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In the two years after a concussion, women are less likely to become pregnant than women who injure other parts of their body.

To study the effects of concussion on pregnancy, at the University of Rochester in New York and her colleagues recruited 102 women with concussion and 143 women who had other injuries that required a visit to an emergency room in Rochester, New York.

The participants were all aged between 18 and 45 and those with concussion all had head injuries from vehicle crashes. Those without concussion were only recruited if they had an injury serious enough to warrant an X-ray but hadn鈥檛 broken any bones. 鈥淲e wanted there to be a psychological parallel between these injuries and those who had suffered a concussion,鈥� says Anto-Ocrah.

No participant had a history of being subject to domestic violence, so the researchers could focus on what effect a single injury may have on fertility.

The team found that across the 24 months after injury, concussed women had a 76 per cent lower rate of pregnancy than the study鈥檚 other participants, even when taking into account a person鈥檚 ethnicity, education, use of birth control and obstetric history.

Those who reported sexual dysfunction six to 10 weeks after their concussion had an 84 per cent lower pregnancy rate.

鈥淚 was not surprised by the results,鈥� says Anto-Ocrah. 鈥淲e know that concussions affect menstruation and can cause sexual dysfunction in some women 鈥� it only makes sense that this would affect pregnancy rates also.鈥�

She says there may be several reasons. 鈥淭here鈥檚 definitely a big psychosocial dimension,鈥� she says, noting that concussion can lead to depression and make people less likely to want to be intimate with someone.

But beyond that, concussion can also affect hormones key to pregnancy. 鈥淲hat happens is that hormonal regulation gets a little bit wonky,鈥� says Anto-Ocrah. 鈥淵our progesterone and oestrogen levels get dysregulated, for example.鈥�

The researchers didn鈥檛 consider whether the women intended to get pregnant in the first place, and Anto-Ocrah says the next step is looking specifically at this in people who also suffer a concussion.

at the University of Pittsburgh in Pennsylvania says the lack of accounting for intent to become pregnant is a limitation, but nevertheless says 鈥渢he findings support the potential impact of concussion on female reproductive health outcomes鈥�.

鈥淢oving forward, researchers should examine other factors that might be associated with the reported relationship between concussion and pregnancy such as psychological stressors, as well as the timing of concussion with regard to age and hormone cycles,鈥� he says.

Anto-Ocrah says a lot of the issues that women face after a concussion are probably overlooked, and that there is a taboo about discussing any effects on sex lives after such incidents. 鈥淚t sounds frivolous to complain about it after you鈥檝e had a major head injury,鈥� she says. 鈥淚鈥檝e had women email me to say they have throbbing headaches when they orgasm several months after getting a concussion.鈥�

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