1 Vanderbilt-Meharry Center of Excellence in Sickle Cell Disease, Vanderbilt University Medical Center, Nashville, Tennessee.
2 Department of Pediatrics, Rodeghier Consultants, Chicago, Illinois.
J Womens Health (Larchmt). 2019 Feb;28(2):162-169. doi: 10.1089/jwh.2018.7147. Epub 2019 Jan 16.
Acute vaso-occlusive pain episodes in sickle cell disease (SCD) are associated with increased rates of hospitalization and early mortality. Despite the observation that women have higher rates of acute vaso-occlusive pain episodes than men, sex-specific risk factors for acute vaso-occlusive pain have not been identified. We tested the hypothesis that acute vaso-occlusive pain is temporally associated with the onset of menstruation in women with SCD.
Initially, using a cross-sectional study design, we administered questionnaires, including validated measures of SCD pain frequency and severity within the last 30 days, as well as menstrual symptoms in a discovery group (n = 103). We then confirmed our findings by administering the same questionnaires online in a replication group (n = 118). A validated questionnaire was used to define dysmenorrhea.
In the initial discovery group, 28% (29 of 103) reported acute vaso-occlusive pain episodes temporally associated with menstruation, and 72% (74 of 103) did not. Of the 29 reporting acute vaso-occlusive pain associated with menstruation, 90% (26) and 10% (3) did and did not meet criteria for dysmenorrhea, respectively. In the replication group, 36% (43 of 118) reported acute vaso-occlusive pain temporally associated with menstruation. Of the 43 reporting acute vaso-occlusive pain associated with menstruation, 60% (26) and 40% (17) did and did not meet criteria for dysmenorrhea, respectively.
In both the discovery and replication groups, we demonstrate that acute vaso-occlusive pain is temporally associated with the onset of menstruation that women with SCD can distinguish from dysmenorrhea.
镰状细胞病（SCD）的急性血管阻塞性疼痛发作与住院率和早期死亡率的增加有关。尽管观察到女性的急性血管阻塞性疼痛发作率高于男性，但尚未确定急性血管阻塞性疼痛的性别特异性危险因素。我们检验了这样一个假设，即 SCD 女性的急性血管阻塞性疼痛与月经初潮有关。
最初，我们采用横断面研究设计，在发现组（n=103）中使用问卷，包括过去 30 天内 SCD 疼痛频率和严重程度的验证性测量，以及月经症状。然后，我们通过在复制组（n=118）中在线管理相同的问卷来确认我们的发现。使用验证性问卷来定义痛经。
在最初的发现组中，28%（29/103）报告了与月经有关的急性血管阻塞性疼痛发作，72%（74/103）没有。在报告与月经有关的急性血管阻塞性疼痛的 29 名患者中，90%（26 名）和 10%（3 名）分别符合和不符合痛经标准。在复制组中，36%（43/118）报告了与月经有关的急性血管阻塞性疼痛。在报告与月经有关的急性血管阻塞性疼痛的 43 名患者中，60%（26 名）和 40%（17 名）分别符合和不符合痛经标准。
在发现组和复制组中，我们都证明了急性血管阻塞性疼痛与 SCD 女性月经初潮有关，她们可以将其与痛经区分开来。
