690 FO53 – Tackling female health in rugby, one cycle at a time: the association between menstrual cycle regularity and concussion history

Abstract

<h3>Background</h3> Concussions are the most common injury in female rugby union. Due to the increased popularity of women’s rugby, it is important to ensure female-specific factors are considered, including the menstrual cycle. Function of the pituitary axes have been reported to be affected following concussion, which may contribute to irregular menses and greater concussion-like symptoms. <h3>Objective</h3> The objective of this study was to evaluate the association between previous concussion history and irregular menses in female rugby union players. <h3>Design</h3> Cross-sectional study within cohort studies. <h3>Setting</h3> Youth, varsity, and professional female rugby leagues in Canada, Ireland, and South Africa. <h3>Participants</h3> Female rugby players participating in one of two prospective cohort studies (Ireland, South Africa; ages 18–39 or Canada; ages 11–18) were included. <h3>Assessment of Risk Factors</h3> The association between self-reported previous concussion history (yes/no) and reports of irregular menses was evaluated using multivariable logistic regression (adjusting for cluster by team). <h3>Main outcome measurements</h3> Self-report of regular menses (yes/no). <h3>Results</h3> A total of 278 players [116 adolescents (median age=17.16; IQR:16.91–17.59)) and 180 adults (median age=18.97; IQR:18.47–19.50)] rugby players participated. A total of 99/278 players (33.56%) reported a previous concussion history and 53/278 (17.97%) reported irregular menses. In adult players, there was a 2.17-fold (95%CI 1.02–4.62) greater odds of reporting irregular menses in players with a previous concussion history relative to players without a previous concussion history. There was no difference in adolescent players [ORadolescent=0.56 (95% CI 0.15–2.13). <h3>Conclusions</h3> Adult rugby players with a concussion history have greater odds of reporting irregular menses. The relationship between menstrual cycle irregularity and concussion risk requires further evaluation using a prospective cohort design. These study findings highlight the importance of sex-specific considerations in concussion prevention and potentially recovery following concussion.