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

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.

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