Exploring the relationship between contraceptive medication use and concussion recovery in female collegiate athletes: a LIMBIC MATARS consortium investigation

ABSTRACT

Objective

While recovery from concussion is variable, women are more likely to report symptoms, experience worse outcomes, and have longer recovery trajectories following concussion than men. Preliminary data suggest that hormonal fluctuations, specifically progesterone, may be associated with this variability. This study aimed to understand the effect of contraceptive medication on concussion recovery.

Methods

A retrospective chart review using consensus-based common data elements was conducted at 11 NCAA institutions as part of the LIMBIC MATARS consortium. Participants included female collegiate athletes diagnosed with a concussion who did (n = 117) or did not report (n = 339) contraceptive medication use. Number of days between diagnosis and symptom resolution were compared using Mann-Whitney U tests. Self-reported diagnosis of attention deficit hyperactivity disorder, concussion history, anxiety, and depression was compared using Chi-squared tests.

Results

The proportions of participants who did or did not take contraceptive medication were similar across covariates. Female athletes regardless of contraceptive medication use recovered similarly following a concussion.

Conclusions

Our findings suggest that contraceptive medication use did not significantly impact concussion recovery. Future prospective investigations should examine documentation practices and operationalize terminology for hormonal contraceptive medication to better understand their role on recovery from sport-related concussion in female collegiate athletes.

KEYWORDS:

• Sports-related concussion
• gender differences
• sex differences
• hormonal contraceptives
• female athletes

Acknowledgments

The authorship would like to acknowledge the contributing LIMBIC MATARS site investigators: Michelle Kirk, M.D. and David Gable, ATC, (Texas Christian University), Brett Mortensen, Ph.D., Michael J. Larson, Ph.D., (Brigham Young University), Erica Beidler, Ph.D. (Duquesne University), James Day, Ed.D. (Augustana University), Thayne Munce, Ph.D. and Allison Peplowski (University of South Dakota), Trish Kelshaw, Ph.D., (University of New Hampshire), Kristin Wilmoth, Ph.D., Nyaz Didehbani, Ph.D., and C. Munro Cullum, Ph.D., (The University of Texas Southwestern Medical Center), Meredith Decker, Ph.D., (The University of Texas at Arlington), Tom Campbell, M.S. (Old Dominion University), Monique Pappadis, Ph.D. (The University of Texas Medical Branch), Sean Ahonen, ATC (Virginia Union University), Verle Valentine, M.D. (Sanford Health), Kate Higgins, Psy.D. and Heather Bouchard, M.A. (University of Nebraska), Jessica Wallace, Ph.D. (University of Alabama), Jessica Gill, Ph.D. (Johns Hopkins University), Catherine Donahue, M.Ed., Daniel Rosenblum, M.Ed., Donna Broshek, Ph.D. and Rachel Smetana, Ph.D. (University of Virginia), Tom Bowman, Ph.D., Caroline Wesley Siler, MS, ATC, and Tenesha Helm (University of Lynchburg), Samuel Walton, Ph.D., and Jessie Oldham, Ph.D. (Virginia Commonwealth University) as well as the NCAA collegiate athletes who contributed to this dataset.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

JER has received funding by the Medical Technology Enterprise Consortium.