How Women’s Concussions Differ Biologically from Men’s

Research shows that women and girls are up to twice as likely to suffer a concussion as their male counterparts when playing the same sports under the same rules. They also tend to report more symptoms and experience longer recovery times. Despite this, gender differences in concussion remain underrecognized in both clinical guidelines and research.

Biological Factors Behind Increased Risk and Severity

Several biological differences contribute to why females may be more susceptible to concussion and experience worse outcomes. These include variations in neck strength, head size, and hormonal influences that affect brain function and injury response.

Studies indicate that approximately 80% of participants in key concussion research are male, and 40% of studies exclude women entirely. Only 1% of research focuses exclusively on female athletes, according to a review published in the British Journal of Sports Medicine. This lack of representation has limited understanding of how sex differences influence concussion risk and recovery.

Symptom Reporting and Recovery Patterns

In the acute phase following a mild traumatic brain injury (mTBI), women consistently report more symptoms than men. Meta-analyses of TBI studies show that 60% of published research found worse outcomes in women compared to men, although only 9% reported better outcomes in women.

Common concussion symptoms include headache, dizziness, memory disturbance, and balance problems. Loss of consciousness occurs in only about 10% of cases. Despite these patterns, many return-to-play guidelines do not account for sex-based differences in symptom duration or severity.

Gaps in Guidelines and Research

A recent guide to recognizing and managing concussion in grassroots sport, issued by the Minister for Public Health in March 2026, made no reference to gender differences. It focused only on children and young people as potentially higher-risk groups. While the guideline’s core message of “if in doubt, sit them out” applies universally, the omission of sex-specific considerations overlooks growing evidence of biological disparities.

Experts emphasize that increasing female participation in concussion research is essential to developing more effective, individualized approaches to prevention, diagnosis, and management.

Conclusion

Women face a disproportionate burden when it comes to concussion risk and recovery due to a combination of biological factors and historical underrepresentation in research. Addressing these disparities requires targeted studies, inclusive guidelines, and greater awareness among coaches, clinicians, and athletes. As research evolves, recognizing how sex influences concussion outcomes will be key to improving care for all individuals affected by this common injury.