scholarly journals Effect of menstrual cycle phase, menstrual irregularities and hormonal contraceptive use on anterior knee laxity and non-contact anterior cruciate ligament injury occurrence in women: a protocol for a systematic review and meta-analysis

2021 ◽  
Vol 7 (4) ◽  
pp. e001170
Author(s):  
Elisa Nédélec ◽  
Elvis Foli ◽  
Sandra J Shultz ◽  
Paul A Swinton ◽  
Eimear Dolan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Menstrual Cycle ◽  
Cruciate Ligament ◽  
Meta Analysis ◽  
Ligament Injury ◽  
Secondary Outcome ◽  
Hormonal Contraceptives ◽  
Cycle Phase ◽  
Acl Injuries ◽  
Anterior Knee

Exercising women report three to six times more ACL tears than men, which happen, in the majority of cases, with a non-contact mechanism. This sex disparity has, in part, been attributed to the differences in reproductive hormone profiles between men and women. Many studies have shown that anterior knee (AK) laxity and the rate of non-contact ACL injuries vary across the menstrual cycle, but these data are inconsistent. Similarly, several studies have investigated the potential protective effect of hormonal contraceptives on non-contact ACL injuries, but their conclusions are also variable. The purpose of this systematic review and meta-analysis is to, identify, evaluate and summarise the effects of endogenous and exogenous ovarian hormones on AK laxity (primary outcome) and the occurrence of non-contact ACL injuries (secondary outcome) in women. We will perform a systematic search for all observational studies conducted on this topic. Studies will be retrieved by searching electronic databases, clinical trial registers, author’s personal files and cross-referencing selected studies. Risk of bias will be assessed using the Newcastle Ottawa Quality Assessment Scale for Cohort and Case–Control Studies. Certainty in the cumulative evidence will be assessed using the Grading of Recommendations Assessment, Development and Evaluation approach. The meta-analyses will use a Bayesian approach to address specific research questions in a more intuitive and probabilistic manner. This review is registered on the international database of prospectively registered systematic reviews (PROSPERO; CRD42021252365).

The Relationship between Menstrual Cycle Phase and Anterior Cruciate Ligament Injury

2006 ◽  
Vol 34 (5) ◽  
pp. 757-764 ◽  
Author(s):  
Bruce D. Beynnon ◽  
Robert J. Johnson ◽  
Stuart Braun ◽  
Mike Sargent ◽  
Ira M. Bernstein ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Menstrual Cycle ◽  
Anterior Cruciate Ligament Injury ◽  
Cruciate Ligament ◽  
Ligament Injury ◽  
Cycle Phase ◽  
Menstrual Cycle Phase ◽  
Anterior Cruciate ◽  
The Relationship

scholarly journals Exacerbation of Psychosis During the Perimenstrual Phase of the Menstrual Cycle: Systematic Review and Meta-analysis

2019 ◽  
Vol 46 (1) ◽  
pp. 78-90 ◽  
Author(s):  
Thomas J Reilly ◽  
Vanessa C Sagnay de la Bastida ◽  
Dan W Joyce ◽  
Alexis E Cullen ◽  
Philip McGuire
Keyword(s):  
Systematic Review ◽  
Menstrual Cycle ◽  
Random Effects ◽  
Psychotic Disorders ◽  
Meta Analysis ◽  
Psychotic Symptoms ◽  
Cycle Phase ◽  
Menstrual Cycle Phase ◽  
Psychiatric Admission ◽  
Admission Rates

Abstract Psychotic disorders can be exacerbated by the hormonal changes associated with childbirth, but the extent to which exacerbations occur with the menstrual cycle is unclear. We addressed this issue by conducting a systematic review. Embase, Medline, and PsychINFO databases were searched for studies that measured exacerbations of psychotic disorders in relation to the menstrual cycle. We extracted exacerbation measure, definition of menstrual cycle phase, and measurement of menstrual cycle phase. Standard incidence ratios were calculated for the perimenstrual phase based on the observed admissions during this phase divided by the expected number of admissions if the menstrual cycle had no effect. Random effects models were used to examine pooled rates of psychiatric admission in the perimenstrual phase. Nineteen studies, comprising 1193 participants were eligible for inclusion. Eleven studies examined psychiatric admission rates, 5 examined symptoms scores, 2 examined self-reported exacerbation, and 1 examined both admission rates and symptom scores. A random effects model demonstrated the rate of admissions during the perimenstrual phase was 1.48 times higher than expected (95% CI: 1.31–1.67), with no significant heterogeneity detected. Four of six symptom score studies reported perimenstrual worsening, but lack of consistency in timepoints precluded meta-analysis. Two studies examining self-reported menstrual exacerbations reported prevalences ranging from 20% to 32.4%. Psychiatric admission rates are significantly higher than expected during the perimenstrual phase. There is some evidence that a worsening of psychotic symptoms also occurs during this phase, but further research with more precise measurement of the menstrual cycle and symptomatology is required.

