Hormonal Birth Control Might Reduce Female Athletes’ ACL Tears

Female athletes are two to eight times more likely to tear their anterior cruciate ligament (ACL) than their male counterparts performing the same sport at the same level. They are also at greater risk for other ligament and tendon injuries, such as ankle sprains.

March 4, 2025
6 min

Cedars-Sinai Pulse

At a Glance

Category	Detail
Condition	Anterior Cruciate Ligament (ACL) Tears in Female Athletes
Key Mechanisms	Hormonal influences, particularly relaxin, affect ligament stability and injury risk.
Target Population	Female athletes, particularly those in high-level collegiate sports.
Care Setting	Sports medicine and orthopedic clinics.

Key Highlights

Female athletes are 2-8 times more likely to tear their ACL compared to males.
Hormonal birth control may reduce relaxin levels, potentially lowering injury risk.
Study showed hormonal birth control users had better knee and hip alignment during landings.
Injuries such as ankle sprains and meniscal tears were fewer in athletes using hormonal birth control.
Further research is needed to fully understand hormonal impacts on female athletes.

Guideline-Based Recommendations

Diagnosis

Assess ACL injury risk factors in female athletes, including hormonal influences.

Management

Consider hormonal birth control as a potential strategy to reduce ACL injury risk.

Monitoring & Follow-up

Monitor hormone levels and injury occurrences in female athletes using hormonal birth control.

Risks

Evaluate the individual risks and benefits of hormonal birth control for each athlete.

Patient & Prescribing Data

High-level collegiate female athletes.

Hormonal birth control may provide additional protective benefits against ACL injuries.

Clinical Best Practices

Encourage strength training programs focusing on stabilizing muscles like hamstrings and gluteals.
Educate female athletes on the potential benefits and risks of hormonal birth control.