Pain crisis is a major feature of sickle cell disease, causing pain when crescent blood cells block the flow of oxygen to tissue. Now, new research finds that these crises can be exacerbated by hormonal shifts during the menstrual cycle.
Sickle Cell Disease (SCD) is a group of genetic disorders that lead to red blood cells that carry abnormally sickle-shaped red blood cells into the body. This increases the risk of anemia, infections and can lead to organ damage.
Also, people with SCD experience episodes of severe pain, as abnormal forms of blood cells can block blood vessels Vaso-occlusive episode (VOE) That can lead to hospitalization. The voice is The most common type of pain crisis People with SCD experienced this.
It is established that women with SCD experience more serious and more voices than sick men. Several recent reports suggest that these painful episodes occur more frequently at certain points During the menstrual cycle – That is, when the uterine lining is washed away during menstruation. However, the molecular mechanisms behind this periodic pattern are still unknown, making it difficult to find treatments to manage pain.
Now, in a survey published in the journal on April 9th Blood vessels, thrombosis and hemostasisResearchers at the University of Pennsylvania inflammation – C-reactive protein (CRP) – Increased blood in the blood in the blood in women with SCD in the first half of the menstrual cycle, then falls later.
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“We are absolutely thrilled that the healthcare and research community is focusing on reproductive health-related morbidity among women with sickle cell disease,” he said. Dr. Deva Sharmaphysicians and hematology and transfusion medicine researchers at Vanderbilt University Medical Center who were not involved in this study.
“This era has been ripe for decades to expand the fairness of research and healthcare advocacy in women and girls with sickle cell disease,” Sharma told Live Science in an email.
The link between menstruation and pain crisis
According to Sharma, menstrual-related complications, including VOE, contribute to substantial distress and symptoms of SCD throughout the lifespan of sick women. This incidence hinders daily activities such as showering, dressing, interacting with friends, and going to work. Severe voices can also lead to organ damage and potentially life-threatening complications.
People with SCD are in the state Chronic inflammationinflammatory cells and markers of inflammation are always at higher levels in the body with disease-free inflammatory cells. That's because blocking blood flow in the VOE kills blood cells Oxidative stress Increased inflammation.
One of the characteristics of chronic inflammation is that the body makes more CRPproteins produced by the liver in response to inflammation. Baseline's SCD has a higher CRP level and equality It's high during VOE. However, interestingly, CRP has also been shown to fluctuate. The whole menstrual cycleeven in the general population of people without SCD.
“Menteric cycles are often overlooked in research and clinical care, but as we see with SCD, they can interact with health in important ways.” Dr. Andrea Lawan assistant professor of obstetrics and gynecology at the University of Pennsylvania, and a senior author of the study, statement.
The researchers analyzed blood plasma samples from more than 30 patients to determine CRP levels as well as other inflammatory markers, inflammatory cell counts and hormone levels. They found that increased CRP levels were correlated with changes in sex hormone levels in women with SCD, and found that these increases were much higher than those seen in women without SCD.
Specifically, they found higher CRP levels Follicular phasestarts on the first day of a person's period, ends the next time they ovulate or release the egg. CRP levels drop during the luteal phase from about 15th to 28th day of the ring, during which the released eggs migrate into the uterus.
Next Steps
This is the first study showing that CRP levels are higher in women with SCD during the follicular phase, giving researchers and clinicians the opportunity to design more specific pain interventions for sick women.
Hormonal contraceptives that suppress menstruation, and hormonal fluctuations, are already present. Therefore, the study authors suggested that these drugs may suppress an increase in inflammation in women with SCD.
“SCD is a truly debilitating and painful illness,” read study author Dr. Jessica Wuan obstetrician and gynecologist at the University of Pennsylvania said in a statement. “The more data we have about how it is presented to female patients, the more we can advise them by predicting and managing pain.”
In the future, researchers hope to expand sample sizes and test additional markers of SCD against changes in the menstrual cycle.
“In the end, this kind of work is hopeful that it can shape treatment recommendations,” Sharma said. ” Given that most people with sickle cell disease live in middle-to-low income countries, we look forward to future research conducted in these settings that globally fill scientific advances in the management and prevention of menstruation-related acute vascular obstructive pain.”
This article is for informational purposes only and is not intended to provide medical advice.
