Oral Contraception use and Musculotendinous Injury in Young Female Patients: A Database Study

Abstract

ABSTRACT Purpose The purpose of this study is to characterize the effect of sex and the influence of oral contraception usage on musculotendinous injury (MTI). Current literature suggests a disparity in the incidence of MTIs between males and females. This may be attributed to inherent biological differences between the sexes, such as in the sex hormonal milieu. There is a lack of information associating sex hormone milieu and MTI. Methods We searched the PearlDiver database (a for-fee healthcare database) for males, females taking oral contraceptives (OC), and eumenorrheic females not taking any form of hormonal contraceptives (non-OC) aged 18-39. The three populations were matched by age and BMI. We queried the database for lower-extremity skeletal muscle/tendon injury diagnoses in these groups. Results Each group contained 42,267 patients with orthopedic injuries. There were a total of 1476 (3.49%) skeletal muscle and tendon injuries in the male group, 1078 (2.55%) in non-OC females, and 231 (0.55%) in OC females. Both the non-OC and OC groups had a significantly smaller proportion of MTIs than males (P < 0.0001), and therefore these groups were less likely (adjusted odds ratios 0.72 and 0.15, respectively) to experience MTIs when controlled for potential covariates. Conclusions In this study we show that females are less likely to develop MTIs to total injuries, when compared to males, with OC using females being least likely followed by non-OC females. These results are consistent with other epidemiological studies; however, overall results in the literature are variable. This study adds to the emerging body of literature on sex hormone-influenced musculoskeletal injury but, more specifically, MTIs, which have not been rigorously investigated.