News — Women who experience traumatic brain injuries face distinct challenges and barriers to recovery because of anatomic, hormonal, socioeconomic, and cultural differences as compared to men.
Dr. Christine Greiss, D.O., director of the Center for Brain Injuries at JFK Johnson Rehabilitation Institute, outlines these distinctions in a special issue of .Dr. Greiss argues that these differences make women more vulnerable to traumatic brain injury and can lengthen their recoveries.
“As a brain injury specialist, I want this article to provide guidance to physicians so they can develop a more tailored approach to treatment and rehabilitation for their female patients with concussion and other traumatic brain injuries,” Dr. Greiss said.
The article, a review of the most up-to-date research, is part of a 14-article collection on issues surrounding women and rehabilitation medicine. Sara Cuccurullo, M.D., medical director of JFK Johnson Rehabilitation Institute, is Editor-in-Chief of the collection, along with Co-Editors Kristen Harris M.D. and Hayk Petrosyan Ph.D.
The articles explore the many medical issues that are specific to women in areas such as , , , rheumatology, pain, and Long Covid. The authors, all experts in their fields, synthesize and distill the latest research and practice guidelines to support physicians in the United States and around the world.
“We want to provide insight to health care professionals nationally and internationally about how to best treat and understand their female patients receiving medical care and treatment during their rehabilitation,” Dr. Cuccurullo said. Physicians at JFK Johnson and elsewhere surveyed existing medical literature and used their own expertise and experience to write the articles.
Dr. Greiss said understanding how women may respond differently to traumatic brain injury is critical. For instance, she said the healing process may take longer based on when during the woman’s menstrual cycle the injury occurred. Hormonal fluctuations over a woman’s lifetime also can influence both susceptibility and recovery. Meanwhile, women can be more susceptible to brain injury and concussion because their smaller necks absorb less impact.
Additionally, women who experience traumatic brain injuries may face fertility struggles as the injury can impact the pituitary gland, the organ at the base of the brain that produces hormones.
Other key observations from the study include:
- Women have a higher prevalence of post-traumatic brain injury depression, anxiety, and posttraumatic stress disorder compared to men.
- Women with traumatic brain injuries face unique challenges around social and sexual intimacy, self-esteem, and relationships — highlighting the need for social support as the woman returns to her home and community.
- Health care providers should consider domestic violence as a factor in the diagnosis and management of women with traumatic brain injuries.
In the article, Dr. Greiss notes that significant changes in progesterone levels during a woman’s menstrual cycle have been implicated as an explanation for lengthening recovery after a brain injury. Another factor is that the brain injury itself can cause a dramatic drop in progesterone, leading to worse outcomes.
“Understanding the hormonal and other complexities related to gender makes the provider more aware that certain patients may take longer to recover,” said Dr. Greiss. “We need more research to more fully understand gender and brain injury so all patients can achieve the best outcome possible.”
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