In the US, it’s estimated that 16% of males live with a traumatic brain injury, also known as a TBI (Kleffelgaard et al., 2018). Although TBIs can stem from any number of traumatic impacts to the head and body, a strikingly large percentage of TBIs sustained in youth are incurred during contact sports, particularly American football. Considering that TBI symptoms generally worsen with time the prevalence of TBIs is a cause of concern that’s worth investigating.
However, the impact of TBI, particularly in the context of sports-related concussions, extends far beyond just neurological symptoms. In her article, Dr. Foeking examined the effects of mild TBI on male rats' vestibular function and testosterone levels. Her results showed a significant worsening in vestibular function post-injury, and importantly, TBI was found to lower testosterone levels in rats. These findings from Dr. Foecking's study draw attention to an ongoing aspect of TBI research, which examines how brain injury can impact men’s sexual health.
A potential result of sustaining a TBI is Chronic Traumatic Encephalopathy or CTE. This is a progressive degenerative disease that is commonly found in athletes in contact sports, particularly ones that involve frequent or repeated head injuries such as American Football. The symptoms of CTE include aggression, memory loss, confusion, and eventually dementia. As a result, the topic of CTE has had the spotlight in the media in the past 20 years as we have only just begun to learn the severity of its impacts. However, the connection between CTE and male testosterone levels hasn't been elucidated clearly. An article published by Reuters titled “Football concussions tied to middle-age erectile dysfunction” explores the unexpected side effects of football-related brain injuries on men's sexual health. The article discusses a Harvard research study that recruited 3409 former NFL players with a history of multiple concussions. These participants were asked about the severity of their concussion symptoms, their medication history, and their sexual health. Some of the participants self-reported CTE while other participants did not. It was found that those reporting CTE had more comorbidities on average, including low testosterone. Across the participants, 18.3% had low testosterone levels and 22.70% suffered from erectile dysfunction. A correlation between the number of reported concussion symptoms and low testosterone levels/erectile dysfunction was found. The players who reported the highest number of concussion symptoms were 72% more likely to experience ED and 2x as likely to report low testosterone than those who reported few symptoms. Even after adjusting for factors such as age and medication, the results remained significant.
Overall, this study provides valuable insight linking TBIs to hormonal imbalances and sexual dysfunction in men. Although the association between TBIs and low testosterone is becoming increasingly recognized, the neural mechanisms implicated remain poorly understood. Future research investigating neural factors in TBI-related sexual dysfunction will be crucial for developing interventions aimed at improving the lives of those affected by TBIs.
Sources:
Grashow R, Weisskopf MG, Miller KK, et al. Association of Concussion Symptoms With
Testosterone Levels and Erectile Dysfunction in Former Professional US-Style Football
Players. JAMA Neurol. 2019;76(12):1428–1438. doi:10.1001/jamaneurol.2019.2664
“Football concussions tied to middle-age erectile dysfunction.” Thomson Reuters, Reuters, 28
Aug. 2019, www.reuters.com/article/idUSKCN1VI2KZ. Accessed 1 May 2024.
I. Kleffelgaard, et al., The effects of vestibular rehabilitation on dizziness and balance problems
in patients after traumatic brain injury: a randomized controlled trial, Clin. Rehabil. 33
(1) (2019) 74–84.
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