Photo via askchiq.com |
When
you think of sports related concussions you probably think of men’s football,
rugby, ice hockey, and other aggressive sports but, many wouldn’t jump to
females suffering many concussions due to sports injuries as well. Well
according to Dr. Bazarian at the University of Rochester Sport Concussion
Clinic about 70% of the head injuries patients he sees are females. Women
typically show longer recovery times than do men when faced with a head injury
but, menstrual cycles could play a role in just how long.
After
receiving a head injury sex hormones are often immediately changed from the
normal levels. This is due to the pituitary gland in the brain which can be
shut down by a hit to the head. The pituitary gland is part of the endocrine
system which releases several hormones such as luteinizing hormone (LH) and
follicle stimulating hormone (FSH) which are both important to the regular
menstrual cycle of females (Discovery Communications, LLC. , 2013). The
pituitary is often called
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The hormone progesterone is a hormone in the human body that is produced in the ovaries, in the placenta after implantation of a fetus, and by the adrenal glands (National Women's Health Resource Center, 2013). Progesterone is important in preparing the body for conception and is also responsible for maintaining a regular monthly menstrual cycle (National Women's Health Resource Center, 2013). As is shown in the diagram, when the levels of progesterone are high the uterine lining is thickening, preparing for implantation and if an egg is not fertilized and implanted the levels of progesterone quickly drop and the lining will be broken down and removed via menses (National Women's Health Resource Center, 2013). The menstrual cycle is broken into the two weeks prior to menstruation and the two weeks after, including the seven day menses. The point you are in this cycle proves to be viable information for females recovering from concussion and other head trauma related injuries.
Bazarian and his team took 144 women from age 18 to 60 that had just experienced a head injury within the past four hours. These women gave blood samples as soon as they arrived and their progesterone levels were calculated determining the phase of the menstrual cycle they were currently in (University of Rochester Medical Center, 2013). Based on progesterone levels all 144 females were placed into three groups: the first was women who were in the premenstrual phase; their progesterone levels were high. The second group tested low for progesterone, which indicated they are postmenstrual (University of Rochester Medical Center, 2013). The third and final group was those who reported being on birth control pills which have synthesized progesterone hormones and females taking birth control pills receive a constant flow of hormones (University of Rochester Medical Center, 2013).
The
researchers and Bazarian came up with the “withdrawal hypothesis” before
proceeding with any additional follow-up tests. This hypothesis stated that if a
woman suffers a concussion during the premenstrual period her progesterone
levels are high and after the injury they are drastically dropped leaving her
with symptoms such as headaches, nausea, dizziness, and other uncomfortable
side effects (University of Rochester Medical Center, 2013). But, if she
suffers a concussion after her menstrual cycle her progesterone levels are
already drastically reduced naturally so the effects previously stated won’t
apply to these females because the progesterone isn’t dropping dramatically (University
of Rochester Medical Center, 2013). This should cause females in the
premenstrual group to suffer longer after their injury while postmenstrual
females recover quicker.
After one month these same 144
females were brought back to do follow-up testing to see if the different
phases of menstruation and progesterone levels have effects on the slow
recovery time females endure after head injury. Standardized tests were used to
assess the women for their concussion recovery and their quality of life; they
were asked questions about their mobility, daily activities, and the pains they
experience (University of Rochester Medical Center, 2013). The women who were
in the premenstrual phase were twice as likely to score worse on these tests as
the postmenstrual women and those on the pill. Women in the birth control group
has the highest scores overall than the other groups. These results concur with
Bazarian’s “withdrawal hypothesis” but further testing needs to be done to
conclude that birth control pills are even more advantageous to female
athletes. Birth control pills are already popular among female athletes because
of the predictable periods and the added protection for bones; if this data is
another plus for birth control pills it will be one more reason for female
athletes to use them.
AskChiq.
(2010, December 08). Concussion symptoms differ between girls and boys.
Retrieved from http://askchiq.com/fitness_health/5588432
Discovery
Communications, LLC. (2013). What does the pituitary gland do?.
Retrieved from http://health.howstuffworks.com/human-body/parts/what-does-pituitary-gland-do.htm
National
Women's Health Resource Center. (2013). Progesterone overview. Retrieved
from http://www.healthywomen.org/condition/progesterone
University
of Rochester Medical Center (2013, November 13). Menstrual cycle influences
concussion outcomes. ScienceDaily,
Retrieved November 16, 2013, from http://www.sciencedaily.com/releases/2013/11/131113130033.htm
WebMD.
(2010, July 23). Pituitary gland. Retrieved from http://www.webmd.com/brain/pituitary-gland
Womack,
L. (2013). Birth control and the female athlete. Retrieved from http://www.sportsmd.com/SportsMD_Articles/id/309.aspx