Do men and women recover from a concussion in the same way?

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Photo by Ray Kasprowicz &Getty images 

As a woman, I always want to say that I am equal to a man, that I can do anything a man can do. I don’t like to hear anything that makes me feel like the “weaker” sex. But there are some areas where the differences between women and men shouldn’t be ignored and concussions are one of them.

 

Concussions are a form of mild Traumatic Brain Injury (or TBI) that occur from a blow or shaking of the head and cannot be seen with any imaging studies. They cause symptoms ranging from headaches and dizziness, to depression and slowed cognitive function. As the world focuses more and more on concussion research, there have been significant differences found in men and women. Women were studied a little later, partially because science tends to do that anyway, but also because in order to study concussion differences, it was important to find a sport in which the exact same mechanism of injury would occur. Additionally some of the data was a little skewed, making the conclusions more difficult to understand. This is because, generally speaking, women discuss pain more than men and are more likely to report concussion symptoms.

Article by Dr. Andrea Verburg Hill. Doctor Hill is a Ringside Physician in the United States.
She graduated from Texas A&M University College of Medicine in 1999. After graduation, she worked primarily as a pediatrician and moved to her work as a ringside physician five years ago. She is certified by the Association of Ringside Physicians and certified by USA Boxing. She has worked extensively with USA boxing, including Golden Gloves and has worked with both the UFC and Mayweather Productions as well as many amateur events with the ISKA and IKF. She trained for ten years in Muay Thai and owned a Muay Thai gym with her husband, a pro-MMA and Muay Thai fighter. In 2016 her husband died by suicide secondary to Chronic Traumatic Encephalopathy and Acute Concussion Syndrome. Since that time she has worked extensively with fighters to promote concussion awareness and CTE prevention, and changed to training in traditional boxing.
For questions or to learn more about her personal story DM her IG
@fightdoctress

With these two issues in mind in research, there have been differences found in concussions between the genders which impact their medical treatment and recovery. Women have been found to be more prone to concussions and take longer for their symptoms to resolve. More concussions are reported in men than women since men compete more in professional sports that are at risk for concussions. However, research suggests that women might be nearly fifty percent more likely than men to get a concussion with the same mechanism of injury. Also, women can take at least a month longer to recover from a concussion than their male counterparts.

 

Why these differences might exist is a topic of much ongoing research. There are several possibilities and all probably contribute.
Firstly, women’s brains are structurally different from men in ways for example, like a bigger verbal area of the brain. Their brains are also different in regards to size and blood flow. Secondly, men typically have stronger neck muscles which would hold the head more stable and therefore minimize shaking of the brain. Thirdly, some research has shown differences in concussion rates and severity of symptoms in women during different phases of their menstrual cycle. In particular, the brain is thought to be more susceptible to injury with worse symptoms in the last two weeks of the menstrual cycle, when progesterone is higher.

As a combat sports physician, I take these differences into consideration. During a Muay Thai or MMA event, for example, I might take more notice of an elbow to the head in a woman than a man. Elbows are dangerous in either gender, but I do see more concussions and send more fighters to the emergency room when the fighter is female.

 

These differences are obviously fascinating and are currently topics of much research. The last change in concussion management worldwide came from the Berlin Concussion Consensus in 2016. I believe that in the future, with more research, recovery guidelines will contain differences in recommendations depending on gender (and likely age as well).

 

The important thing for women to take home from reading this, in my opinion, is to understand their recovery time might take longer than a man and to be patient with the recovery process.


If you have symptoms that persist, particularly emotional symptoms like depression, don’t assume you are crazy, let your doctor know because you likely are still experiencing symptoms of your concussion. Remember that current guidelines and expectations regarding recovery are primarily geared towards men and don’t expect the same results and the same recovery time as they have.

Unfortunately, some of the same things that make women so wonderful – like our brain which allows us to be better in areas like communication, probably also make our recovery from concussions more difficult. But that’s life, you have to take the good with the bad.

 

For more information, I recommend looking at the University of California and Boston University’s websites regarding research as well as their concussion clinics.

 

Andrea Verburg Hill MD, Certified Ringside Physician