Sickle Cell Pain Events Linked to Period Cycle

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Women with sickle cell disease often have pain crises around the time of their period, and researchers now think they know why.

Inflammation increases significantly in women during their period, and that could be contributing to sickle cell pain events, researchers reported.

“The amount of inflammation is significantly elevated in the follicular phase, or first half, of the menstrual cycle in female patients with sickle cell disease,” said lead researcher Dr. Jessica Wu, a resident in obstetrics and gynecology at the University of Pennsylvania School of Medicine.

“This observation correlates with what we see in the literature, that this is the time in which this patient population has the most vaso-occlusive events (VOEs),” the technical term for [sickle cell pain events], Wu added in a news release.

This finding could point to treatments that would help reduce women’s risk of sickle cell pain events, researchers said.

“Many hormonal contraceptives can suppress menstruation or suppress the hormone fluctuations that occur from cycle to cycle, so contraceptives could help these patients manage their pain crises,” Wu said.

This is the first study to examine the relationship between menstrual cycles and inflammation in sickle cell disease, Wu noted.

Sickle cell disease is the most common inherited red blood cell disorder in the U.S., researchers said in background notes. The disease causes red blood cells to become misshapen and sticky.

These cells can become lodged in veins and block blood flow, leading to organ damage and infection, researchers said. These blockages can also cause VOEs, episodes of severe pain so intense that people often require hospitalization.

For the new study, researchers analyzed blood samples of 13 women and 18 men with sickle cell disease. The team specifically tracked C-reactive protein, which is produced by the liver when there’s inflammation in a person’s body.

Researchers found that C-reactive protein was higher on average among women in the first half of their menstrual cycle, compared to women in the second half.

These results jibe with earlier research, which has shown that women with sickle cell have more frequent and severe pain events around the time of their period, researchers said.

“The menstrual cycle is often overlooked in research and clinical care, but can interact with health in important ways, as we are seeing in sickle cell disease,” senior researcher Dr. Andrea Roe, an assistant professor of obstetrics and gynecology at the University of Pennsylvania, said in a news release.

Lead author Wu said sickle cell disease is debilitating and painful and learning more about its effects on women is important.

“The more data we have about how it presents in female patients, the better we can counsel them on anticipating and managing their pain,” she said.

However, Wu said more research is needed, both to track more women and to observe inflammation throughout each woman’s menstrual cycle.

The new study was published April 9 in the journal Blood Vessels, Thrombosis & Hemostasis.

How do sickle cell pain events affect Black women?

Sickle cell pain for Black women is a significant health burden often compounded by systemic inequities. The unpredictable and excruciating pain crises can disrupt every aspect of their lives, from work and family responsibilities to social engagement.

Furthermore, studies suggest that the pain reported by Black patients, including women with sickle cell, is often underestimated and undertreated by healthcare providers, potentially due to racial bias. This can lead to delays in receiving adequate care, increased hospitalizations, and a diminished quality of life.

The intersection of race and gender can create unique challenges in accessing equitable and compassionate care for Black women living with sickle cell disease.

More information

The Cleveland Clinic has more on sickle cell crisis.

SOURCE: American Society of Hematology, news release, April 9, 2025

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