Estrogen and Cortisol Fluctuations Throughout the Menstrual Cycle in Athletes in Association with ACL Injuries

Herrold, Emily

Estrogen and Cortisol Fluctuations Throughout the Menstrual Cycle in Athletes in Association with ACL Injuries

Author(s)

Herrold, Emily

Date Issued

April 1, 2024

Abstract

Athletes who menstruate are two to eight times more likely to experience an ACL injury as a result of biomechanical, anatomical, and neuromuscular differences between the sexes. Hormonal fluctuations throughout the menstrual cycle also have a prominent role in this uptick of injuries, specifically those of the sex hormone estrogen. Estrogen receptors have previously been found in ACL tissue and are associated with ACL injuries; however, estrogen’s relationship and effect on other hormones, like the stress hormone cortisol, is not well understood. A self-report survey was distributed to collegiate student-athletes across NCAA divisions to gather more information on menstruating athletes’ ACL injuries and menstrual cycle history. Additionally, a sputum study was conducted at Allegheny College, a Division III liberal arts college, amongst student-athletes to observe the hormonal fluctuations of estradiol and cortisol. Statistical analyses of the survey determined that there was a significant association between the day of the menstrual cycle and when menstruating athletes experienced their ACL injury, and that birth control has protective effects against ACL injuries. The sputum study analyses found that menstruating athletes on birth control may experience a blunted cortisol response. While this study could not determine the relationship between estradiol and cortisol due to multiple limitations, its results indicate that hormonal fluctuations throughout the menstrual cycle in association with ACL injuries have further points of study that need to be investigated and lay the ground for future research.

Major

Biology

Honors

Biology, 2024

First Reader(s)

Dawson, Rebecca S.