• Catherine Segbefia, Jillian Campbell, Immacolata Tartaglione, Eugenia Vicky Asare, Biree Andemariam, William Zempsky, Raffaella Colombatti, Gifty Dankwah Boatemaa, Donna Boruchov, Sudha Rao, Connie M Piccone, Ashya Smith, Haikel Haile, Esther Kim, Samuel Wilson, Fatimah Farooq, Rebekah Urbonya, Angela Rivers, Deepa Manwani, Jiaxiang Gai, Fredericka Sey, Baba Inusa, Charles Antwi-Boasiako, Crawford Strunk, and Andrew D Campbell.
• Department of Child Health, University of Ghana Medical School, Accra, Ghana.
• J Womens Health (Larchmt). 2023 Dec 1; 32 (12): 128412911284-1291.

AbstractBackground: Pain crises in sickle cell disease (SCD) lead to high rates of health care utilization. Historically, women have reported higher pain burdens than men, with recent studies showing a temporal association between pain crisis and menstruation. However, health care utilization patterns of SCD women with menstruation-associated pain crises have not been reported. We studied the frequency, severity, and health care utilization of menstruation-associated pain crises in SCD women. Materials and Methods: A multinational, cross-sectional cohort study of the SCD phenotype was executed using a validated questionnaire and medical chart review from the Consortium for the Advancement of Sickle Cell Research (CASiRe) cohort. Total number of pain crises, emergency room/day hospital visits, and hospitalizations were collected from a subcohort of 178 SCD women within the past 6 months and previous year. Results: Thirty-nine percent of women reported menstruation-associated pain crises in their lifetime. These women were significantly more likely to be hospitalized compared with those who did not (mean 1.70 vs. 0.67, p = 0.0005). Women reporting menstruation-associated pain crises in the past 6 months also experienced increased hospitalizations compared with those who did not (mean 1.71 vs. 0.75, p = 0.0016). Forty percent of women reported at least four menstruation-associated pain crises in the past 6 months. Conclusions: Nearly 40% of SCD women have menstruation-associated pain crises. Menstruation-associated pain crises are associated with high pain burden and increased rates of hospitalization. Strategies are needed to address health care disparities within gynecologic care in SCD.

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