Abnormal Menstrual Patterns Common in Young Women With Concussion

Concussions may increase the risk of multiple abnormal menstrual patterns in adolescent and young women, a recent study showed.

Brain injury may alter hypothalamic-pituitary-ovarian axis function, which could subsequently interrupt menstrual patterns. However, the relationship between concussion and menstrual patterns in adolescent and young women has not been adequately explored.

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In their prospective cohort study, the researchers evaluated 129 adolescent and young women aged 12 to 21 years who had presented with a sport- or recreation-related concussion (n = 68) or non-head orthopedic injury (n = 61) between October 14, 2014, and January 24, 2016. All participants included the study presented at a concussion or sports medicine clinic at a single academic center within 30 days post-injury, were at least 2 years post-menarche, reported regular menses in the previous year, and did not use hormonal contraception.

Patient information was collected via text-message surveys. The researchers defined abnormal menstrual patterns as having an intermenstrual interval of less than 21 days (short) or more than 35 days (long) or a bleeding duration of less than 3 days or more than 7 days.

Overall, the researchers assessed 487 menstrual patterns in 128 patients. Among the 68 participants with a concussion, 16 (23.5%) experienced 2 or more abnormal menstrual patterns vs 3 (5%) of 60 participants with an orthopedic injury.

Participants with a concussion faced a significantly higher risk of 2 or more abnormal menstrual bleeding patterns after injury than those with an orthopedic injury, despite similar gynecologic age, body mass index, and type of sports participation between groups.

“Because abnormal menstrual patterns can have important health implications, monitoring menstrual patterns after concussion may be warranted in this population,” the researchers concluded. “Additional research is needed to elucidate the relationship between long-term consequences of concussion and the function of the hypothalamic-pituitary-ovarian axis.”

—Christina Vogt


Snook ML, Henry LC, Sanfilippo JS, Zeleznik AJ, Kontos AP. Association of concussion with abnormal menstrual patterns in adolescent and young women [Published online July 3, 2017]. JAMA Pediatr. doi:10.1001/jamapediatrics.2017.1140.