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Estrogen and ACL
If estrogen directly inhibits
collagen growth,
then the more
estrogens in a
female's system the more athletic injuries she should incur at certain times of
the month. During the menstrual cycle, the absolute levels of estrogen and
progesterone, and the ratio of these hormone concentrations, change over the
mean cycle duration of 28 days. In the follicular phase (days 1 to 9),
concentrations of both estrogen and progesterone are low. Ovulation (day 10 to
14) is preceded by a midcycle surge of estrogen. During this time, estrogen
concentrations are at their highest. During the luteal phase (day 15 to end of
cycle), progesterone levels rise significantly because of secretion by the
corpus luteum, and
relaxin levels increase halfway through this phase
Because women suffer four to eight times the number of ACL injuries for the same
sports as men, Dr. Edward Wojtys and colleagues, at the University of Michigan
in Ann Arbor, decided to look at when in the menstrual cycle these injuries
occurred.(Wojtys, E. Association between the menstrual cycle and
anterior cruciate ligament injuries in female athletes. American Journal of Sports
Medicine. 1998; 26:614-619.) This study was designed to investigate the
variation in ACL injury rates during the female monthly cycle. These injuries
were noncontact ACL injuries, meaning they could not be injuries due to a female
athlete being hit by another player. Twenty-eight women with ACL injuries were
studied. Each woman was asked to provide a detailed history of her menstrual
cycle, including frequency and regularity, date of last menstrual period,
average length of cycle, premenstrual symptoms, and
oral contraceptive or
hormone replacement use. The study showed a significant association between the
stage of the menstrual cycle and likelihood for an ACL injury In particular,
there were more injuries during the ovulatory phase of women than expected.
Female athletes were much more likely to injury their ACL during the ovulatory
phase when estrogen levels are highest. Of interest is that 20 of the 28
believed that their individual athletic performance was hindered during this
premenstrual time. This is another reason for women to seek out a
Prolotherapist
who also uses natural medicine treatments and can relieve PMS using vitamins,
herbs, and other nutritional remedies.
During a normal menstrual cycle, the estrogen concentration rises during day 10
and peaks on day 12. This is the peak time during which female athletes suffer
ACL injuries. It was clear in this study that estrogen negatively affected the
strength of ligament tissue, as injury rates were increased during this time.
Other studies, in rabbits that have been ovariectomized (no estrogen), have
documented that the estrogen given to them negatively affected the ligament
strength. (Booth, F.W., Tipton, C.M.. Ligamentous strength measurements in
pre-pubescent and pubescent rats. Growth. 1970; 34:177-185.; Slauterbeck, J.
Effects of estrogen level on the tensile properties of the rabbit anterior
cruciate ligament. Orthop. Trans. 1997; 21:747-748.)
The more estrogen given to these rabbits, the weaker their ligaments became. |
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