The effects of menstrual cycle phase on clinical measures of concussion in healthy college-aged females

J Sci Med Sport. 2009 May;12(3):383-7. doi: 10.1016/j.jsams.2008.05.003. Epub 2008 Sep 3.


The management of concussion and mild traumatic brain injury is an area of clinical uncertainty for many sports medicine professionals. While recent studies suggest sex differences in neurocognitive function may exist, our understanding of the effects of menstrual cycle phase and oral contraceptive pill (OCP) use in healthy females is limited. The purpose of this study was to investigate whether there were changes in neurocognitive function, postural stability and self-reported symptoms between the early and late stages of the menstrual cycle, and also to identify whether performance across menstrual cycle would differ between females using OCP and eumenorrheic females not using OCP. Healthy college-aged females completed a standard concussion test battery including computerised assessment of neurocognitive function, postural stability and symptom status. Participants completed the counterbalanced testing design during the early and late phases of their menstrual cycle. No significant main effects or interactions for any neurocognitive function or postural stability outcome measure were observed. Eumenorrheic females endorsed a higher number of symptoms and reported an increased symptom severity score compared to females using OCP. Menstrual cycle phase had no effect on the total severity or the number of symptoms endorsed. These results suggest preseason neurocognitive and postural stability baseline tests are stable across the menstrual cycle, regardless of OCP use. Therefore, decreased performance on these measures following a suspected concussion is likely not attributable to menstrual cycle phase or use of OCP.

Publication types

  • Clinical Trial

MeSH terms

  • Athletic Injuries / physiopathology*
  • Brain Concussion / physiopathology*
  • Cognition / physiology
  • Contraceptives, Oral / administration & dosage
  • Female
  • Humans
  • Menstrual Cycle / physiology*
  • Neuropsychological Tests
  • Postural Balance / physiology
  • Prospective Studies
  • Severity of Illness Index
  • Single-Blind Method
  • Young Adult


  • Contraceptives, Oral