Concussion tied to erectile dysfunction in former football players

  • Grashow R & al.
  • JAMA Neurol
  • 26 Aug 2019

  • International Clinical Digest
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Takeaway

  • Former football players with concussion symptoms during their career were more commonly recommended or prescribed testosterone or medications for erectile dysfunction (ED).

Why this matters

  • Long-term potential for pituitary insufficiencies and related problems among individuals experiencing head trauma.

 Key results

  • Prevalence of indicators:
    • Low testosterone indicator: 18.3%.
    • ED indicator: 22.7%.
  • In adjusted models, higher concussion symptom score was associated with increased odds of:
    • Low testosterone indicator (highest vs lowest quartile, OR, 2.39; P<.001>
    • ED indicator (highest vs lowest quartile, OR, 1.72; P<.001>
  • Findings similar among subgroups:
    • Men ≤50 years of age.
    • Men who last played ≥20 years before study.
  • Largest mediators of observed associations were current use of prescription pain medication, sleep apnea.

Study design

  • Cross-sectional cohort study of 3409 former professional football players (mean age, 52.5 years).
  • 10-item concussion symptoms score (e.g., loss of consciousness, disorientation, nausea, memory problems, dizziness at time of football-related head injury).
  • Main outcomes: self-reported recommendation or prescription for low testosterone, for ED medication.
  • Funding: Sidney R. Baer, Jr. Foundation; National Institutes of Health; others.

Limitations

  • Indicators were indirect measures.
  • Retrospective collection of concussion data.
  • Symptom scale has not been validated.
  • Temporal association unknown.

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