Pain Frequency and Health Care Utilization Patterns in Women with Sickle Cell Disease Experiencing Menstruation-Associated Pain Crises

Catherine Segbefia, Department of Child Health, University of Ghana Medical School, Accra, Ghana.
Jillian Campbell, Center for Cancer and Blood Disorders, Children's National Hospital, Washington, District of Columbia, USA.
Immacolata Tartaglione, Department of Women, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli," Naples, Italy.
Eugenia Vicky Asare, Department of Hematology, Korle-Bu Teaching Hospital, Accra, Ghana.
Biree Andemariam, Division of Hematology-Oncology, New England Sickle Cell Institute, Neag Comprehensive Cancer Center, University of Connecticut, Farmington, Connecticut, USA.
William Zempsky, Department of Pediatrics, Connecticut Children's Medical Center, Hartford, Connecticut, USA.
Raffaella Colombatti, Department of Women's and Child Health, Clinic of Pediatric Hematology Oncology, Azienda Ospedaliera-Università di Padova, Padova, Italy.
Gifty Dankwah Boatemaa, Department of Physiology, University of Ghana Medical School, University of Ghana, Accra, Ghana.
Donna Boruchov, Department of Pediatrics, Connecticut Children's Medical Center, Hartford, Connecticut, USA.
Sudha Rao, Department of Child Health, Korle Bu Teaching Hospital, Accra, Ghana.
Connie M. Piccone, Department of Pediatric Hematology/Oncology, Rainbow Babies and Children's Hospital, Cleveland, Ohio, USA.
Ashya Smith, Division of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, Michigan, USA.
Haikel Haile, Division of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, Michigan, USA.
Esther Kim, Division of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, Michigan, USA.
Samuel Wilson, Division of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, Michigan, USA.
Fatimah Farooq, Division of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, Michigan, USA.
Rebekah Urbonya, Division of Pediatric Hematology/Oncology, University of Michigan, Ann Arbor, Michigan, USA.
Angela Rivers, Department of Pediatrics, University of California San Francisco, San Francisco, California, USA.
Deepa Manwani, Department of Pediatrics, Albert Einstein College of Medicine, Children's Hospital at Montefiore, Bronx, New York, USA.
Jiaxiang Gai, Division of Biostatistics and Study Methodology, Children's National Hospital, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA.
Fredericka Sey, Ghana Institute of Clinical Genetics, Korle Bu Teaching Hospital, Accra, Ghana.
Baba Inusa, Department of Pediatric Haematology, Evelina Children's Hospital, Guy's and St. Thomas NHS Trust, College of Nursing, London, United Kingdom.
Charles Antwi-Boasiako, Department of Physiology, University of Ghana Medical School, University of Ghana, Accra, Ghana.
Crawford Strunk, Pediatric Hematology Oncology and Blood and Marrow Transplantation, Cleveland Clinic Foundation, Cleveland, OH, USA.
Andrew D. Campbell, Center for Cancer and Blood Disorders, Children's National Hospital, Washington, District of Columbia, USA.

Document Type

Journal Article

Publication Date

12-1-2023

Journal

Journal of women's health (2002)

Volume

32

Issue

12

DOI

10.1089/jwh.2023.0023

Keywords

health care utilization; hospitalizations; menstruation; pain crises; sickle cell disease

Abstract

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. 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. 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,  = 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,  = 0.0016). Forty percent of women reported at least four menstruation-associated pain crises in the past 6 months. 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.

Department

Pediatrics

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