title: The impact of female reproductive function on outcomes after traumatic brain injury.
abstract: OBJECTIVE
  To determine the impact of traumatic brain injury (TBI) on female menstrual and reproductive functioning and to examine the relationships between severity of injury, duration of amenorrhea, and TBI outcomes.
  
  
  METHODS
  Retrospective cohort survey.
  
  
  METHODS
  Telephone interview.
  
  
  METHODS
  Women (N=30; age range, 18-45y), between 1 and 3 years postinjury, who had completed inpatient rehabilitation for TBI.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Data collected included menstrual and reproductive functioning pre- and postinjury, demographic, and injury characteristics. Outcome measures included the Glasgow Outcome Scale-Extended (GOS-E), the Mayo-Portland Adaptability Inventory-4 (MPAI-4), and the Medical Outcome Study 12-Item Short-Form Health Survey, Version 2 (SF-12v2).
  
  
  RESULTS
  The median duration of amenorrhea was 61 days (range, 20-344d). Many subjects' menstrual function changed after TBI, reporting a significant increase in skipped menses postinjury (P<.001) and a trend toward more painful menses (P=.061). More severe TBI, as measured by the duration of posttraumatic amnesia, was significantly predictive of a longer duration of amenorrhea (P=.004). Subjects with a shorter duration of amenorrhea scored significantly better on the SF-12 physical component subscale (P=.004), the GOS-E (P=.05), and the MPAI-4 participation subscale (P=.05) after controlling for age, injury severity, and time postinjury.
  
  
  CONCLUSIONS
  The severity of TBI was predictive of duration of amenorrhea and a shorter duration of amenorrhea was predictive of better ratings of global outcome, community participation, and health-related quality of life postinjury.
authors.affiliation: CNS Medical Group, Craig Hospital, Englewood, CO 80113, USA. dripley@craighospital.org
authors.forename: David L
authors.initials: DL
authors.lastname: Ripley
authors.forename: Cindy
authors.initials: C
authors.lastname: Harrison-Felix
authors.forename: Melissa
authors.initials: M
authors.lastname: Sendroy-Terrill
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Cusick
authors.forename: Amy
authors.initials: A
authors.lastname: Dannels-McClure
authors.forename: Clare
authors.initials: C
authors.lastname: Morey
mesh_terms: D000293:Adolescent; D000328:Adult; D000568:Amenorrhea / Q000209:etiology*; D001930:Brain Injuries / Q000150:complications*; D015331:Cohort Studies; D004412:Dysmenorrhea / Q000209:etiology; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008875:Middle Aged; D016016:Proportional Hazards Models; D012189:Retrospective Studies