WASHINGTON (Reuters) - Olympic figure skating champion Sarah Hughes vividly recalls falling on her head in practice and suffering her first concussion.
"They carried me off the rink and then I threw up," the 29-year-old Hughes, the 2002 Olympic champion said, her deep blues eyes widening. "We knew something was wrong. It was really, really scary. Incredibly frightening. I was just 11."
While men's contact sports like football and ice hockey are most associated with concussions, women actually have them much more often than men, said Dr. Robert Stevens, an associate professor at Johns Hopkins University School of Medicine who specializes in brain injury.
He also said new studies suggest the concussion symptoms in women are also more acute than those suffered by men.
"The incidence of concussions in sports is higher in women than in men, possibly two times higher," he said, adding that concussions in women tend to be "more severe" and it takes women longer to recover than men.
Stevens cautioned, however, that results may be skewed by "reporting bias." He said some researchers believe that the number of concussions in men is "vastly underreported" because they want to remain on the field, while women are generally more apt to report a concussion.
The National Football League is expected to pay out about $1 billion when a lawsuit by ex-players who suffered concussion-related brain damage is settled in court. But it's not football that is producing the most concussions.
Percentage-wise, women's soccer and basketball rank the highest in terms of concussion-inducing sports, followed by football and men's soccer, said Stevens.
The rules in certain sports, like soccer, "need to be reviewed," he said.
Two-time Olympic soccer champion Angela Hucles never suffered a concussion because, she believes, she learned from her father to go up for a header with her arms out to protect herself from banging heads with an opponent.
Hucles said headgear for soccer players has been around for years but never gained traction.
"There should be headgear out there on the market, especially for children, because it's just another way for them to protect themselves," said Hucles, a former eight-year member of the U.S. national team. "They need it."
Stevens said doctors are researching if anatomy plays a role in concussions since women have smaller heads with thinner necks that have less muscle than men.
"It's also very clear that a woman's brain is not the same as a man's brain in many, many respects, not just in terms of the way women think," he said with a chuckle. "It's different in terms of the actual anatomy."
The news is not all bad for women when it comes to brain injuries sustained while playing sports.
Chronic traumatic encephalopathy (CTE), a progressive degenerative disease of the brain often found in athletes who suffered repetitive brain trauma, is "almost exclusively" found in men, said Stevens.
Democratic Representative Bill Pascrell Jr. of New Jersey is sponsoring a bill that would, in part, establish guidelines for states to treat concussions suffered by student athletes.
Pascrell recalls a women high school athlete in New Jersey that suffered 10 concussions playing basketball and is now sidelined with concentration issues and headaches.
"This is serious business," he said. "You're talking about people's lives here. Every concussion is brain damage, whether it be little or great. We have to take this very seriously."
Pascrell said despite the high cost, perhaps the best solution is to have doctors attend all games.
"Maybe the answer is not to put your kid in sports," he said. "We're not going to be a nation of wussies. But we're not going to be stupid about it. And we have been."
Editing by Frank Pingue