Understanding the Connection

Pregnancy, hormones, contraception and kneecap instability

Pregnancy, hormones, contraception and kneecap instability

Why do my knees hurt?

Pregnancy results in natural weight gain and a change in how you walk. Towards the end of pregnancy hormone changes also prepare the body (such as the ligaments around the pelvis) for childbirth.

A combination of more weight through your knees and kneecaps as well as being less mobile can mean your knees hurt. If your kneecaps were unstable before you became pregnant then the pregnancy hormones preparing your body for childbirth can mean your ligaments are more lax and this may make your kneecaps feel more unstable.

What can I do?

Sometimes knee braces or taping can help to provide some extra support to your kneecaps. Also try wearing trainers or shoes with good cushioning for your feet to help your knees.

More information can be found here

Should I stop taking the oral contraceptive pill (OCP) before surgery?

Women taking combined hormonal contraceptives or hormone replacement therapy (HRT) have an increased risk of developing a clot or thrombo-embolism compared to non-users. Surgery also carries a risk of thrombo-embolism.

The British National Formulary recommends discontinuing combined OCPs 4-6 weeks before lower limb surgery. Patients should not begin taking the combined OCP within two weeks of surgery or after prolonged immobilisation.

Alternative forms of contraception should be used.

More information can be found here (section 14.3):


Should I stop taking HRT before surgery?

If the surgery is minor and you are likely to be walking normally then there is no need to stop HRT.

If you are taking HRT and the surgery is major lower limb surgery and you will not be full weight bearing straight after then you may be asked to stop HRT 4 weeks before and start 2 weeks after the surgery or return to full weight bearing.

More information can be found here:



For expert guidance and support regarding knee health during pregnancy, hormonal changes, contraception, and kneecap instability, reach out to Prof. Hing We understand the importance of addressing knee pain and instability during life’s changes.