We're talking here about individuals who are either born biologically male or biologically female, and there are definite differences in the risks of sustaining a concussion and also the recovery process. My research, which was done through University of Toronto and Toronto Rehab, focused mostly on women with persistent symptoms.
And what we find is that females are at a high risk of sustaining hormone imbalances over time if they've had a concussion. Males also have hormone disturbances, but they're different of course, because the hormones are different.
Menstruating females will have disruptions in their periods, and this can last weeks, months, and in some cases, even years. A disruption in this reproductive access is actually the second most common hormone disruption. The first most common is growth hormone and that's for both females and males. For males, what they would experience is a disruption in testosterone.
So, similar pathways, but different hormones.
The other thing about females relates to sport. Females are actually at a greater risk of sustaining a concussion while playing the same sport as males (for example, soccer). So while males overall have higher numbers of concussion for similar activities, females are often at higher risk.
There are a lot of theories as to why, but there is no definitive answer. Some theories that have been thrown around have to do with neck musculature, biomechanics, and then this hormone portion. What we do know is that females are at a higher risk of sustaining a concussion in the luteal phase of their cycle. This is actually super powerful because it is one of the only ways that we can look at concussion prevention.
While we'll never really prevent concussions, we do know females are at a higher risk during a certain stage of the month. So you can actually take actions towards how much time they're going to be on the field or what kind of training they're going to have.
There's a lot of information, but as we get more information with the research, we can definitely use it in a proactive way and hopefully either prevent some concussions or minimize the severity of concussions that are happening.