Impact of the menstrual cycle on peripheral vascular function in premenopausal women: systematic review and meta-analysis

2020 ◽  
Vol 319 (6) ◽  
pp. H1327-H1337
Author(s):  
Jennifer S. Williams ◽  
Emily C. Dunford ◽  
Maureen J. MacDonald
Keyword(s):  
Systematic Review ◽  
Menstrual Cycle ◽  
Endothelial Function ◽  
Vascular Function ◽  
Meta Analysis ◽  
Premenopausal Women ◽  
Cycle Phase ◽  
Peripheral Vascular ◽  
The Impact

Fluctuations in endogenous hormones estrogen and progesterone during the menstrual cycle may offer vasoprotection for endothelial and smooth muscle (VSM) function. While numerous studies have been published, the results are conflicting, leaving our understanding of the impact of the menstrual cycle on vascular function unclear. The purpose of this systematic review and meta-analysis was to consolidate available research exploring the role of the menstrual cycle on peripheral vascular function. A systematic search of MEDLINE, Web of Science, and EMBASE was performed for articles evaluating peripheral endothelial and VSM function across the natural menstrual cycle: early follicular (EF) phase versus late follicular (LF), early luteal, mid luteal, or late luteal. A meta-analysis examined the effect of the menstrual cycle on the standardized mean difference (SMD) of the outcome measures. Analysis from 30 studies ( n = 1,363 women) observed a “very low” certainty of evidence that endothelial function increased in the LF phase (SMD: 0.45, P = 0.0001), with differences observed in the macrovasculature but not in the microvasculature (SMD: 0.57, P = 0.0003, I2 = 84%; SMD: 0.21, P = 0.17, I2 = 34%, respectively). However, these results are partially explained by differences in flow-mediated dilation [e.g., discrete (SMD: 0.86, P = 0.001) vs. continuous peak diameter assessment (SMD: 0.25, P = 0.30)] and/or menstrual cycle phase methodologies. There was a “very low” certainty that endothelial function was largely unchanged in the luteal phases, and VSM was unchanged across the cycle. The menstrual cycle appears to have a small effect on macrovascular endothelial function but not on microvascular or VSM function; however, these results can be partially attributed to methodological differences.

scholarly journals Limited Evidence Suggests a Protective Association Between Oral Contraceptive Pill Use and Anterior Cruciate Ligament Injuries in Females: A Systematic Review

2017 ◽  
Vol 9 (6) ◽  
pp. 498-510 ◽  
Author(s):  
Kathleen Samuelson ◽  
Ethan M. Balk ◽  
Erika L. Sevetson ◽  
Braden C. Fleming
Keyword(s):  
Systematic Review ◽  
Anterior Cruciate Ligament ◽  
Oral Contraceptive ◽  
Menstrual Cycle ◽  
Study Design ◽  
Methodological Quality ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Acl Injuries ◽  
Anterior Cruciate

Context: Female athletes aged 14 to 18 years are at particular risk for anterior cruciate ligament (ACL) injuries. Hormonal factors are thought to predispose them to this injury. Oral contraceptive pills (OCPs) might reduce ACL injury risk, although the literature appears controversial. Objective: To evaluate the association between OCP use and ACL injuries in women. The secondary objective was to determine the rates of ACL injuries in the pre- and postovulatory phases of the menstrual cycle in OCP and non-OCP (NOCP) users. Data Sources: Searches were performed across 4 reference databases (PubMed, CINAHL, Embase, Cochrane), abstracts from 6 specialty societies, ClinicalTrials.gov , and reference lists of relevant papers. Study Selection: We included studies investigating the association between OCP use and ACL injuries in females of any age or the distribution of ACL injuries across the menstrual cycle in OCP and NOCP users. Study Design: Systematic review. Level of Evidence: Level 3. Data Extraction: Data regarding study design, population characteristics, OCP details, outcome definitions, analytic methods, and results were extracted from the included studies. The methodological quality of each study was assessed using the Newcastle-Ottawa scale. Results: The search yielded 1305 citations, of which 7 retrospective observational studies met the inclusion criteria. Two large case-control studies with higher methodological quality suggested that OCP use may reduce the risk of sustaining an ACL injury. Five comparative studies examining injury distribution across the menstrual cycle in OCP and NOCP users had conflicting findings, were heterogeneous, and were limited by low methodological quality. Conclusion: The evidence suggests OCP use may reduce the risk of ACL injury; however, no conclusions can be drawn regarding differences in risk of ACL injuries between OCP and NOCP users across the menstrual cycle. Studies were limited by small sample sizes, heterogeneity, and methodological concerns.

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