ArticlePM & R : the journal of injury, function, and rehabilitation2021
Menstrual Irregularity, Hormonal Contraceptive Use, and Bone Stress Injuries in Collegiate Female Athletes in the United States.
Article in PM & R : the journal of injury, function, and rehabilitation, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
25 citing papers in PubMed, 39 citations in OpenAlex.
- The Association Between Hormonal Contraceptives and Lower Extremity Injuries in Female Athletes With Sports-Related Clinical Encounters.Sports health · 2026Article
- Approach to sport-savvy contraceptive counselling for athletes.Canadian family physician Medecin de famille canadien · 2026Review
- Fueling Women's Football: Evidence-Informed Practical Nutrition Strategies for Performance and Health.Sports medicine (Auckland, N.Z.) · 2026Review
- Bone stress injuries in elite runners: intrinsic and extrinsic risk factors in Italian track and field athletes.BMC sports science, medicine & rehabilitation · 2026Article
- The role of oral contraceptive use in associations of concussion history with kynurenine pathway metabolites, inflammation, and psychological symptoms in female athletes.Brain, behavior, & immunity - health · 2026Article
- Gender Differences in the Incidence and Types of Sports Injuries Among Female Athletes: A Scoping Review.Journal of nursing management · 2025Article
- The Menstrual Health Manager (MHM): A Resource to Reduce Discrepancies Between Science and Practice in Sport and Exercise.Sports medicine (Auckland, N.Z.) · 2024Article
- The Association Between Menstrual Cycle Phase, Menstrual Irregularities, Contraceptive Use and Musculoskeletal Injury Among Female Athletes: A Scoping Review.Sports medicine (Auckland, N.Z.) · 2024Article
- The hormonal profile in women using combined monophasic oral contraceptive pills varies across the pill cycle: a temporal analysis of serum endogenous and exogenous hormones using liquid chromatography with tandem mass spectroscopy.American journal of physiology. Endocrinology and metabolism · 2024Article
- Effects of Education, Nutrition, and Psychology on Preventing the Female Athlete Triad.Cureus · 2024Review
- Editorial: Women in sports 2022.Frontiers in physiology · 2024Article
- The Influence of Energy Balance and Availability on Resting Metabolic Rate: Implications for Assessment and Future Research Directions.Sports medicine (Auckland, N.Z.) · 2023Review
- Association Between Serum Neurofilament Light and Glial Fibrillary Acidic Protein Levels and Head Impact Burden in Women's Collegiate Water Polo.Journal of neurotrauma · 2023Observational
- Training-induced impairment of endothelial function in track and field female athletes.Scientific reports · 2023Article
- Contraception, female cycle disorders and injuries in Swiss female elite athletes-a cross sectional study.Frontiers in physiology · 2023Article
- Bone health in Norwegian female elite runners: a cross-sectional, controlled study.BMJ open sport & exercise medicine · 2023Article
- Sex-Specific Changes in Physical Risk Factors for Anterior Cruciate Ligament Injury by Chronological Age and Stages of Growth and Maturation From 8 to 18 Years of Age.Journal of athletic training · 2022Article
- Passing on the exercise baton: What can endocrine patients learn from elite athletes?Clinical endocrinology · 2022Review
- Vascular Function in Norwegian Female Elite Runners: A Cross-Sectional, Controlled Study.Sports (Basel, Switzerland) · 2022Article
- Prevalence of Female Athlete Triad Risk Factors among Female International Volunteers and College Age-Matched Controls.International journal of environmental research and public health · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundMenstrual irregularity (MI) is common in female athletes and is a component of the Female Athlete Triad (Triad). Many athletes with the Triad are started on hormonal contraceptives (HC) for MI, but this interferes with the ability to monitor menstrual cycle regularity and can mask other causes of MI. There are limited studies investigating the relationship between MI, HC use, and injury in female collegiate athletes.
objectiveTo examine the prevalence of and relationship between HC use, MI, and bone stress injuries in female collegiate athletes in the United States.
designCross-sectional study.
settingOnline survey.
participants1020 U.S. female collegiate athletes (age ≥ 18 years). METHODS OR
interventionsAssessment of risk factors for menstrual irregularity and bone stress injuries was conducted via a one-time survey.
main outcome measuresHC use, MI, history of stress fractures.
resultsCurrent HC use prevalence was 65% (95% confidence interval [CI], 61.9%, 67.8%). Of all athletes, 47% reported past MI. Of the athletes who were not currently using HCs, 32% had current MI. Compared with athletes without past MI, more athletes with past MI reported current HC use (73% vs. 57%) and indicated menstrual cycle consistency as the primary reason for use (24% vs. 4%) (P < .001). Additionally, 25% of athletes reported a history of stress fractures, which was associated with lean/aesthetic sports participation (odds ratio [95% CI]: 1.9 [1.4, 2.5]; P < .001) and less oral contraceptive pill (OCP) use (0.7 [0.5, 1.0]; P = .043). Compared with OCPs, injectable HCs were associated with greater odds of a history of stress fractures (4.5[1.6, 12.3]; P = .004).
conclusionsHC use was prevalent among this cohort of female collegiate athletes, and almost half of the athletes reported past MI. A goal of menstrual cycle regularity was cited by 24% of athletes as a primary reason to use HCs, which shows that more athlete education is needed to avoid masking MI and the Triad with HCs. Further studies elucidating the relationship between HC use, MI, and sports-related injury are warranted.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.