Photo: Sex & Gender and TBI

Sex & Gender and TBI

This section provides some information on brain injury in women. Men are more likely to experience brain injury overall and as such much research has focused on men and not exclusively on women. While there is a growing amount of research that has identified that girls/women may experience brain injury differently, we are still in the very early stages of trying to understand how brain injury may affect men and women differently and the research is not always consistent.

In research on concussion, it has been found that girls/women have on average a longer recovery time and may experience more severe symptoms.1 Girls/women were also found to have more neck injuries with their concussions than boys/men during the reproductive years.2 They are also more likely to experience challenges maintaining mental health that may put them at risk of a longer recovery time.3

It has also been found that menstrual cycle changes are not uncommon after a brain injury which could be due to the injury to the brain or other challenges that may occur along with the brain injury.1 Research has also identified that after a brain injury, women may have fewer births and more postpartum problems than women without a brain injury.4 Brain Injury may be affected by physiological factors such as different hormones, pain receptors, and brain structure. For instance, it has been found that females have nerve fibres in the brain which are more likely to break than those in male brains.5 Also, females have weaker neck muscles which make it harder for them to withstand a blow to the head.

As well as physiological, there are social/societal factors that may explain why women and men experience brain injury differently. For instance, women have reported not being believed by health care providers with respect to their symptoms which could be because the injury may look different among girls/women.6 7 Also, while women may be more likely to seek care for health problems under other circumstances,8 in the case of intimate partner violence, many women do not seek care for their brain injury when it occurs for a variety of reasons. They may not realize it could have happened, they may not be able to go to the hospital or their doctor, or they may not feel safe disclosing the violence at all.9 10

Some of these issues are explained in the video below. More information can also be found at the Public Health Agency of Canada's website, Applying GBA+ to Concussion Prevention and Treatment.

  • The Role of Sex and Gender in Traumatic Brain Injury

References

  1. Valera EM, Joseph A-LC, Snedaker K, et al. Understanding Traumatic Brain Injury in Females: A State-of-the-Art Summary and Future Directions. The Journal of Head Trauma Rehabilitation 2021;36(1)
  2. Sutton M, Chan V, Escobar M, et al. Neck Injury Comorbidity in Concussion-Related Emergency Department Visits: A Population-Based Study of Sex Differences Across the Life Span. Journal of Women's Health (2002) 2019;28(4):473-82. doi: 10.1089/jwh.2018.7282 [published Online First: 2018/12/29]
  3. Mikolić A, van Klaveren D, Groeniger JO, et al. Differences between Men and Women in Treatment and Outcome after Traumatic Brain Injury. Journal of Neurotrauma 2021;38(2):235-51. doi: 10.1089/neu.2020.7228 [published Online First: 2020/08/26]
  4. Colantonio A, Mar W, Escobar M, et al. Women's health outcomes after traumatic brain injury. Journal of Women's Health 2010;19 6:1109-16.
  5. Dollé JP, Jaye A, Anderson SA, et al. Newfound sex differences in axonal structure underlie differential outcomes from in vitro traumatic axonal injury. Experimental Neurology 2018;300:121-34. doi: 10.1016/j.expneurol.2017.11.001 [published Online First: 2017/11/07]
  6. Hanafy S, Amodio V, Haag H, et al. Is it prime time for sex and gender considerations in traumatic brain injury? Perspectives of rehabilitation care professionals. Disability and Rehabilitation 2020:1-9. doi: 10.1080/09638288.2020.1774670
  7. Haag HL, Caringal M, Sokoloff S, et al. Being a Woman With Acquired Brain Injury: Challenges and Implications for Practice. Archives of Physical Medicine and Rehabilitation 2016;97(2 Suppl):S64-70. doi: 10.1016/j.apmr.2014.12.018 [published Online First: 2015/02/11]
  8. Thompson AE, Anisimowicz Y, Miedema B, et al. The influence of gender and other patient characteristics on health care-seeking behaviour: a QUALICOPC study. BMC Family Practice 2016;17(1):38. doi: 10.1186/s12875-016-0440-0
  9. Dams-OʼConnor K, Cantor JB, Brown M, et al. Screening for traumatic brain injury: findings and public health implications. The Journal of Head Trauma Rehabilitation 2014;29(6):479-89. doi: 10.1097/htr.0000000000000099 [published Online First: 2014/11/06]
  10. Ivany AS, Bullock L, Schminkey D, et al. Living in Fear and Prioritizing Safety: Exploring Women's Lives After Traumatic Brain Injury From Intimate Partner Violence. Qualitative Health Research 2018;28(11):1708-18. doi: 10.1177/1049732318786705 [published Online First: 2018/07/22]