rugby risks

[mumofchris]

I'm shocked at a glaring omission in yesterday's Telegraph. There's an article headed WHAT CONCUSSION CAN DO TO YOU where the symptoms are listed - headaches or dizziness, difficulty concentrating or remembering, anxiety, low mood, fatigue and difficulty sleeping. But what isn't listed is the worst symptom of all! That is, for anyone wanting to be a grandparent. LOSS OF LIBIDO! Don't parents need to know that getting concussed in rugby might make their son impotent?

If anyone wants to check this, it's in the Handbook of Clinical Neurology, Vol. 158 (3rd series), Christopher Giza et al and the relevant text is:

PITUITARY DYSFUNCTION
IN MALE ATHLETES
Common postconcussion symptoms include: memory
and concentration deficits; impaired judgment, decision
making, and problem solving; depression, anxiety,
fatigue, and malaise; and loss of libido (Bigler, 2008;
Kinnunen et al., 2011; Scherwath et al., 2011

Righto.

I’m not a parent but if I had a son aI’d care more about his health and wellbeing than getting grandchildren.

For all the risks in rugby this is a weird take.

OP missed out the rest of the paragraph:

All of these symptoms overlap with those reported by patients with hypopituitarism, and thus may be due to endocrinologic deficits rather than the TBI itself (Bavisetty et al., 2008).

Essentially, in around 20% of cases, concussion (and particularly a severe concussion) can lead to chronic hypopituitarism. This can be readily treated, so routine pituitary hormonal testing within 6 months of injury should be carried out.

https://www.sciencedirect.com/science/article/abs/pii/B9780444639547000069

TBH, I’m more concerned about the need for more research into concussion in females.

Bit weird? Not really my top worry when I think about concussion.

Bit weird OP.

Poor chris

You're 'shocked' at this omission, are you? Right.

That goes without saying. Of course you want them to be healthy. But being impotent is a terrible undermining thing for a man's self esteem. It IS a risk that parents should be told about.
I speak personally here, because our son had a head injury when he was seven - not a concussion, it was worse than that - and it had this effect on him, and he committed suicide when he was 31. Apparently head injury can do this to you, even mild head injury like concussion, and we didn't know. If we had known, perhaps he would be alive now.

Sabrina, I'm so glad you are aware of this. Yes, people should be routinely tested for hypopituitarism and by and large they aren't. The hormone most commonly affected is growth hormone, and it needs dynamic testing (insulin stress test, glucagon stimulation test, GHRH+arginine test) but consultants give all kinds of reasons not to do this. Is it that giving replacement GH for the rest of the person's life is expensive?

And yes, I agree with you about the risk to females. The research does already exist - eg https://jamanetwork.com/journals/jama/fullarticle/208915 (a systematic review by Schneider into hypopituitarism after head injury of all degrees of severity)

@mumofchris I’m very sorry to hear about your son

Research into head injury in women’s sport is still limited - it’s known that women suffer more significant effects of head injuries but it’s still under reported and under studied.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7366411/

@mumofchris 💐

But I couldn't stop my 20 year old son playing rugby even with those risks, the enjoyment / physical activity / social side - especially as a uni student - are extremely big factors for him.

Thanks Sabrina that's really helpful and interesting. I have just skimmed through the research so far but will read it properly later. A lot of it I had no idea about.

Yes it's very difficult to get a ds to take any notice of warnings about future risks when all they see is the immediate benefit. All I would say is that if he (hopefully not) ever gets symptoms of depression and fatigue and weight gain, even years later, it would be good to get him checked out for hypopituitarism, (See Sabrina's post). The GP will do checks on most of the hormones (LH/FSH, thyroid stimulating hormone, T4, prolactin, ACTH, anti-diuretic hormone) - the easy, cheap ones, but you have to push to get the proper dynamic tests for growth hormone deficiency and cortisol deficiency. Very detailed information for a remote eventuality! But someone else may read this, so I'm putting it all down. And while I'm about it never let a consultant fob you off with the short synacthen test or the IGF-1 levels . . .

I mean.

my relative was a pro rugby player & has been diagnosed with motor neurone disease…

I think impotence would be the least of my worries

Also worth having a listen here (Woman’s Hour 7th Jan 2020) with Dr Willie Stewart talking about TBI in women. Starts at about 10.00 minutes in.

https://www.bbc.co.uk/sounds/play/m000d1z1

That's terrible, I'm so sorry.

Bother, I meant to message that to Sauvblanctime!
Thanks for the Woman's Hour link, I'm listening to it now.

Sabrina Thwaite

I've listened to it now - very important for teenage girls to know about this danger (well, any age really, but girls at school all have to do sport).

Could I ask what triggered your interest in concussion in women? I hope you haven't had one yourself.

@mumofchris Not that I can recall, but I heard the Woman’s Hour interview and it really got me thinking about how much research is centred on males and how women slip under the radar because we don’t present or respond in the same way (heart attacks for instance).

Invisible Women is quite an eye opener.

https://carolinecriadoperez.com/book/invisible-women/

Well, I may read that after Christmas. At the moment I'm reading a spy thriller (all male cast so far, naturally) . . .