Every TBI is different, and every woman's health journey is shaped by unique genetics, co-morbidities, and challenges. This is mine, and what I wish I'd known earlier.
What the research says
Brain injury doesn't just affect memory or concentration. It can also disrupt the pituitary gland, the "master gland" that regulates hormones affecting reproduction, thyroid function, metabolism, stress, and mood.
Studies suggest that around one in three people with TBI develop some form of pituitary dysfunction. Women with concussions are especially vulnerable to hormone imbalances in reproductive and thyroid systems.
For women, this can show up as irregular cycles, worsening PMS or PMDD symptoms, thyroid dysfunction, mood instability, and a body that feels constantly out of sync, symptoms that are easy to dismiss as "just hormones" or "just depression" rather than consequences of brain injury.
The hormones most commonly affected
Research identifies several hormonal pathways that can be disrupted following TBI:
- Growth hormone, the most commonly affected, often leading to fatigue, poor recovery, and changes in body composition
- Reproductive hormones, disruptions to LH and FSH can affect cycle regularity, fertility, and symptoms of conditions like PMDD and endometriosis
- Thyroid hormones, low thyroid function post-TBI can cause weight changes, fatigue, brain fog, and low mood
- Cortisol, the stress hormone; dysregulation makes managing daily demands and recovery harder
These issues are frequently missed because their symptoms overlap with depression, anxiety, perimenopause, and the general experience of "not feeling well" after a brain injury. Asking specifically for hormone panels, thyroid checks, and cortisol testing is worth pushing for.
Ally's experience
Eight concussions, adenomyosis, PMDD, and finally some answers
In 2025, at age 40, I had a hysterectomy and oophorectomy to treat adenomyosis and PMDD. It was the end of a very long chapter, and the start of a new one.
Alongside these conditions, I've lived with the impact of eight concussions, starting at age 12 during puberty, and a life-changing one at 30 that left me with a permanent TBI affecting many body systems. Looking back, the two storylines were always connected. I just didn't have the framework to understand that until much later.
Through my teens and twenties I experimented with contraceptives, but nearly every hormonal option worsened my mood or triggered extreme side effects. After the birth of my son at 21, I struggled with postnatal depression. By my mid-twenties I was asking doctors about a hysterectomy and being told I was "too young" or that I might "change my mind."
In my thirties, concussions and women's health challenges began to collide. My sixth concussion at 30 was my most severe, leaving me with lasting cognitive issues. Meanwhile, my periods remained heavy and painful, and my mood increasingly unpredictable. Entering perimenopause amplified everything: PMDD symptoms worsened to the point of another crisis, days lost to painkillers and bed rest, and cycles of mood swings that made even basic tasks overwhelming.
One of the strangest things was the contrast. I could feel like a capable, motivated, vibrant woman for part of the month, only to flip into exhaustion, uncontrollable crying, severe pain, and a deep loss of self. That unpredictability made it hard to manage relationships, work, and even just know who I was.
Things that have helped me
- Regular gentle exercise, even a walk around the block counts
- An anti-inflammatory diet
- Meditation and time in nature
- Talk therapy to understand thought patterns and belief systems
- A solid support network of family and friends
- Cacao and maca drinks that supported my overall health
- Hormone-balancing supplements
- Mugwort tea for cramps during my cycle
Following the surgery I've started Estradiol patches and I'm excited about what comes next. The connection between my TBI and my hormonal health was something I had to piece together myself over years. I hope you don't have to wait as long.
Further reading
Pituitary dysfunction following mild TBI in female athletes
Even mild concussions can disrupt pituitary hormones. Around 12% of women in this study had dysfunction.
Read on PubMed Central →Acute and chronic hypopituitarism following traumatic brain injury
A meta-analysis showing pituitary hormone problems are common both right after injury and months or years later.
Read on PubMed Central →Traumatic Brain Injury as Frequent Cause of Hypopituitarism
Growth hormone deficiency is the most common long-term effect of TBI, and often overlooked.
Read on Frontiers in Endocrinology →Endocrine Dysfunction After TBI: An Ignored Population
Estimates around one-third of people with TBI have some pituitary dysfunction.
Read on Springer →