Health Matters

Females Top Males in Number of Concussions, Length of Recovery

Nov. 13, 2013

Concussion and menstrual cycleAcross the country, high school and college sports are in full swing. Parents and fans may be surprised to learn that females participating in high school athletics now experience more concussions than males. In a ranking of high school and college sports, women’s soccer and basketball had the highest percentage of concussions, followed by football and men’s soccer.

Dr. Jeffrey Bazarian, who treats patients and conducts research on head injuries among athletes, says females get a double whammy; not only are they sustaining more concussions, they also have more symptoms and take longer to recover than young men. Dr. Bazarian estimates that 70 percent of the patients he treats in the URMC Sport Concussion Clinic are young women. He believes the number is so high because they often need more follow-up care.

In a new study, Dr. Bazarian explores a possible reason why females do worse than males following a head hit. The results suggest that a sudden drop in the hormone progesterone, which is highest in women of childbearing age, is a big reason for their prolonged recovery.

He believes that a concussion temporarily “knocks out” the function of the pituitary gland, which is located deep within the brain and is responsible for stimulating the production of the hormone progesterone in the ovaries.  If the pituitary doesn't work, the level of progesterone would drop quickly.  Progesterone is known to have a calming effect on the brain and on mood.  If it drops suddenly he thinks it produces a kind of withdrawal, which either contributes to or worsens post concussive symptoms like headache, nausea and trouble concentrating. Men, who have low pre-injury levels of progesterone, would not be affected by a drop in the hormone.      

Read more about the study and watch a video featuring University of Rochester soccer goalie Allison Bernstein, who is recovering from a recent concussion, here.


Jeff BazarianJeffrey J. Bazarian, M.D., M.P.H., is an associate professor of Emergency Medicine at the University of Rochester School of Medicine and Dentistry. He treats patients at the URMC Sport Concussion Clinic.