According to the National Institute of Neurological Disorders and Stroke, there are gaps in knowledge on the effects of traumatic brain injury (TBI) in women
The Centre for Disease Control defines a TBI as a “disruption in the normal function of the brain that can be caused by a bump, blow, or jolt to the head, or penetrating head injury.”
Why is it important to know how women react?
What scientists and healthcare professionals know about how these injuries works, largely comes from studying men – from soldiers to athletes, the impact of TBI is studied in the aftermath of a rugby players’ retirement or a soldiers’ therapy. Falls are considered the most common cause of TBI, across all genders. However, domestic violence is a highly common scenario, in which traumatic brain injury can be sustained by everyone, regardless of gender. The 2019 Crime Survey for England and Wales found that 1.6 million women and 786,000 men experienced domestic abuse that year. That’s 7 in 100 women, 4 in 100 men. The data does not address non-binary people.
According to this data, there is an urgent need to understand how TBI impacts women – whether due to abuse, or due to the increasing presence of women in combat zones and sports. The lasting symptoms can include impairments to thinking or memory, movement, sensation, or emotional functioning – including depression.
‘Many of these studies have been done in males’
“We are making advances in understanding the effects of head injury on the brain, but many of these studies have been done in males,” said Patrick Bellgowan, Ph.D., program director at NINDS.
“There is evidence that traumatic brain injury affects women differently, but we need focused research efforts to get a full understanding of those differences to help improve prevention and treatment strategies.”
What are the sex-based differences?
The reason why scientists are sure there could be differences in how men and women respond to TBI is because they can already see some. For example in children ages 0-4, boys are two times more likely to have a TBI than girls, but during the adolescent years, female athletes are likelier to experience concussions than male athletes. Among older populations, women who are 65 and older are most likely to experience mild TBI, and the majority of those result from falls.
The menstrual cycle could change how the body reacts
Studies suggest that women may have different outcomes, depending on when during their menstrual cycle they were injured.
For example, there is evidence that head injuries occurring during the luteal phase of the menstrual cycle, when levels of progesterone are high, may be associated with worse outcomes and decreased quality of life. Additional research on reproductive hormones, such as progesterone or estrogen, may provide important clues to recovery from head injury.
Not much is known about military-related TBI in female servicemembers, although studies have reported sex-based differences in symptoms as well as functional connectivity, which is the activity between brain regions. Having more female veterans in longitudinal research studies would increase this sparse area of knowledge.