Concussion Effects — Men Versus Women

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How Concussion Affects Women and Men Differently

One of the questions that I sometimes get is, “Who is more susceptible to a concussion: men or women?” And the answer turns out to be that women are more susceptible to a concussion and to having worse symptoms. They are also more susceptible to having those symptoms last longer. Let me tell you why.

A smaller head

There are three main reasons. The first is anatomy. Women tend to have smaller heads than men. Let me give you an example of what I mean. Take soccer. The soccer ball is a standard size. But that ball is hitting a man’s head with the same force as a woman’s head.

If a woman’s head is smaller, that force is transferring over a smaller area, which means that each part of the head and each cell in the brain is getting more of the force of the impact. And that’s true for any kind of impact. A man’s head is just bigger and it can dissipate the force over a greater area.

Weaker muscles

The second reason why women might suffer more concussions or have worse symptoms is because we typically have weaker muscles. We have weaker neck muscles and weaker shoulder muscles. Again, when we have an impact on our head, our shoulders can’t absorb the impact as well as a man’s shoulders can. This is called the shoulder girdle.

Women also have weaker neck muscles. They are going to sustain a greater head-neck angular acceleration. Because of the weaker neck muscles, our head is going back and forth to a higher degree than a man’s head or the head of a person with stronger neck muscles.

Hormones

The third reason is what all women love to talk about: hormones. It turns out that when women are in the second half of their menstrual cycle, the estrogen is higher and the progesterone is rising.

If women are injured in the last two weeks of their cycle when progesterone is higher, that can lead to worse post-concussion symptoms compared to those of women who were injured during the first two weeks or who are on contraceptive pills that keep those levels a little bit more flat.

Women are more susceptible

Yes, unfortunately women are more susceptible to concussions and more susceptible to having more symptoms as well as to having those symptoms last longer.

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