Arnold School of Public Health, University of South Carolina, Columbia, SC.
Cummings School of Medicine, Calgary, Alberta, CANADA.
Med Sci Sports Exerc. 2023 Aug 1;55(8):1375-1381. doi: 10.1249/MSS.0000000000003162. Epub 2023 Mar 6.
The hormonal withdrawal hypothesis suggests that progesterone reduction in women after concussion may lead to greater symptom burden and longer recoveries. Current evidence indicates that hormonal stability after head injury may be an important moderator of postconcussive recovery. Thus, female athletes using hormonal contraceptives (HC) may exhibit better recovery profiles as their hormone levels are artificially stabilized. Our investigation sought to examine the relation between HC use and concussion outcomes in female student-athletes.
This longitudinal study examined concussion outcomes from female student-athletes participating in the NCAA-DoD CARE Consortium Research Initiative, including academic years 2014 to 2020. Eighty-six female collegiate athletes reporting HC use (HC+) were group matched on age, body mass index, race/ethnicity, sport contact level, concussion history, and current injury characteristics (i.e., amnesia, loss of consciousness) to 86 female collegiate athletes reporting no HC use (HC-). All participants had sustained a concussion and completed the Sport Concussion Assessment Tool, 3rd edition Symptom Scale, Brief Symptom Inventory-18, and Immediate Post-concussion Assessment and Cognitive Testing at preinjury baseline, 24 to 48 h postinjury, and when cleared for unrestricted return to play. To provide an index of recovery trajectory, days between injury and unrestricted return to play were calculated.
Groups did not differ on length of recovery, postconcussion symptoms, psychological health, or cognitive assessments. No differences were observed between groups on any measure when accounting for baseline levels of performance.
Our findings suggest that HC use does not influence recovery trajectory, symptoms, or recovery of cognitive function after concussion.
激素撤退假说表明，女性在脑震荡后孕酮水平降低可能导致更严重的症状负担和更长的恢复期。目前的证据表明，头部受伤后激素的稳定性可能是影响脑震荡后恢复的一个重要调节因素。因此，使用激素避孕的女性运动员（HC）可能会表现出更好的恢复情况，因为她们的激素水平得到了人为的稳定。我们的研究旨在调查女性运动员中使用 HC 与脑震荡结果之间的关系。
这项纵向研究检查了参加 NCAA-DoD CARE 联合会研究计划的女性大学生运动员的脑震荡结果，包括 2014 年至 2020 年的学术年。86 名报告使用 HC（HC+）的女性大学生运动员按年龄、体重指数、种族/族裔、运动接触水平、脑震荡史和当前损伤特征（即健忘、意识丧失）与 86 名报告不使用 HC（HC-）的女性大学生运动员进行组匹配。所有参与者都遭受了脑震荡，并在受伤前基线、受伤后 24 至 48 小时以及解除限制返回比赛时完成了运动性脑震荡评估工具第 3 版症状量表、简明症状问卷-18 和即刻性脑震荡评估和认知测试。为了提供恢复轨迹的指标，计算了从受伤到无限制返回比赛的天数。
两组在恢复时间、脑震荡后症状、心理健康或认知评估方面没有差异。在考虑基线表现水平时，两组在任何测量指标上都没有差异。
我们的发现表明，HC 使用不会影响脑震荡后恢复轨迹、症状或认知功能的恢复。
