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WASHINGTON – According to a team of Harvard researchers, former football players with more serious concussions were more likely to report erectile dysfunction and low testosterone than other players.
Former athletes were more likely to say that physicians had recommended or prescribed treatments for sexual health conditions if they had a higher "Concussion symptom score", a measure derived from self-reported head injury symptoms, such as dizziness and nausea, or if they reported more unconsciousness while playing football.
"We found a very strong association between the number of concussion symptoms and the likelihood that a former football player reported erectile dysfunction or low testosterone levels," Rachel Grashow, a researcher at T.H. of Harvard Chan School of Public Health and the lead author of the study, said in an interview. "As you increase the number of reported concussion symptoms, you will experience a subsequent increase in the risk of ED or low T. "
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This is the latest study on the long-term effects of football. However, most research on the impact of football on health has focused on future cognitive health problems, such as dementia and depression. The researchers said it was the first study to examine sexual health in a non-clinical setting among a large population of football players who have suffered repeated brain damage.
In the survey published Monday in JAMA Neurology, researchers used self-reported data on the treatment of erectile dysfunction and low testosterone in 3,409 former players. More than 18% of players reported low testosterone levels, 22.7% reported erectile dysfunction and both increased in association with head trauma. Less than 10% reported treatment for both symptoms.
Although the investigators did not directly attribute the association to a specific physical injury, the document cites pituitary damage often caused by major injuries, as likely responsible for related sexual health problems.
The association between the overall severity of concussions and unconsciousness remained strong even when researchers adjusted to external factors, including the footballer's specific position, body mass index, age, race and age. self-reported use of prescription or performance enhancing drugs.
Many previous studies have shown a link between brain trauma and sexual dysfunction. However, these studies were often linked to a single serious incident, such as a car accident or battlefield injury – and not football injuries that put comparatively less risk of death. The researchers also observed an association with sexual dysfunction, regardless of the number of brain injuries suffered by a football player.
"We found a statistically significant increase in the risk of low testosterone levels, even with a relatively low number of concussive symptoms reported," said Grashow, "suggesting that there might not be a number blows to the head without danger. "
Measuring the consequences of smaller concussions is also instructive in the context of previous research, said Dr. Daniel Daneshvar, a researcher at the Boston Center for Chronic Traumatic Encephalopathy, who conducted the first large-scale study on brain health among former NFL players. . Daneshvar has not been involved in Harvard research.
"We are seeing more and more that the repetitive number of impacts makes it easier to predict whether a person is developing. [chronic traumatic encephalopathy] as opposed to a limited number of more serious injuries, "said Daneshvar. CTE, a neurodegenerative disease that can affect mood and behavior, is one of the most studied health effects of football-related brain damage.
The study could also influence society's beliefs about the effects of football on health. The results of prolonged brain damage are normally considered to be related to depression, suicidality and dementia. The Harvard inquiry could broaden society's view that football-related brain injuries cause not only cognitive health problems, but also physical health problems, Daneshvar said.
"When we talk about CTE, we mainly talked about problems related to behavior, mood, cognition," he said. "But we know that traumatic brain injuries have associations with problems throughout your body. Numerous studies have shown that there is a link between pituitary problems and major traumatic brain injuries. "
The authors of the study cited many factors, including the use of self-reported health data rather than clinical assessments and potential memory bias, to recognize the limitations of the document.
However, Grashow and Danesvhar both stated that they considered the correlation to be stronger and more likely to be caused by a causal link, as it remained constant both for measuring the overall severity of concussions only for the reporting of incidents of blackout. According to Grashow, self-reported loss of consciousness events were probably distinct and memorable, and were therefore less subject to recall bias.
Overall, Grashow called the results "the most solid statistical relationship I have ever found in my career".
The finding, she said, could have profound implications in the real world, given the broader implications of sexual health on quality of life and the fact that they often presage more health problems. extensive.
"If you are a former player who has had a head injury and you have erectile dysfunction, talk to your doctor," said Grashow. "The hope is that we can eliminate some of the stigma associated with erectile dysfunction, whether it's a personal failure or a failure of masculinity – it's a real biological reason why you live this. "
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