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. 2025 Dec;41(12):5118-5124.
doi: 10.1016/j.arthro.2025.07.017. Epub 2025 Aug 20.

Systemic Hormonal Contraception Is Associated With a Greater Rate of Greater Trochanteric Pain Syndrome, Labral Tear, and Femoroacetabular Impingement Syndrome in Female Patients

Kira L Smith  1 , Aakash K Shah  2 , Robert J Burkhart  3 , Jeremy M Adelstein  3 , Andrew J Moyal  3 , Bhargavi Maheshwer  3 , James E Voos  3 , Michael J Salata  3
Affiliations

Systemic Hormonal Contraception Is Associated With a Greater Rate of Greater Trochanteric Pain Syndrome, Labral Tear, and Femoroacetabular Impingement Syndrome in Female Patients

Kira L Smith et al. Arthroscopy. 2025 Dec.

Abstract

Purpose: To evaluate the association between various hormonal contraception (HC) formulations and pathology around the hip.

Methods: The TriNetX U.S Collaborative Network database was used to complete a retrospective review of female patients, aged 13 to 50 years old, who were on sex hormone modulation. The primary outcome assessed was the development of pathology around the hip occurring within 5 years of starting various forms of HC. The included pathologies were greater trochanteric pain syndrome (GTPS), labral tear, femoroacetabular impingement syndrome (FAIS), or any combination of those injuries. The categories of HC were a progestin-only cohort and a mixed estrogen-progestin cohort. Odds ratio (OR) with a 95% confidence interval (CI) was used to measure the association between exposure to HC and development of hip pathology. Statistical significance was set to P < .05.

Results: After 1:1 propensity matching, a total of 1,397,123 patients were included in the final analysis. Progestin-only hormonal contraceptives (HCs) were associated with a greater likelihood of developing GTPS (OR 1.93, P < .001), labral tear (OR 1.75, P < .001), FAIS (OR 1.63, P < .001), or a form of combined hip pathology (OR 1.83, P < .001) compared with the control group. The mixed-HCs also were associated with a greater likelihood of developing GTPS (OR 2.13, P < .001), labral tear (OR 2.21, P < .001), FAIS (OR 1.82, P < .001), or a form of combined hip pathology (OR 2.10, P < .001) compared with the control group.

Conclusions: There is an association between systemic HC and hip pathology 5 years after initiation of HC among female patients aged 13 to 50 years old. Both progestin-only HCs and mixed-HCs were associated with a greater likelihood of developing GTPS, labral tear, FAIS, or a form of combined hip pathology compared with their control groups.

Level of evidence: Level IV, retrospective case-control series.

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Conflict of interest statement

Disclosures The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: M.J.S. reports consulting or advisory with Styker. J.E.V. reports consulting or advisory with Arthrex and DePuy Synthes. All other authors (K.L.S, A.K.S., R.J.B., J.M.A., A.J.M., B.M.) declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.