title: Common gynecological challenges in adolescents with sickle cell disease.
abstract: 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.
authors.affiliation: a Department of Pediatrics, Division of Hematology/Oncology, Vanderbilt-Meharry-Matthew Walker Center for Excellence in Sickle Cell Disease , Vanderbilt University Medical Center , Nashville , TN , USA.
authors.forename: Sarah-Jo
authors.initials: SJ
authors.lastname: Stimpson
authors.affiliation: b Department of Obstetrics & Gynecology, Vanderbilt Center for Women's Health , Vanderbilt University Medical Center , Nashville , TN , USA.
authors.forename: Erin C
authors.initials: EC
authors.lastname: Rebele
authors.affiliation: a Department of Pediatrics, Division of Hematology/Oncology, Vanderbilt-Meharry-Matthew Walker Center for Excellence in Sickle Cell Disease , Vanderbilt University Medical Center , Nashville , TN , USA.
authors.forename: Michael R
authors.initials: MR
authors.lastname: DeBaun
mesh_terms: D000293:Adolescent; D000367:Age Factors; D018798:Anemia, Iron-Deficiency / Q000209:etiology / Q000628:therapy; D000755:Anemia, Sickle Cell / Q000150:complications* / Q000235:genetics; D015519:Bone Density; D005260:Female; D005831:Genital Diseases, Female / Q000209:etiology* / Q000378:metabolism; D005838:Genotype; D042341:Gonadal Hormones / Q000378:metabolism; D006451:Hemoglobin, Sickle / Q000235:genetics; D006801:Humans; D008297:Male; D008572:Menarche; D008595:Menorrhagia / Q000150:complications / Q000209:etiology; D008597:Menstrual Cycle; D008598:Menstruation; D010146:Pain / Q000209:etiology; D011091:Polyesters / Q000008:administration & dosage; D011137:Polystyrenes / Q000008:administration & dosage; D011374:Progesterone / Q000008:administration & dosage; D012737:Sex Factors; D014652:Vascular Diseases / Q000150:complications / Q000209:etiology
chemical_list: D042341:Gonadal Hormones; D006451:Hemoglobin, Sickle; D011091:Polyesters; D011137:Polystyrenes; C440495:contraceptive agent, RISUG; D011374:Progesterone
keywords: Contraception; iron deficiency anemia; menorrhagia; menstrual cycle; progesterone; sickle cell anemia; sickle cell disease; vaso-occlusive pain