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Birth control may help elite young athletes for an unexpected reason, study says

A one-month dosage of hormonal birth control pills is displayed in Sacramento, Calif.
A one-month dosage of hormonal birth control pills is displayed in Sacramento, Calif. AP

Birth control might be able to ward off more than just pregnancy, a new study finds.

Researchers at Brown University in Rhode Island have found that oral contraceptives are also linked to a lower risk of serious knee injuries — particularly in teenagers, according to a news release from the British Taylor & Francis Group, which published the findings this week in the journal “The Physician and Sportsmedicine.”

“Young athletes use oral contraceptives for a variety of reasons,” lead researcher Dr. Steven DeFroda said in a statement, citing menstrual cycle regulation and stopping pregnancy. “With careful assessment of the risks, injury risk reduction could be another way in which female athletes may benefit from their use.”

The authors’ observational study analyzed more than 165,000 women and girls who ranged in age from 15 to 49 and were found in a United States database showing insurance and prescription information over the course of ten years, researchers said. Their analysis revealed that teenagers on birth control were 63 percent less likely to need reconstructive surgery following an anterior cruciate ligament (ACL) tear than those not taking oral contraceptives, according to the study.

Overall, women taking the most common birth control pills by mouth were 18 percent less likely to need reconstructive surgery compared to similar women not taking the pill, the study said.

That’s an important finding, considering the fact that half of athletes who tear an ACL (which is “extremely common”) can’t return to competitive sports, and anywhere from 20 to 50 percent of those with tears have arthritis within two decades of the injury, researchers said.

And women are more prone than men: Researchers said the injury is two to eight times more prevalent in girl competitors than in boys, possibly because of elevated estrogen levels.

“It’s likely that oral contraceptives help maintain lower and more consistent levels of estrogen and progesterone,” DeFroda said.

Researchers concluded that doctors should consider prescribing birth control to “elite high school and college-aged athletes, especially those at higher risk of ACL tears such as soccer and basketball players.” That determination should only be made “after careful assessment of the risks of these commonly prescribed medications,” the researchers said.

But other experts said it’s early to recommend the pill for young women athletes.

University of Nottingham obstetrics and gynecology professor Jim Thornton said there might be other explanations for the higher rates of ACL tear surgery in women not on the pill, such as the fact that women who exercise extensively may stop menstruating and not take the pill on those grounds, while also being at higher risk of injury because of their frequent physical activity, the Guardian reports.

Past research has also tied birth control to a lower risk of ACL tears, but those studies “suffer from critical shortcomings, and don’t prove that it’s the pills that are providing the protection,” according to the Sports Institute at the University of Washington School of Medicine.

Researchers emphasized that because the new study was observational, “no firm conclusions can be drawn about cause and effect.” The study was also limited by the fact that it only looked at those who required surgery, and didn’t analyze the activity levels of those studied, which “might explain why some women tore their ACLs and others did not,” researchers said.

Those are similar to the shortcomings cited by the Sports Institute in assessing earlier studies.

The Brown researchers’ findings could be confirmed by a controlled study following athletes on and off birth control over time, according to the news release.

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