Abstract
Sex disparity in anterior cruciate ligament injury is multifactorial. Sex hormones, such as relaxin, may play a role in the increased risk of injury in female athletes. In order to fully investigate this relationship, optimal strategies for capturing serum relaxin concentration across the menstrual cycle must be determined. The aim of this study was to describe the variability in the timing and magnitude of relaxin concentration changes across the menstrual cycle.
Highlights
Future investigation of the role of relaxin in anterior cruciate ligament injury should employ serial sampling, throughout days 8-12 of the luteal phase to increase the likelihood of accurately capturing the peak relaxin concentration
The increased risk of anterior cruciate ligament (ACL) injuries in female athletes is a multifaceted problem partly governed by sex differences in anatomy, neuromuscular control and sex hormones which have been linked to compromised knee stability [2]
The potential role of relaxin as a hormonal contributor to ACL injury has gained credibility since this “pregnancy hormone” was found to fluctuate in non-pregnant women across the menstrual cycle [4,5], relaxin receptors were identified on the human ACL [6], and relaxin was found to be associated with ACL injury risk [7]
Summary
The increased risk of anterior cruciate ligament (ACL) injuries in female athletes is a multifaceted problem partly governed by sex differences in anatomy, neuromuscular control and sex hormones which have been linked to compromised knee stability [2]. As ACL injuries are more likely to occur in the peri-ovulatory phase (while estrogen is rising and progesterone is stable) than in the post-ovulatory phase (when progesterone reaches peak concentration) [3], estrogen has been the primary hormone of interest. Relaxin is a member of the insulin-like superfamily and is primarily recognized for facilitating vaginal delivery by increasing pelvic ligament laxity [8].
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