Common gynecological challenges in adolescents with sickle cell disease

Sickle cell anemia is one of the most common genetic blood disorders worldwide. Individuals with sickle cell disease (SCD) experience clinical manifestations such as chronic anemia, developmental delay, vaso-occlusive pain, acute chest syndrome, and neurological complications. Adolescent girls with SCD face unique gynecological challenges including delayed puberty marked by a later onset in menarche, vaso-occlusive pain associated with their menstrual cycle, and underdiagnosed abnormal uterine bleeding. This review focuses on these challenges with particular emphasis on delayed menarche and vaso-occlusive pain episodes associated with menstruation, in addition to the evaluation and initial management of heavy menstrual bleeding for adolescents with SCD. We highlight research opportunities in this neglected area to help enhance the comprehensive care model for this population.

镰状细胞贫血是全球最为常见的遗传性血液疾病之一。镰状细胞病（SCD）患者会出现慢性贫血、发育迟缓、血管闭塞性疼痛、急性胸部综合征及神经系统并发症等多种临床表现。罹患SCD的青春期女孩面临独特的妇科挑战，具体包括以月经初潮延迟为特征的青春期延迟、与月经周期相关的血管闭塞性疼痛，以及诊断不足的子宫异常出血。本综述聚焦此类妇科挑战，重点探讨月经初潮延迟与月经相关的血管闭塞性疼痛发作，同时涵盖SCD青春期女孩月经过多的评估与初始管理方案。此外，我们还梳理了这一被忽视领域的研究机遇，以期助力优化该群体的综合照护体系。