Even though concussions may affect women differently than men, there is still not enough information about concussions in women to create guidelines.

The brain bank at Boston University detected chronic traumatic encephalopathy (CTE) in 236 of 377 brains in the lab. Only four of those brains belonged to women. None of those four had CTE.

This is where the problem lies. There is not enough information about concussions in women to determine guidelines for treatment.

Soccer stars Brandi Chastain, Abby Wambach, and Megan Rapinoe pledged to donate their brains to research after their deaths. One other person has promised to donate her brain to science after her death: Katherine Snedaker, a clinical social worker from Norwalk, Connecticut.

Snedaker founded the nonprofit PINK Concussions in 2013 to raise awareness about this bias in science.

Research cited on the PINK website stated that women have concussions at a higher rate than their male counterparts; they report a higher number of and more severe symptoms than males; and they also have a longer recovery process.

No guidelines specific to women exist, leaving female patients poorly educated about the differences of concussions in females and poorly prepared to cope with longer recovery times.

It seems like people are just now starting to include women in the study of concussions. One $30 million study by the Pentagon and the NCAA currently tracks 1,288 college athletes with concussions, of which one-third are female.

Dr. Christopher Giza, director of the UCLA Steve Tisch BrainSPORT Program, cautioned about jumping to conclusions about gender research. He said many of the results showing differences come from small, poorly controlled studies, who are conducted by researchers who might be biased toward finding gender differences. He also said that some studies show no differences, but those don’t get the media attention.

The Scientific American article offered an explanation as to why there may be gender differences in concussions. One study shows that the female hormonal cycle may play a role in how long it might take a person to recover. One study showed that the women who were injured in the two weeks before their period had a slower recovery time than those injured in the two weeks after their period, or those on birth control. In addition, premenstrual and postmenopausal women had recovery times similar to males with concussions.

The article offers the scientific opinion that a blow to the head may damage the pituitary gland at the base of the brain, which releases progesterone. This hormone has a calming effect and promotes cell growth. During certain times of the female cycle, the problem may be more damaging to neurons, which worsens symptoms and leads to social withdrawal that patients report.

They also mention that it may be due to females having less strong necks than men.

Researchers also wonder if females are more willing than men to disclose their symptoms of concussions.

The hope now is to integrate more women into research on brain injury to hopefully learn more about the gender differences in concussion management.

Gordon Johnson

Attorney Gordon Johnson is one of the nations leading brain injury advocates. He is Past-Chair of the TBILG, a national group of more than 150 brain injury advocates. He has spoken at numerous brain injury seminars and is the author of some of the most read brain injury web pages on the internet.

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