SICKLE CELL DISEASE | Inflammation during Menstrual Cycle May Trigger Pain Crises
Emerging research suggests that in women with sickle cell disease (SCD), inflammation fluctuates across the menstrual cycle — with higher levels during the follicular phase — which might help explain why painful vaso-occlusive episodes often cluster around menstruation.
SCD is a genetic disorder in which red blood cells can become abnormally shaped (“sickle”), leading to blockages in blood vessels, tissue damage, and intense pain known as vaso-occlusive events (VOEs).
A new study measured levels of C-reactive protein (CRP) — a well-known marker of inflammation — and found that in female patients with SCD, median CRP was significantly higher in the follicular (first half) phase of the menstrual cycle compared to the luteal (second half) phase (8.80 vs 0.82 mg/L, p = 0.03). The researchers also showed that this rise in inflammation did not differ by SCD genotype (e.g. SS vs SC) or by use of hydroxyurea, which suggests the menstrual cycle effect is independent of those factors.
Because inflammation plays a central role in triggering VOEs, this cyclical inflammatory pattern may increase susceptibility to pain crises around menstruation in women with SCD. The authors note the study is preliminary (small sample size, single timepoint samples) and that prospective studies are needed to confirm whether these inflammatory fluctuations track with clinical pain episodes.
In the future, understanding these menstrual‐linked patterns might lead to targeted strategies (for example, hormonal modulation or anti‐inflammatory timing) to reduce VOE frequency in women with SCD.
For women living with sickle cell disease, these insights offer a new lens to understand pain patterns and open possibilities for more personalized care.
Source: Hematology Advisor
