Do concussions affect women’s menstrual cycles?

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Concussions can affect numerous parts of the body that might surprise people, like vision and hearing. But, a new study has potentially found one unforeseen side-effect that could have significant effects on young women with brain injuries.

A new study published in the journal JAMA Pediatrics shows that girls who have experienced a concussion are significantly more likely to experience irregular periods or issues with menstruation following their brain injury.

The researchers came to this conclusion based on a survey of 128 girls and women between the ages of 12 and 21. All participants had experienced either a brain injury or an orthopedic injury during athletic or recreational activities within 30 days of the study.

Of the women who reported having a brain injury, almost a quarter of the girls (23.5%) also said they had experienced two or more abnormal bleeding patterns in the 120 days after their injuries. In comparison, only 5% of the girls without head injuries reported similar irregularities.

The report says these irregular menstruation cycles are the result of a disruption of the “neuroendocrine hypothalamic-pituitary-ovarian axis” which can result from a concussion. This system is the part of the brain responsible for developing and regulating reproductive and immune systems.

The effects of this disruption could potentially lead to long-term issues for girls. The authors say short-term period of irregular menstruation can cause reduced estrogen production, while long-term disruptions to the menstrual pattern can lead to reduced bone mineral density and delayed sexual development.

Co-author of the study Anthony P. Kontos, research director at the University of Pittsburgh Medical Center Sports Medicine Concussion Program, says the study was inspired by a talk with Dr. Meredith Snook, an OB-GYN fellow. Snook suggested Kontos examine whether concussions can have an effect on the menstrual cycle based on her own anecdotal experiences.

To evaluate this, Kontos and Snook decided to survey a younger group of girls who were told to send text message updates regarding their periods. Kontos said they were concerned about the effectiveness of this approach, but followed it because they wanted to see if the disrupted menstrual cycle could have long-term effects later in life.

“We did not know if the participants would even provide us with this information because it was somewhat sensitive,” he said. “We just didn’t know if they would respond, and we had a 95% response rate, which was off-the-charts ridiculous, so clearly they were interested.”

The findings raise significant concern about the long-term effects concussions could have on women’s bodies and reproductive health, but more research will need to be done to better understand the results. This initial study is limited by how small the sample size was.

Additionally, the researchers did not account for what point participants were at in their sporting seasons. Experts note that regular intense exercise can also cause menstrual irregularities.

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