Concussions tied to menstrual problems in young women

Young women who suffer a concussion may be at increased risk of menstrual irregularities, at least for a few months, suggests a new US study.

Researchers found that young women were nearly six times more likely to have irregular menstrual cycles after a concussion, compared to young women who were treated for non-head-related injuries.

After a concussion, women should talk to their healthcare providers about the increased risk, said senior author Anthony Kontos, of the University of Pittsburgh Medical Centre Sports Medicine Concussion Programme. It’s important, he added, “for care providers to be concerned about menstrual patterns and encouraging women to track that after their injury”.

Irregular menstrual cycles may disrupt the body’s hormones and lead to delayed body development in young women, Kontos told Reuters Health. Hormone disruption can also lead to poor bone health.

Concussions result from a hit or blow to the head that causes the brain to move back and forth or twist inside a person’s skull, according to the Centres for Disease Control and Prevention. 

A study last year by the Seattle Sports Concussion Research Collaborative estimated that up to 1.9 million children in the US experience a sports-related concussion each year. Girls are also known to have a more difficult concussion recovery than buys, Kontos and his colleagues write in JAMA Paediatrics.

Hormone disorders are known to occur after traumatic brain injuries, they add. Some research has suggested menstrual disorders are more common after those types of injuries, too.

For the new study, the researchers recruited 68 girls and women, ages 12 to 21, who were recovering from concussions. The participants received a text message every Sunday night for about four months linking to a survey that asked about their menstrual cycle. They were asked about bleeding, new injuries, possibly pregnancies and birth control.

Sixty-one young women with non-head-related injuries were also surveyed every week.

About 24 per cent of concussion patients had at least two abnormal menstrual cycles during follow-up, compared to 5 per cent of patients with other types of injuries.

Kontos said concussions might increase the risk of irregular menstrual cycles by disrupting the hypothalamic-pituitary-ovarian axis, a group of hormone-emitting glands that often act in concert.

Dr Jeffrey Bazarian, an emergency physician and brain injury expert at the University of Rochester Medical Centre in New York, told Reuters Health a concussion could interfere with the pituitary gland in the centre of the brain.

“It’s possible that this also happens to males and the question is how does it effect them,” said Bazarian, who was not involved in the new study.

The researchers can’t yet explain their findings, however. Nor can the study prove concussions actually cause abnormal menstruation.

Kontos also said it’s unclear whether the increased risk of abnormal menstrual patterns lasts beyond four months.

“We don’t know beyond that,” he said. “It’s one of the studies we’d like to do.”