Adolescent and young women may have increased chance of disrupted menstrual patterns following a concussion, according to new research led by the University of Pittsburgh Sports Medicine Concussion Program and Magee–Womens Hospital of UPMC Department of Obstetrics, Gynecology and Reproductive Sciences.

The results, published online by JAMA Pediatrics journal, suggest adolescent and young women have significantly increased risk for multiple, abnormal menstrual patterns following concussion compared to an orthopaedic injury.

“All concussions are different and some have emotional symptoms. Higher stress associated with the concussive injury may cause the body to respond in a particular way,” said senior author Anthony Kontos, PhD, research director at Pitt Sports Medicine Concussion Program. Symptoms like depression and anxiety may exacerbate the response.

The researchers analyzed 129 participants between the ages of 12 to 21 years – all with reportedly normal menstrual cycles prior to their injuries; 68 had endured a concussion and 61 presented with an orthopaedic injury. The patients were followed prospectively to monitor menstrual patterns for 120 days following their injuries. Approximately 45 percent of all patients had at least one abnormal bleeding pattern with no difference between the two groups. Of the 68 patients with a concussion, 24 percent had two or more abnormal menstrual bleeding patterns during the study period compared to 5 percent in the patients with orthopaedic injuries.

Lead author, Meredith Snook, MD, a reproductive endocrinology and infertility fellow at Magee–Womens Hospital of UPMC at the time of the study, recommends patients monitor menstrual patterns following injury regardless of severity.

“Abnormal menstrual patterns – especially over time – can impact overall health, so it is important for those providing care to adolescents and young women to ask about menstrual patterns and encourage menstrual cycle monitoring. Anything out of the ordinary should prompt referral to the appropriate clinician for evaluation and possible treatment,” said Dr. Snook.