Risk of female sexual dysfunction following concussion in women of reproductive age

ABSTRACT

Objectives: Traumatic Brain Injury (TBI) has frequently been associated with changes in sexual functioning. The TBI and sexuality literature, however, has limited generalizability to concussed females, who often use the emergency department (ED) as their first line of care after head injury.

Primary Objective: The primary objective of this study was to evaluate the impact of concussions on female sexual functioning.

Secondary Objective: Secondarily, we evaluated if concussed women with sexual dysfunction also report more post-concussion symptoms (PCS) and/or mood changes.

Research Design: This was a prospective cohort, with outcomes assessed at 6–10 weeks after ED enrollment.

Methods and Procedures: Sexual dysfunction was defined as ≤ 45 on the Brain Injury Questionnaire on Sexuality (BIQS). The Rivermead Post-concussion Symptoms Questionnaire (RPQ) and the Hospital Anxiety and Depression Scale (HADS) assessed PCS and post-injury mood, respectively.

Main Outcomes & Results: Eighty-nine eumenorrheic females (8–14 menstrual cycles/year) completed the study; 31(36%) had concussions, and 55(64%) were extremity injured. Concussed women had 70% increased risk of sexual dysfunction (adj.RR:1.70, 95% CI: 1.04,2.76; p = .03) versus extremity injured. Of clinical relevance, concussed women with sexual dysfunction also reported more PCS symptoms (adj.β = 5.5, 95% CI: −6.7,18.2; p = .37) and mood scores (adj.β = 8.0; 95% CI: −0.4, 16.4; p = .06).

Conclusions: This study highlights the need for more research and interventions for one of the fastest growing subgroups within the TBI population.

KEYWORDS:

• Concussion
• women
• sexual function
• gender

Acknowledgments

Much gratitude to Drs. Susan Hyman and Jennifer Herrera for your incredibly objective insights and constructive feedback; not to mention the institutional support provided, through the Developmental Pediatrics Fellowship program. Acknowledgments to the Leadership Education and Neurodevelopment (and other Neurological) Disorders (LEND) Program for providing the administrative support required for processing the participants’ incentives. Final acknowledgments to the Emergency Department Research Associate (EDRA) Program, for your diligent recruitment efforts.

Declaration of Interest

The authors report no declarations of interest.