha = .01 ) and 0.72 ( alpha = .01 ) , respectively . Ten of 27 athletes who reported their cycle day at time of injury sustained an ACL injury immediately before or 1 to 2 days after the onset of menses . We rejected the null hypothesis that such high frequency was due to r and om chance . CONCLUSIONS : A significantly greater number of ACL injuries occurred on days 1 and 2 of the menstrual cycle . Salivary sex-hormone levels correlated with the reported cycle day
The clinical relevance of this finding is that female athletes may be more predisposed to anterior cruciate ligament injuries during the preovulatory phase of the menstrual cycle .
These findings may lead to potential interventions targeted toward this phase of the menstrual cycle to reduce the incidence of anterior cruciate ligament injury
Several theories have been proposed to explain the 3- to 6-fold gender difference in the incidence of anterior cruciate ligament injuries .
One potential theory for the increased incidence is based on gender-related hormonal differences between men and women , especially after puberty and the onset of menses in the female athlete .
The purpose of this systematic review was to compile and systematic ally analyze the published literature to determine if the menstrual cycle is associated with anterior cruciate ligament injury risk and to provide an objective comparison of the published results .