The Super Bowl generates gut-busting menus, fierce rivalries, and possibly some unexpected health consequences for the game’s players. A recent JAMA Neurologystudy found that the more concussion symptoms former National Football League (NFL) players had during their careers, the more likely they were to have been prescribed medication for low testosterone levels or erectile dysfunction (ED) later in life. Knowing that head injuries may cause sexual dysfunction could help more men and their physicians overcome the stigma of ED and talk about treatment.

The research fills a knowledge gap. One large study found an association between ED and single traumatic brain injuries in the general Taiwanese population. So far, only small studies have linked elite athletes’ head injuries with hormone insufficiencies and sexual dysfunction. With 3409 participants, this is the first large study to make the connection in athletes and to show a dose-response relationship: as self-reported concussion symptoms increased so did the odds of having indicators of ED and low testosterone levels. The study was also large enough to assess a variety of confounding factors.

The research is part of the Football Players’ Health Study, a Harvard University project to understand US-style football’s health risks and benefits. For the ED study, participants on average were about 53 years old and had played around 7 seasons. Former offensive linemen made up the largest group of respondents, almost 22%.