Sex-related Side Effects of Corticosteroid Injections

Caroline H. Hu, BA; Emily Brook; and Elizabeth G. Matzkin, MD

Corticosteroid injections are a nonsurgical treatment modality, frequently used when other conservative treatments are ineffective. Corticosteroids are often used to treat knee and shoulder osteoarthritis, rotator cuff tendinopathy, adhesive capsulitis, and acute inflammation. By reducing vascular permeability and inhibiting the production and accumulation of inflammatory mediators such as prostaglandins and leukotrienes, corticosteroids are clinically effective in increasing joint mobility, reducing joint inflammation, and decreasing erythema, swelling, and acute pain.

Although corticosteroid injections are simple to perform and the risk-benefit ratio is highly favorable, some adverse side effects are not unusual. Commonly discussed side effects include postinjection flare, skin changes (hypopigmentation), fatty atrophy, infection, facial flushing/allergic reaction, tendon damage, and transient increase in blood glucose. Furthermore, female patients may face additional sex-related adverse effects, most notably abnormal menstruation. This article discusses these potential side effects to increase awareness of their existence among orthopaedic surgeons.

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