Contraception Experience among Adolescents with Sickle Cell Disease

Adolescent females with sickle cell disease face unique challenges related to menstruation, contraception, and reproduction. Not only does pregnancy pose higher maternal morbidity and mortality risks in these patients [1], but hydroxyurea, a commonly used treatment for the disease is teratogenic [2]. Further, the frequency of vasoocclusive pain crises increases during pregnancy, which is thought to be due the associated immune modulation, hypercoagulability, and necessary suspension of hydroxyurea use [3]. Studies have indicated that women with sickle cell disease also experience greater degrees of dysmenorrhea and pains distinct from dysmenorrhea during menses [4,5]. Females with menstruationinduced vaso-occlusive crises often have heavier, longer menstrual periods [4]. Blood loss from menstruation can increase the risk of iron deficiency anemia, compounding the already existent sickle cell anemia.