Approximately 47% of collegiate and elite female athletes have reported the use of hormonal contraceptives (HC) (Beals & Hill, 2006). HCs provide high levels of synthetic estrogen and progesterone throughout the menstrual cycle, and have been demonstrated to improve verbal and fine motor memory tasks and increase reaction time (Garrett & Elder, 1984; Warren, 2014). The influence of HCs has yet to be demonstrated on the Immediate Post-Injury Assessment and Cognitive Test (ImPACT). The ImPACT is commonly used to return an athlete to play after a concussion. We examined the influence of HC use on pre-injury ImPACT performance. In a cross sectional study, 308 collegiate female athletes were divided into two groups based on whether they reported taking [HC+ (n=154)] or not taking [HC- (n=154) at the time of their pre-injury ImPACT. Independent t-tests were used to compare ImPACT outcome scores. HC+ participants were observed to have higher visual motor speed scores and faster reaction times. Our results suggest HCs introduce systemic error that may influence ImPACT performance. Clinicians must consider the role of HCs when interpreting post-injury outcome scores.
