{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T16:24:37Z","timestamp":1787675077961,"version":"build-2784847793"},"reference-count":38,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,4,26]],"date-time":"2026-04-26T00:00:00Z","timestamp":1777161600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,26]],"date-time":"2026-04-26T00:00:00Z","timestamp":1777161600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["arthroscopyjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthroscopy"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To evaluate whether systemic estrogen\u2010only, progestin\u2010only, or combined hormonal contraceptives (HCs) are associated with increased risk of shoulder pathologies in reproductive\u2010age females.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A retrospective cohort study of female patients presenting to clinic from 2013 to 2020 and aged 13\u201050 with 5\u2009years of follow\u2010up was conducted using the TriNetX database. Patients prescribed estrogen\u2010only, progestin\u2010only, or combined HCs were matched 1:1 to controls using propensity score matching. Odds ratios (ORs) 95% confidence intervals (CIs), and\n                      <jats:italic>P<\/jats:italic>\n                      values were calculated after 5\u2009years for 10 shoulder pathologies.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Estrogen\u2010only (n\u2009=\u200995,109) users had increased odds of rotator cuff tears (RCT; OR: 2.0,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.001), shoulder instability (SI; OR: 1.5,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.001), bursitis (B; OR: 2.0,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.001), superior glenoid labral tears (SLT; OR: 1.8,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.001), impingement (IMP; OR: 1.8,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.001), and calcific tendinitis (CT; OR: 1.8,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.001), with no difference in rotator cuff capsule sprains (CS; OR: 1.3,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.117), dislocation or subluxations (DS; OR: 1.3,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.069), acromioclavicular (AC) joint sprains (AC\u2010S; OR: 1.3,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.272), or AC joint dislocations (AC\u2010D; OR: 1.2,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.486). Progestin (n\u2009=\u2009766,264) and combined (n\u2009=\u2009625,809) users had increased odds for all pathologies (all\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.05), with ORs for RCT, SI, CS, DS, B, SLT, IMP, CT, AC\u2010S, and AC\u2010D of 1.6, 1.6, 1.3, 1.5, 1.5, 1.4, 1.6, 1.5, 1.6, and 1.2 for progestin, and 1.6, 1.6, 1.7, 1.4, 1.7, 1.6, 1.8, 1.6, 1.8, and 1.3 for combined HC users.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The HC formulations studied were associated with increased odds of all 10 shoulder pathologies. Surgeons should be aware of these potentially increased risks when treating patients on HCs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level III, retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/arj.70201","type":"journal-article","created":{"date-parts":[[2026,4,26]],"date-time":"2026-04-26T10:34:01Z","timestamp":1777199641000},"page":"1529-1537","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Systemic Hormonal Contraceptive Use Is Associated With Greater Odds of Rotator Cuff Tears, Shoulder Instability, Dislocation, and Other Shoulder Pathologies: A Propensity Matched Epidemiological Study"],"prefix":"10.1002","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-9718-3803","authenticated-orcid":false,"given":"Argen","family":"Omurzakov","sequence":"first","affiliation":[{"name":"Case Western Reserve University School of Medicine  Cleveland Ohio U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arsen M.","family":"Omurzakov","sequence":"additional","affiliation":[{"name":"Weill Cornell Medical College  New York New York U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert J.","family":"Burkhart","sequence":"additional","affiliation":[{"name":"UH Drusinsky Sports Medicine Institute  Cleveland Ohio U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1229-6852","authenticated-orcid":false,"given":"Aakash K.","family":"Shah","sequence":"additional","affiliation":[{"name":"Case Western Reserve University School of Medicine  Cleveland Ohio U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rayyan","family":"Abid","sequence":"additional","affiliation":[{"name":"Case Western Reserve University School of Medicine  Cleveland Ohio U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James E.","family":"Voos","sequence":"additional","affiliation":[{"name":"UH Drusinsky Sports Medicine Institute  Cleveland Ohio U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4895-1046","authenticated-orcid":false,"given":"Jacob G.","family":"Calcei","sequence":"additional","affiliation":[{"name":"UH Drusinsky Sports Medicine Institute  Cleveland Ohio U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John M.","family":"Apostolakos","sequence":"additional","affiliation":[{"name":"UH Drusinsky Sports Medicine Institute  Cleveland Ohio 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