How concussion affects female sexual and reproductive health


Over the last 20+ years, medical research about concussion (temporary unconsciousness or confusion caused by a blow to the head; also called “mild Traumatic Brain Injury”) has resulted in better treatment of and equipment for athletes and people who work in jobs where concussion is a risk.

In this country, however, most of the research is done on men.

That disparity doesn’t sit well with Dr. Martina Anto-Ocrah, a Reproductive Epidemiologist in Pitt’s School of Medicine.

“There is a great deal of research about concussion in men, especially young athletes,” says Dr. Anto-Ocrah. “That includes how concussion affects their sexual and reproductive health.”

She continues, “For example, we know that concussion has been associated with changes in sexual functioning in men. Because we know this, we can now try to understand why and how that happens; and develop ways to treat the dysfunction. However, there are very few of such studies on women — especially non-athletes.”

One of the first researchers in the U.S. to tackle this bias, Dr. Anto-Ocrah believes representation matters — especially in medical research. She and her colleagues set out to evaluate the impact of concussions on female sexual functioning.

After recruiting females visiting the Emergency Room for their research, and analyzing data on two types of patients — those needing concussion care and those needing care for other physical, non-head injuries — Dr. Anto-Ocrah found that those with concussions were 70% more likely to report sexual dysfunctions compared to their study counterparts.

“We’re talking about things like diminished desire and interest in sex, trouble having sex due to pain,  as well as decreased sexual pleasure; even changes in their relationship dynamics with their partners” Dr. Anto-Ocrah explains.

In her latest research, Dr. Anto-Ocrah and colleagues studied pregnancy and concussion, including what impact, if any, concussion has on a female’s reproductive health.


The team looked at the data of more than 240 women aged 18 to 45. Some had concussions and others had physical, non-head injuries.

“What we found is that women with concussions were 76% less likely to become pregnant than women in the other group,” Dr. Anto-Ocrah notes. “That includes taking into account things like obstetric history and  birth control use.”

This information, she feels, serves as a loud-and-clear call for researchers to do more studies on the long-term reproductive effects of concussion on women, including developing effective treatments.

Studying this data closely is validating for Dr. Anto-Ocrah personally as a researcher and as a woman. “Concussion can happen to anyone. Now women can go to their healthcare providers with proof that the pain they’re having during sex or the trouble their experiencing getting pregnant may be related to the fact that they’ve had a concussion,” she states. “The data demands we take their symptoms seriously.”

Why has it taken so long for the research to begin to catch up? “It goes back to social determinants of health,” she says. “In many countries, including my own birthplace in Ghana, West Africa, gender and socio-cultural norms around reproduction often determine one’s socio-economic status, and their access to healthcare.”

“Ghana is not that far from the United States (US). Women who live in underserved communities in the U.S. still find it difficult to access good healthcare simply because of the circumstances of where they’re born, live, and work.”

Dr. Anto-Ocrah also believes the unequal representation of female outcomes in this line of research has to do with the taboo of sexuality. “We need to treat women’s sexuality in the same way we treat men’s — as an essential part of our health as human beings.” 


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