Does a Relationship Exist Between the Prevalence of Anterior Cruciate Ligament Injuries in Females and the Use of Estrogen and Progesterone Containing Contraception? Rebecca Runge, PA-S and Patricia Bunton, MS, PA-C Department of Physician Assistant College of Health Professions, Wichita State University Introduction More females have been participating in competitive athletics in the past twenty years than previously and sustaining more injuries. Anterior cruciate ligament (ACL) injuries have a higher incidence in females than in males. One study cites that women have a four to eight times higher chance of sustaining a grade three sprain of the ACL than men. One factor that researchers have been exploring involves the female hormones estrogen and progesterone. Hormonal influence has yet to be unanimously accepted among the medical community as a precipitating factor. The purpose of this study is to determine if a relationship exists between the use of hormonal contraceptives and the prevalence of ACL injuries in females. Results from this study may influence women athletes’ decision whether or not to use hormonal contraceptives while participating in competitive sports. Methodology Womens’ basketball and volleyball coaches from 11 universities and colleges in Kansas were contacted by to determine their willingness to distribute surveys to female athletes at their location. Two hundred & fifty surveys and cover letters, which described the purpose of the study, were sent to the coaches in September 2005 for distribution by the coaches. A self-addressed stamped envelope was included to encourage participation in the study. Because of a poor initial response, a second was sent out in late September. Results 26 athletes responded for a 10.4% response rate. 8 respondents (30.8%) had no history of ACL injury and had been using prescription contraceptives for greater than 12 months. Oral contraceptives were the type most commonly used. 16 respondents (61.5%) had no history of ACL injury and no contraceptive use within the last 12 months. 1 respondent (3.8%) had sustained an ACL injury but was not using contraceptives at the time of the injury. 1 respondent (3.8%) had sustained an ACL injury and was using a hormonal contraceptive. Conclusion Although no conclusion can be made from this pilot study, the ongoing debate over this issue indicates the need for further research to determine the role, if any, that endogenous hormones play in either increasing or decreasing the risk of ACL injury. As female athletics increases in popularity, so does the need for research in prevention of injury while encouraging high levels of competition. Discussion No conclusions can be drawn from this study due to the small number of respondents. Methods for increasing the response rate need to be considered if replication of this research were to be done, such as mailing the surveys directly to the athletes, or use of telephone or online surveys. Better methodology may increase the ability to determine if there is an association between whether or not a female athlete uses hormonal contraceptives and the risk of sustaining an ACL injury. Table 1: Survey Results No ACL injury ACL injury Hormonal contraceptive use 161 No Hormonal contraceptive use 81