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Dr. Amy Wagner discusses sex, hormone physiology, & hypogonadism after TBI.

Educational objectives:

Upon completion of this activity, participants should be able to:

  • Review neuroprotective mechanisms of action for gonadal and adrenal hormones after TBI as outlined from experimental literature and how this literature contrasts with endogenous serum profiles observed in clinical populations with TBI.
  • Describe pituitary gonadotrophin hormone profile changes that occur acutely and chronically after severe TBI and state an appropriate time window in which gonadal hormones and gonadotrophins can be checked to screen for persistent hypogonadotropic hypogonadism after severe TBI
  • Delineate relationships between persistent hypogonadotropic hypogonadism, demographic factors, and long term outcomes.

Reading Resources:

  1. Wagner AK., McCullough EH., Niyonkuru C., Ozawa H., Loucks T., Dobos JA., Brett CA., Santarsieri M., Dixon CE., Berga S., Fabio A.  Acute Serum Hormone Levels: Characterization and Prognosis after Severe Traumatic Brain Injury. J. Neurotrauma. June 2011, 28(6): 871-888. PMID: 21488721.
  2. Wagner AK,  Brett CA., McCullough EH., Niyonkuru C., Loucks T., Dixon CE., Ricker JH., Arenth PM., Berga SL. Persistent Hypogonadism Influences Estradiol Synthesis, Cognition and Outcome in Males after Severe TBI.  Brain Inj. 2012; 26(10):1226-42. PMID: 22571223.
  3. Rosario ER, Aqeel R, Brown MA, Sanchez G, Moore C, Patterson D. Hypothalamic-Pituitary Dysfunction Following Traumatic Brain Injury Affects Functional Improvement During Acute Inpatient Rehabilitation.  J Head Trauma Rehabil. 2012 May 18. [Epub ahead of print] PMID: 22613945.
  4. Wilkinson CW, Pagulayan KF, Petrie EC, Mayer CL, Colasurdo EA, Shofer JB, Hart KL, Hoff D, Tarabochia MA, Peskind ER.   High prevalence of chronic pituitary and target-organ hormone abnormalities after blast-related mild traumatic brain injury.  Front Neurol. 2012 Feb 7;3:11.
  5. Ripley DL, Harrison-Felix C, Sendroy-Terrill M, Cusick CP, Dannels-McClure A, Morey C.  The impact of female reproductive function on outcomes after traumatic brain injury.  Arch Phys Med Rehabil. 2008 Jun;89(6):1090-6. PMID:  18503804.
  6. Agha A, Rogers B, Mylotte D, Taleb F, Tormey W, Phillips J, Thompson CJ.  Neuroendocrine dysfunction in the acute phase of traumatic brain injury.  Clin Endocrinol (Oxf). 2004 May;60(5):584-91. PMID: 15104561


Dr. Wagner has no relevant relationships with any entities producing health care goods or services.

Accreditation Statement:

The University of Pittsburgh School of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The University of Pittsburgh School of Medicine designates this enduring material for a maximum of 0.75 AMA PRA Category 1 CreditsTM. Each physician should only claim credit commensurate with the extent of their participation in the activity. Other health care professionals are awarded (0.075) continuing education units (CEU) which are equivalent to 0.75 contact hour.

For your credit transcript, please access our website 4 weeks post-completion at and follow the link to the Credit Transcript page. If you do not provide the last 5 digits of your SSN on the next page you will not be able to access a CME credit transcript. Providing your SSN is voluntary.

Release Date: 12/5/2013 | Last Modified On: 3/20/2015 | Expires: 3/21/2015

This course has been expired.