617 - Impact of Oral Contraceptive and Hormone Replacement Therapy Use Resulting in Increased Risk of Meniscal Degeneration of Female Athletes

Thursday, February 19, 2026

5:00 PM - 6:30 PM AST

Presenting Author(s)

BM

Brijon McKinley, n/a

Medical Student
Howard University College of Medicine
Washington, District of Columbia, United States
TC

Tabitha Carson, n/a

Student
Howard University College of Medicine
Washington, District of Columbia, United States
JH

Jared Hall, n/a

Medical Student
Howard University College of Medicine
Washington, District of Columbia, United States
MS

Malachi Scott, n/a

Medical Student
Howard University College of Medicine
Washington, District of Columbia, United States
JP

Jeffrey Palmer, II, BS

Medical Student
Howard University College of Medicine
Hyattsville, Maryland, United States

Co-Author(s)

MM

Miriam Michael, MD

Project Overseer
HUCM
Washington, District of Columbia, United States
DR

Damon Ross, n/a

Student
Howard University College of Medicine
Washington, District of Columbia, United States
RE

Rawan Elkomi, MD

Researcher
Howard University College of Medicine
Washington, District of Columbia, United States
DM

Diwane Mills, n/a

Student
Howard University College of Medicine
Washington, District of Columbia, United States
AE

Amari Eubanks, n/a

Student
Howard University College of Medicine
Washington, District of Columbia, United States
KA

Kiana Allen, n/a

Student
Howard University College of Medicine
Washington, District of Columbia, United States
DK

Dy'Quan Kearney, n/a

Student
Howard University College of Medicine
Washington, District of Columbia, United States
MB

Mekdem Bisrat, n/a

Student
Howard University College of Medicine
Washington, District of Columbia, United States

Submitter(s)

BM

Brijon McKinley, BS

Howard University College of Medicine
Hyattsville, Maryland, United States

Objectives: Meniscus degeneration is the gradual breakdown of cartilage in the knee that could lead to osteoarthritis. Female athletes in high-impact sports are at an increased risk, but the underlying reason for this is unknown. The deficiency of sex hormones (i.e, Estrogen) is known to influence connective tissue and joint health. Still, the impact of elevated hormones, such as those from oral contraceptives and hormone replacement therapy, is unknown. The study aims to evaluate elevated hormone levels in female athletes with the risk of meniscus injuries.

Design: A retrospective cohort study was conducted using the TriNetX Global Collaborative Network. Two cohorts were defined: female athletes aged 15-45 on oral contraceptive or hormone replacement therapy (n=61,888), and a control group of female athletes not on hormonal therapy (n=205,175). The primary outcome was the development of meniscus injuries, including meniscus tears or meniscus derangements. Patients with meniscus-related knee injuries and osteoarthritis before hormonal therapy were excluded. Statistical analyses included risk analysis, Kaplan-Meier survival analysis, and frequency analysis (i.e., the number of instances). Key metrics included risk ratio, hazard ratio, and survival probability over a 5-year follow-up period.

Results: Oral Contraceptive Pills (OCP) and Hormone Replacement Therapy (HRT) in female athletes after matching (n=58,265, 50%) were positively associated with meniscus degeneration compared to female athletes who were not on hormone therapy (n=58,265, 50%). OCP and HRT athletes had a risk ratio of 1.369. Kaplan-Meier Analysis showed similar time-related meniscus injuries with OCP and HRT use (97.59% vs. 97.63%). Users demonstrated a minor increase in the average number of instances post-outcome (3.54 vs. 3.42). This difference was not statistically significant (p = 0.666).

Conclusions: Hormonal therapy slightly increases the number of meniscus-related injuries for female athletes. These findings suggest that oral contraception and hormone therapy may impact joint health and should be considered for future risk assessments.