Post-concussion changes in menstrual cycle reported among adolescent patients

By Shelly Seth. This article was initially published in our Concussion Update newsletter; please consider subscribing.

A study abstract by Roby et al. analyzed data on adolescents’ menstrual cycle following a concussion. The abstract was presented at the 2022 American Academy of Neurology (AAN) Annual Meeting and discussed in an article by Vanessa Martinez in Neurology Advisor. Roby et al. found changes in menstrual patterns 3-4 months post-injury in 1 out of 8 patients. The authors also found higher symptom severity for those who sustained a concussion after ovulation and before menstruation. It is significant that the study focuses on adolescents because most studies have examined menstrual cycle disruptions in adults rather than younger patients, who make up a large portion of mTBI injuries. 

The study aimed to investigate “changes in menstrual cycle post-injury, menses phase at time of concussion, and symptom severity.” The researchers studied 598 patients (mean age 15.4 土 1.4 years) who had sustained a concussion through an initial visit and a follow-up appointment 3-4 months later. Patients were asked if they experienced changes in their menstrual cycle 28 days following their concussion and 3-4 months post-concussion. Menstrual pattern changes were reported in 4% of patients in the initial visit and 12.5% of patients in the follow-up visit. However, only 136 patients returned for the follow-up visit, which may have induced some selection bias in the sample.

Patients’ menstrual phase at the time of injury was not associated with cycle changes but was associated with PCSI (Post Concussion Symptom Inventory) severity. This association means that the specific phase of the menstrual cycle may influence symptoms post-injury. The researchers found that patients injured in the early luteal phase reported the highest symptom severity in their follow-up visit. 

The authors acknowledge that this study represents a foundational start in analyzing the various changes in patients after a concussion. More data is needed to understand the potential hormonal changes that younger patients experience in addition to their development after sustaining an injury.