Does Oral Contraceptive Use Lessen the Impact of Concussions in Adult Female Athletes? [28P

Abstract

INTRODUCTION: Sports-related concussion (SRC) is classified as a mild traumatic brain injury (mTBI) and occurs over 2 million times annually. Female athletes acquire SRCs at higher rates and experience poorer outcomes and increased cognitive impairment compared to males. Progesterone has been utilized as intervention for TBI because of its neuroprotective effects. Applicability of this research to female athletes is limited because of predominantly male subject populations, failure to measure endogenous progesterone levels, menstrual cycle phase at time of injury, and oral contraceptive pill (OCP) use. The purpose of this research was to explore the role of oral contraceptive use on SRC outcomes in women. METHODS: A search of the literature was conducted from June to September 2016 using PubMed and OVID databases. Search terms used included: “concussion”; “brain injury”; “menstrual cycle”; “progesterone” “oral contraception”; and “females.” RESULTS: 76 articles were identified with 5 remaining after applying exclusion criteria. Women on OCPs or in the follicular phase at the time of injury performed significantly better on quality of life and somatic symptom measures. Athletes on OCPs reported fewer concussion symptoms with less symptom severity than eumenorrheic athletes. CONCLUSION: Menstrual cycle phase and OCP use at the time of concussion may influence concussion outcomes. OCP use was associated with better outcomes in adult female athletes with SRC. Gender-specific research efforts are necessary to improve outcomes after SRC, including prospective analysis of SRC outcomes and OCP use in female athletes.