Baumgardner (right) and Beaudoin bucked the system by fighting three-minute rounds.
International Journal of Emergency Medicine found that females were more prone to ligament injuries and contusions, whereas males experienced more dislocations and fractures. Some of the injuries in women athletes relate to anatomy and hormones. The “female athlete triad” refers to three conditions that affect women:
& Science in Sports and Exercise, female athletes had 30% less neck girth, 43% less head mass and 29% less head-neck stiffness. While CTE (chronic traumatic encephalopathy) can only be confirmed on autopsy, there are suggestions that women may be more predisposed.
“A substantial body of research demonstrates sex-based differences in concussion incidence, symptom severity and recovery trajectory.” It admits that no one thing increases women’s vulnerability, but cervical (neck muscle) strength, neck size or hormonal and neuroanatomical differences are involved, along with symptom reporting behavior. Nevertheless, the organization has taken a strong position on its website regarding professional women’s boxing: “Pink Concussions, together with medical professionals and advisory board members […] supports maintaining the current female boxing standard of 10 two- minute rounds rather than extending competition to 12 three-minute rounds, based on clinical evidence indicating higher concussion risk with increased exposure time and fatigue.” Before sending hate mail, please understand I am not proposing that women shouldn’t compete or can’t compete at a championship level. Just because something is different doesn’t mean it’s less. I am saying that it’s time that women fighters are approached differently in training and competition. Women have other risk factors that make them susceptible to injuries separate from men. They have specific nutritional needs that need to be met to improve their success in the ring. And it appears from all the current research that they are more prone to concussion and take longer to recover. This is especially important since we are seeing so many talented women boxers and bouts. Women’s safety protocols in training and bouts need to change, especially as it relates to concussion and CTE prevention. For more information or assistance, please contact pinkconcussions.com. Dr. Margaret Goodman is the former chief ringside physician for the Nevada State Athletic Commission and is the founder/president of the Voluntary Anti-Doping Association. She co-hosts the Fighter Health Podcast.
her February 22 bout against Edith Matthysse and was subsequently diagnosed with a subdural hematoma. Shadasia Green suffered the same life-threatening condition during her April 17 bout with Lani Daniels. Both fights featured two- minute rounds. Should the rounds in women’s 10-round championship fights remain at two minutes (20 minutes total contact)? Or should they be 12 rounds, two minutes per round, totaling 24 minutes of contact? Or lastly, should they be 36 minutes of contact with 12 rounds, three minutes each, the same as in men’s boxing? There is no right answer, but any time you make
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In a study by the Penn Medical Center for Brain Injury and Repair, they found that the axons (nerve cells) in women’s brains may be less dense and narrower, resulting in an increased susceptibility to brain damage from contact and force. Less neck muscle mass in women reduces their ability to absorb impact, which transfers to the brain. After trauma, women’s brains may burn nutrients faster, causing cellular distress and lengthening recovery time. Studies have shown that women’s hormonal fluctuations – especially regarding progesterone (predominantly a female hormone) – can affect concussion recovery. Unfortunately, less research has been performed on the brains of deceased female athletes. This makes it difficult to recommend prevention suggestions and better target warning signs in female fighters.
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Low energy intake: Female athletes have different calorie, protein and nutrient requirements, including needing more calcium and vitamin D. Menstrual dysfunction: This can result from low energy intake. This is especially true for female fighters making weight, as it can stop their menstrual cycle completely. Low bone mineral density: Not eating properly for an extended period of time and hormonal changes can increase
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the risk of sports injuries, including stress fractures.
Low energy intake by women fighters, called REDs (relative energy deficiency in sports), will interfere with performance through decreased muscle strength and endurance along with impaired judgment, irritability, depression, reduced coordination and poor concentration. The Orthopaedic Journal of Sports Medicine reviewed 22 studies performed between 2000-2020 on concussion or craniocerebral trauma incidence in men and women in contact sports. Boxing was included. Female athletes had an increased risk of concussion – despite fewer impacts with less force. The women were also found to have more neuropsychological issues and reported more symptoms. Most importantly, female athletes took longer to recover. Some of the above relates to gender biomechanical differences, including stabilization of the head-neck area with head acceleration from external force. In a research study by Medicine
T he debate rages on regarding two-minute vs. three-minute rounds for women boxers. Not too long ago, the World Boxing Council held strong to their position of having 10 two-minute rounds for title fights. As a result, Alycia Baumgardner vacated her WBC belt and met Leila Beaudoin in a 12-round bout with three-minute rounds. In any case, the inherent dangers for both male and female fighters persist. Earlier in 2026, Sammy Worthington bravely took it upon herself to quit during THE FIGHT DOCTOR ARE WOMEN BOXERS AT GREATER RISK OF INJURY? By Dr. Margaret Goodman
a change in boxing rules – even in men’s bouts – you’re damned if you do when a serious injury occurs. This is especially true if death results from increased contact. Brain injuries decreased when men’s championship boxing was reduced from 15 to 12 rounds. Less contact equals less risk of injury. A topic for another day could be whether men’s championship bouts should be decreased to 10 rounds. Like the round reduction in championship fights, change can be good. But fear of change is one reason why the weigh-in has not reverted to the same day as the fight. I’m not opining here on the total number of minutes or rounds for women’s fights; I’m instead demonstrating that there are insufficient precautions taken for women boxers. Beyond neurologic (brain) injuries, there is already considerable evidence to back up sex differences in injury patterns. A 2025 research review in the
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Pink Concussions, a nonprofit organization, was established in 2017 to train the medical community and provide life-changing support groups for women with brain injury. It focuses on pre-injury education and post-injury medical care for women and girls with brain injury from sport, domestic violence, accident or military service. It also acknowledges that many women have unrealistic expectations regarding recovery time from concussion. Returning to sparring and/or competition too soon increases post-concussive symptoms. Pink Concussions acknowledges,
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