Menstrual Phase and Sexual Dysfunction After Concussion in Women

女性脑震荡后的月经期和性功能障碍

• 批准号: 10369768
• 负责人: Martina Anto-Ocrah
• 金额: $ 3.63万
• 依托单位: UNIVERSITY OF ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-21 至 2021-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10369768
• 关键词: Accident and Emergency department; Acute; Affect; Age; Arousal; Biological; Biological Markers; Brain Concussion; Brain Injuries; Caring; Clinical; Consequentialism; Development Plans; Disease; Drops; Emergency department visit; Emotional; Epidemiologist; Epidemiology; Female; Goals; Health; Hormonal; Human; Hypothalamic structure; Injury; Measures; Menstrual cycle; Mental Health; Mentors; Mild Concussions; Minority; Morbidity - disease rate; National Institute of Neurological Disorders and Stroke; Neurology; Outcome; Participant; Pathology; Patient Self-Report; Patients; Phase; Physiological; Pituitary Gland; Post-Concussion Syndrome; Premenopause; Progesterone; Progestins; Prospective cohort; Public Health; Quality of life; Questionnaires; Recovery; Reporting; Reproductive Health; Research; Research Project Grants; Research Proposals; Risk; Serum; Sex Behavior; Sex Differences; Sex Functioning; Sexual Arousal; Sexual Dysfunction; Sexuality; Source; Subgroup; Surveys; Symptoms; Testing; Time; Training; Withdrawal; Woman; Women' s Group; Women' s Health; World Health Organization; affective disturbance; base; birth control; bridge program; career; career development; clinical care; cohort; concussive symptom; design; digital; experience; follow-up; functional decline; high risk; high risk population; improved; injured; interest; limb injury; men; mild traumatic brain injury; novel; patient subsets; physical conditioning; proliferative phase Menstrual cycle; psychologic; recruit; reproductive; reproductive epidemiology; response; risk stratification; satisfaction; sex; sexual encounter; steroid hormone; tool; trauma centers

Emerging research suggests that changes in sexual functioning after concussion/mild traumatic brain injury (mTBI) are common in women of reproductive age (18-45years). Findings from my pilot research show that 61.3% of women who sustain a concussion report sexual dysfunctions (SD)-defined as disordered sexual interest, desire, arousal or satisfaction-compared to 40% of extremity injured controls of similar menstrual and birth control status. Although concussion symptoms typically resolve within weeks, this line of research demonstrates that for a subgroup of patients, symptoms can linger into months if not years, and can adversely affect an important, yet understudied, aspect of women’s health and function. Human sexuality, according to the World Health Organization (WHO), is an essential aspect of health, a central aspect of “being human.” Poor sexual functioning assumes pathology in the experience of sexual arousal, interest, desire and response, and it has been associated with adverse physical and mental health. It is a marker of quality of life (QOL). In order to decrease the public health burden of mTBI and improve the clinical care of women with concussion, research is needed to identify women at greatest risk for post- concussion SD. Understanding sex-difference in TBI outcomes and the unique challenges faced by women with TBI is a priority for the Neurology’s National Institute of Neurological Disorders and Stroke (NINDS). This K01 application proposes a research plan that incorporates hormonal biomarkers as a novel risk stratification tool to identify high risk groups of female concussion patients. Study participants will use the Ovia® digital reproductive health tracking application (app) and other validated questionnaires to document their sexual activities and relevant covariates. In Aim 1 we test the hypothesis that compared to women with extremity injuries, concussed women will a) have a lower mean score on the BIQS measure of sexual function and b) have fewer sexual encounters reported with Ovia app, evaluated at 1& 3-months post-injury. In Aim 2 we test if women with mTBI injured during the luteal menstrual phase will have a higher risk of SD than women with mTBI injured during the follicular menstrual phase (lower mean score on BIQS and fewer sexual encounters with app); and if the magnitude of the association will be significantly higher for women with mTBI than for women with extremity injuries. I will receive mentoring, career advising and training to develop an independent research program that bridges my epidemiologic skillset with my interests in neurology and reproductive epidemiology.

新的研究表明，脑震荡/轻度创伤性脑损伤后性功能的变化 （mTBI）常见于育龄妇女（18- 45岁）。我的试点研究结果表明， 61.3%遭受脑震荡的女性报告性功能障碍（SD）-定义为性功能障碍 兴趣，欲望，唤醒或满意度-相比之下，40%的肢体受伤的控制类似的月经和 节育状况虽然脑震荡症状通常在几周内消退，但这一系列研究表明， 表明，对于一个亚组的患者，症状可以持续数月，如果不是几年， 影响到妇女健康和功能的一个重要但研究不足的方面。 根据世界卫生组织（世卫组织）的说法，人类性行为是健康的一个重要方面， 是“做人”的核心。性功能不佳在性经验中表现为病理学。 唤醒、兴趣、欲望和反应，它与不良的身心健康有关。它 是生活质量（QOL）的标志。为了减少mTBI的公共卫生负担， 对于脑震荡妇女的临床护理，需要进行研究，以确定最有可能发生脑震荡的妇女。 震荡SD。了解TBI结果的性别差异以及女性面临的独特挑战 TBI是神经病学国家神经疾病和中风研究所（NINDS）的优先事项。 该K 01申请提出了一项研究计划，将激素生物标志物作为一种新的风险 分层工具，以确定高风险群体的女性脑震荡患者。研究参与者将使用 Ovia®数字生殖健康跟踪应用程序（应用程序）和其他经过验证的问卷，以记录 他们的性活动和相关的协变量。 在目标1中，我们检验了这样一个假设，即与肢体受伤的女性相比，脑震荡的女性会： 在BIQS性功能测量中平均得分较低，B）性接触较少 使用Ovia应用程序报告，在损伤后1和3个月进行评估。 在目标2中，我们测试在黄体期月经期mTBI损伤的女性是否具有更高的SD风险 在卵泡期月经期mTBI损伤的女性（BIQS平均评分较低， 与应用程序的性接触）;如果关联的程度将显着高于女性， mTBI比四肢受伤的女性。 我将接受指导，职业咨询和培训，以制定一个独立的研究计划， 将我的流行病学技能与我对神经病学和生殖流行病学的兴趣联系起来。