Research
Hormonal
High estrogen levels decrease tendon stiffness by inhibiting lysyl oxidase activity, which may protect muscles from eccentric injury but can negatively impact performance by reducing power output.
High estrogen levels make your tendons more compliant, which can protect your muscles from strain injuries during exercise. However, this same compliance might reduce your power output. Balance your training to account for these changes.
GoodQualifiesHIGH confidence
In these other musculoskeletal tissues, estrogen improves muscle mass and strength, and increases the collagen content of connective tissues. However, unlike bone and muscle where estrogen improves function, in tendons and ligaments estrogen decreases stiffness, and this directly affects performance and injury rates.
Why this rating
Supported by cell culture and animal studies showing decreased stiffness and LOX activity.
Source
Effect of Estrogen on Musculoskeletal Performance and Injury Risk
Nkechinyere Chidi-Ogbolu et al. · Frontiers in Physiology · 2019
DOI 10.3389/fphys.2018.01834
narrative_reviewCited 358×
Read the paper DOI resolved against Crossref · corpus check 2026-06-10
More from this paper
- High estrogen levels during the ovulatory phase of the menstrual cycle decrease ligament stiffness by inhibiting lysyl oxidase activity, leading to increased knee laxity and a significantly higher risk of anterior cruciate ligament (ACL) injury.Good
- Oral contraceptives (OCs) that maintain stable, moderate estrogen levels reduce the cyclic fluctuation in knee laxity and are associated with a lower risk of ACL injury compared to women with natural menstrual cycles.Good
- Estrogen replacement therapy (ERT) in postmenopausal women improves muscle mass, strength, and power, and enhances the sensitivity of muscle to anabolic stimuli from exercise.Good
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