It’s not surprising that the effects of traumatic brain injury on men and women are different. A new study published in the Orthopedic Journal of Sports Medicine well documents these differences. Researchers at Tulane School of Medicine designed a study to determine the factors that predispose female athletes to more severe concussions than their male counterparts. The researchers performed a systematic review of the literature, finding 25 studies that met the inclusion criteria that examined the effects of concussive and sub-concussive head impacts in female athletes of all ages, regardless of competition level. These studies were further supplemented with epidemiologic studies. Exclusion criteria included narrative reviews, single case reports, abstracts and letters to the editor as well as studies related to chronic traumatic brain injury. The study found that female athletes appear to sustain more severe concussions than male athletes due in part to a lower biomechanical threshold tolerance for head impacts. Additionally, it was believed that concussions could alter the hypothalamic-pituitary-ovarian axis, resulting in worse symptoms and amenorrhea.

The researchers concluded:

This systemic review demonstrates that female athletes may be more susceptible to concussion, have prolonged symptoms after concussion, and are more likely to report a concussion than their male counterparts. However, underreporting still exists among female athletes. Possible factors that put female athletes at a higher risk for concussions include biomechanical differences and hormonal differences.

 The citation for the study is Sport-Related Concussion in Female Athletes: A Systematic Review. Neil K. McGroarty, Symone M. Brown, and Mary K. Mulcahey. Orthopaedic Journal of Sports Medicine 2020 8:7