Girls can do anything boys can do, but girls’ brains are different from boys, and this extends to concussions. Relative to males who sustain concussions, females tend to have a longer recovery time, experience more symptoms overall and have more cognitive and emotional effects.
Explanations for the difference in symptoms and the increased likelihood of concussions in women have been partly attributed to differences in anatomy and blood flow to the brain. A paper just published in JAMA Pediatrics by Snook et al. has shown that adolescent females who sustained a sports related concussion are more likely to have abnormal menstrual cycles relative to a control group who only experienced orthopedic injuries. Girls were followed 120 days after a concussion were more likely to have 2 more irregular menstrual patterns compared to the girls that were not concussed.
This finding is not entirely surprising since older studies have demonstrated that women who suffered from moderate or severe traumatic brain injury had far fewer or no periods after their injury. Mild, moderate or severe head injury somehow affects the endocrine hypothalamic pituitary axis, and this affects the menstrual cycle.
Why is this important? Adequate estrogen production is key for proper bone formation especially during adolescence. Teenage girls who sustain a single or multiple concussions are theoretically at risk for low bone density down the road due to irregular menstrual cycles. As a concussion specialist and a pediatrician, this research study emphasizes the need to ask female athletes who have suffered a concussion whether they have any changes in their menstrual cycle and to make them aware of how concussions can impact the endocrine system.