{"id":10122,"date":"2025-04-09T23:39:59","date_gmt":"2025-04-09T15:39:59","guid":{"rendered":"http:\/\/zestmag.com\/online\/?p=10122"},"modified":"2025-04-09T23:40:15","modified_gmt":"2025-04-09T15:40:15","slug":"menstrual-cycle-may-contribute-to-sickle-cell-disease-pain-crises","status":"publish","type":"post","link":"https:\/\/zestmag.com\/online\/menstrual-cycle-may-contribute-to-sickle-cell-disease-pain-crises\/","title":{"rendered":"Menstrual cycle may contribute to sickle cell disease pain crises"},"content":{"rendered":"\n

A marker linked to inflammation, C-reactive protein, may increase significantly during the follicular phase of the menstrual cycle in female patients with sickle cell disease (SCD), according to emerging research published in\u00a0<\/strong>Blood Vessels, Thrombosis & Hemostasis.\u00a0<\/strong><\/em><\/a>This observation provides insight into the pattern of painful vaso-occlusive events (VOEs), which are driven by inflammation, in female patients with the disorder.<\/strong><\/p>\n\n\n\n

\u201cWe know both from the literature and anecdotally from our patients that women with SCD have VOEs that cluster around their menstrual periods. We wanted to examine the potential reason behind that,\u201d said the study\u2019s lead author, Jessica Wu, MD, a resident physician in the Department of Obstetrics and Gynecology at the Perelman School of Medicine at the University of Pennsylvania. \u201cOur study is the first to examine the association between menstrual cycles and inflammation in female patients with SCD.\u201d<\/p>\n\n\n\n

\u201cThe menstrual cycle is often overlooked in research and clinical care, but can interact with health in important ways, as we are seeing in SCD,\u201d said the study\u2019s principal investigator, Andrea Roe, MD, MPH, an assistant professor of obstetrics and gynecology at the Perelman School of Medicine at the University of Pennsylvania. Dr. Wu, Dr. Roe, and their colleagues analyzed plasma samples in the Penn Medicine BioBank repository from individuals with a confirmed SCD diagnosis. After excluding samples from participants who were pregnant, hospitalized with a VOE, or treated at an emergency department or infusion center at the time of sample collection, 31 plasma samples were included in their analysis \u2013 13 from female patients and 18 from male patients.<\/p>\n\n\n\n

SCD, the most common inherited red blood cell disorder in the United States, is characterized by abnormally shaped blood cells. These cells can become lodged in the veins and block blood flow, leading to organ damage, infection, and episodes of severe pain throughout the body, known as VOEs, which can be so debilitating that people seek treatment at a hospital. Previous literature has shown that female patients with SCD have more frequent, severe VOEs<\/a>, often around the time of their menstrual periods.<\/a><\/p>\n\n\n\n

The researchers measured C-reactive protein in all samples and female sex hormones, including estradiol, progesterone, and luteinizing hormone, in samples from female patients. They compared C-reactive protein, clinical laboratory markers, and other biomarkers by patient sex, SCD genotype, hydroxyurea, and, in the cases of the 13 female patients, made the same comparisons between samples from the follicular and luteal phases of the menstrual cycle. A progesterone level of 1.75 ng\/mL was used to define the occurrence of ovulation and cutoff between the follicular and luteal phases.<\/p>\n\n\n\n

Among the 31 samples, the average concentration of C-reactive protein was 4.45 mg\/L, with no significant differences observed based off SCD genotype or treatment with hydroxyurea. When Dr. Wu and her colleagues compared C-reactive protein between samples from female patients and male patients, they observed no significant difference (3.88 vs. 4.45 mg\/L, p=0.89); however, when they compared C-reactive protein between samples taken during the follicular or luteal phases of the female patients, they observed higher median C-reactive protein in the follicular phase versus the luteal phase (8.80 vs. 0.82 mg\/L, p=0.03).<\/p>\n\n\n\n

\u201cThe amount of inflammation is significantly elevated in the follicular phase, or first half, of the menstrual cycle in female patients with SCD,\u201d said Dr. Wu. \u201cThis observation correlates with what we see in the literature, that this is the time in which this patient population has the most VOEs.\u201d<\/p>\n\n\n\n

These results also mirror the trend seen in the menstrual cycles of the general population, though the magnitude of elevation is much greater in female patients with SCD than in those without SCD during the follicular phase (8.80 mg\/L vs. 0.74 mg\/L). The significant fluctuation of C-reactive protein in female patients with SCD could have clinical implications given the similar temporal pattern of VOEs, providing a target for intervention.  <\/p>\n\n\n\n

\u201cMany 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,\u201d said Dr. Wu. \u201cSCD is a really debilitating and painful disease. The more data we have about how it presents in female patients, the better we can counsel them on anticipating and managing their pain.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"

The amount of inflammation is significantly elevated in the follicular phase, or first half, of the menstrual cycle in female patients with SCD.<\/p>\n","protected":false},"author":3,"featured_media":10123,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4],"tags":[2155,247,2061],"class_list":["post-10122","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-newsmakers","tag-women-empowerment","tag-womens-health","tag-young-women"],"_links":{"self":[{"href":"https:\/\/zestmag.com\/online\/wp-json\/wp\/v2\/posts\/10122","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/zestmag.com\/online\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/zestmag.com\/online\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/zestmag.com\/online\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/zestmag.com\/online\/wp-json\/wp\/v2\/comments?post=10122"}],"version-history":[{"count":1,"href":"https:\/\/zestmag.com\/online\/wp-json\/wp\/v2\/posts\/10122\/revisions"}],"predecessor-version":[{"id":10124,"href":"https:\/\/zestmag.com\/online\/wp-json\/wp\/v2\/posts\/10122\/revisions\/10124"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/zestmag.com\/online\/wp-json\/wp\/v2\/media\/10123"}],"wp:attachment":[{"href":"https:\/\/zestmag.com\/online\/wp-json\/wp\/v2\/media?parent=10122"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/zestmag.com\/online\/wp-json\/wp\/v2\/categories?post=10122"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/zestmag.com\/online\/wp-json\/wp\/v2\/tags?post=10122"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}