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Sex Differences in Outcome after Concussion

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Multiple studies in humans indicate that women have worse outcomes than their male counterparts after concussion. The observation that worse outcome for women was most pronounced during childbearing years was revealed by research in the Bazarian lab and suggested that sex hormones such as estrogen or progesterone were playing a roll. The Bazarian lab subsequently demonstrated that outcome was related to the menstrual cycle phase at the time of injury. Women injured during the luteal phase of their menstrual cycle, when progesterone concentration was high, had significantly lower quality of life and more post concussive symptoms than women injured during the follicular phase of their cycle or women taking oral contraceptives.  This study led to the formation of the “withdrawal hypothesis” as contributor to post concussive symptoms in females.


  • Martina Anto-Ocrah, PhD MPH, Emergency Medicine Research, University of Rochester
  • Kathleen Hoeger MD MPH, Department of Obstetrics and Gynecology, University of Rochester

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