“WOMEN’S ISSUES IN BRAIN INJURY” February 24, 2010

The long-term health of women with brain injuries, and disabilities in general, is not as researched as well as might be thought. There has been more research in traumatic brain injury (TBI) involving men than women. There are more questions than answers in helping women specifically, in dealing with a brain injury.

Women constitute only about 20% of person with TBI (here at OWL, 45% of our Persons Served in 2007-2008 were women). Women with TBI tend to be older and are less likely to have private insurance, an arrest history, or pre- and post-injury employment. Women are more likely than men to receive a brain injury as the result of domestic violence. For women who are battered, assault is not a one-time occurrence, and the cumulative effect of even mild injuries can result in more significant impairment over time.

An organization called “Women Living with the Consequences of Brain Injury” have led discussion as to the particular issues that women face post-brain injury and the research that needs to be done to determine the relative impact of brain injury on women specifically.

We need information on how to handle the emotional lability that often accompanies TBI. Are women’s moods more volatile? Are depression and anxieties harsher as the result of TBI and its interactions with naturally fluctuating hormones?

Women are more likely the axis around which a family revolves. What is beneficial and what isn’t in helping women cope with the role changes that occur when an individual has sustained an injury? Divorce rates are high post-injury, particularly among couples in which the wife sustained the injury. What is happening to women post-injury? How do women resume their roles as mothers? Women are more likely than men to assume the role of caregiver for individuals who have sustained a TBI – what are the effects of caregiver stress for women?

Women’s sexuality has been an issue where rehabilitation professionals tread lightly. More discussion of sexuality post-injury has been on men’s sexual functioning than women’s. The issues of sexuality that women deal with post-injury include:

Difficulties influencing sexual energy, desire and drive
Reduction in sensation and orgasm
Problems with positioning, movement and pain
Changed body image, self-confidence and mood
Decreased ability to sexually satisfy a partner
Society’s “desexualization” of men and women with disabilities
Can and should women become pregnant? And if yes – what is the safest way to carry a baby to term?

Women are more likely than men to be victims of sexual abuse in general. We need to be very mindful, even more mindful than with men, as to sexual abuse post-injury.

In menopause, how do women cope with hormonal changes and their interaction with an already compromised system? What is the course of menopause in women with TBI?

Are women more prone than men post-injury to arthritis and osteoporosis?

Do women respond differently to medication after injury?

A recent consensus panel on TBI convened by The National Institutes of Health (NIH) clearly indicated that women with TBI need more attention. While women constitute a smaller percentage of those with TBI, the issues facing women need to be researched more thoroughly, and optimal care given to these specific issues that women with TBI deal with.