SECTION II - EXERCISE PHYSIOLOGY AND SPORTS MEDICINE / RESEARCH PAPER
Effects of Urinary Sex Hormones during the Menstrual Cycle on Anterior Cruciate Ligament Laxity in Female Adolescent Soccer Players
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Li Cui 4
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Yan Qi 1
 
 
 
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1
Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China.
 
2
Department of Pediatric Surgery, Shanghai Jiahui International Hospital, Shanghai, China.
 
3
Department of Rehabilitation Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China.
 
4
Shanghai Jinyang Community Health Service Center, Tongji University School of Medicine, Shanghai, China.
 
5
Institute of Sports Medicine, Fudan University, Shanghai, China.
 
These authors had equal contribution to this work
 
 
Submission date: 2025-02-23
 
 
Final revision date: 2025-05-28
 
 
Acceptance date: 2025-09-09
 
 
Online publication date: 2026-03-16
 
 
Corresponding author
Yan Qi   

School of Medicine, Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, China
 
 
 
KEYWORDS
TOPICS
ABSTRACT
The aim of this study was to investigate the relationship between urinary sex hormone levels and anterior cruciate ligament (ACL) laxity in female adolescent soccer players, and to explain the relationship through establishing regression equations. Urinary aliquots were collected daily from 15 healthy subjects over a continuous period of 27–34 days. Knee laxity at 67, 89 and 133 N was assessed using a standard KT-1000 knee arthrometer. Urinary metabolite levels of estradiol, progesterone and testosterone were tested using UPLC-Xevo TQ MS. Greatest ACL laxity was recorded during the luteal phase, followed by ovulatory and follicular phases (p < 0.05). In addition, there were significant correlations between ACL laxity and estradiol or progesterone (p < 0.05). Estradiol, progesterone, and their interaction in the model were significant predictors of knee laxity (p < 0.05). In conclusion, ACL laxity was significantly and positively correlated with urinary estradiol and progesterone levels. The menstrual cycle (especially during the luteal phase) had a significant effect on ACL laxity. The regression equations we developed to analyze female adolescent soccer players accounted for 7.39% of the variation in ACL laxity with urinary sex hormones.
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