Are females more prone to concussions?

When you think of concussions, you might think of the typically male-dominated sport of football. However, concussions are more common in females who play comparable sports.

It also has been demonstrated that females of any age are more likely to have persistent and more severe neurological symptoms after concussion and tend to have longer recovery periods compared to males.

So, why is this the case?

Hormonal considerations

Hormonal fluctuations throughout the menstrual cycle influence concussion susceptibility and recovery in females. Research has shown that concussions sustained during the luteal phase — the timeframe after ovulation and before menstruation — results in more severe symptoms and prolonged recovery times.

Concussions can disrupt the hypothalamic-pituitary-ovarian axis, potentially leading to menstrual irregularities. This neuroendocrine disruption underscores the complex interplay between brain injuries and hormonal health in females.

Sociocultural considerations

Sociocultural factors also play a role. Studies indicate that female athletes are more likely to report concussion symptoms than their male counterparts, who may underreport due to cultural norms emphasizing “toughness” and “resilience.”

Mental health considerations

Beyond physical symptoms, concussions can have profound psychological effects, particularly for females in caregiver positions. We see a disproportionate number of nurses, teachers, paraprofessionals and mothers of young children reporting more severe symptoms for longer. Experts presume this is related to the psycho-social effect of having an invisible injury plus the emotional burden of responsibility for others. We also see peri-menopausal and menopausal females suffering with anxiety and cognitive changes for longer after concussion.

The intersection of physical injury and psychological distress highlight the need for a comprehensive approach to concussion management for females.

Treatment approach

Despite growing awareness, there remains a significant gap in research focusing on concussions in females. Historically, studies have predominantly involved male subjects and resulted in male-focused prevention and treatment strategies.

Advocate Health Care and Aurora Health Care neurologists are working on implementing strategies that specifically create better informed treatments for females that other clinics typically don’t offer. The standard of care for concussions will always be creating an individualized plan for each patient, which includes accounting for sex differences.

Dr. Kate Essad is the medical director of concussion and sports neurology at Advocate Health Care and Aurora Health Care.

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