Common gynecological challenges in adolescents with sickle cell disease

• Published in: Expert review of hematology Vol. 9; no. 2; p. 187
• Main Authors: Stimpson, Sarah-Jo, Rebele, Erin C, DeBaun, Michael R
• Format: Journal Article
• Language: English
• Published: England 01.02.2016
• Subjects: Adolescent; Age Factors; Anemia, Iron-Deficiency - etiology; Anemia, Iron-Deficiency - therapy; Anemia, Sickle Cell - complications; Anemia, Sickle Cell - genetics; Bone Density; Female; Genital Diseases, Female - etiology; Genital Diseases, Female - metabolism; Genotype; Gonadal Hormones - metabolism; Hemoglobin, Sickle - genetics; Humans; Male; Menarche; Menorrhagia - complications; Menorrhagia - etiology; Menstrual Cycle; Menstruation; Pain - etiology; Polyesters - administration & dosage; Polystyrenes - administration & dosage; Progesterone - administration & dosage; Sex Factors; Vascular Diseases - complications; Vascular Diseases - etiology; vaso-occlusive pain; menorrhagia; menstrual cycle; progesterone; Contraception; iron deficiency anemia; sickle cell anemia; sickle cell disease
• ISSN: 1747-4094
• DOI: 10.1586/17474086.2016.1126177

Sickle cell anemia is one of the most common genetic blood disorders worldwide. Individuals with sickle cell disease (SCD) experience clinical manifestations such as chronic anemia, developmental delay, vaso-occlusive pain, acute chest syndrome, and neurological complications. Adolescent girls with SCD face unique gynecological challenges including delayed puberty marked by a later onset in menarche, vaso-occlusive pain associated with their menstrual cycle, and underdiagnosed abnormal uterine bleeding. This review focuses on these challenges with particular emphasis on delayed menarche and vaso-occlusive pain episodes associated with menstruation, in addition to the evaluation and initial management of heavy menstrual bleeding for adolescents with SCD. We highlight research opportunities in this neglected area to help enhance the comprehensive care model for this population.