WOMEN’S HEALTH

Menstrual Cycle

A woman’s body is uniquely made to have children. Once a month, when she is not pregnant, the hormone levels in her body change and cause bleeding. This change in hormones can also cause mood changes and menstrual cramps. Hormone changes may trigger sickle cell pain.

If you have sickle cell pain while menstruating, you may be able to prevent the pain by:

If you have sickle cell pain right before or during your period, talk with your health care provider about what therapies may help you.

Your health care provider may recommend a form of birth control to shorten or stop your periods.

Birth control (contraception)

Birth control, also known as contraception, is designed to prevent pregnancy. Birth control methods work in different ways.

Some methods prevent sperm from getting to the eggs. This method uses a barrier like:

◦ Condoms

◦ Diaphragms

◦ Cervical caps

◦ Contraceptive sponges

◦ IUD (intrauterine device)

Some use hormones to keep the woman’s ovaries from releasing eggs that could be fertilized:

◦ Birth control pills

◦ Patches

◦ Shots

◦ Implants under the skin

◦ Vaginal rings

◦ Emergency contraceptive (“morning after”) pills

And some methods permanently remove or change the part of the woman’s or man’s body. These include:

◦ Hysterectomy (removing the woman’s uterus).

◦ Vasectomy (cutting the tube that carries the sperm in the man).

Your choice of birth control depends on several factors:

Talk with your provider about the best form of birth control for you and your partner.

Pregnancy

Women who have sickle cell disease are more likely to have problems during pregnancy than women without sickle cell disease. These problems include:

• More frequent and severe sickle cell pain

• Worsening anemia (lack of red blood cells or hemoglobin)

• High blood pressure (which can lead to pre-eclampsia or eclampsia)

• Early labor

• Smaller babies

Before getting pregnant

• There are some important things to know if you are planning to become pregnant. You need to know your partner’s sickle cell status.

• Even if your partner only has sickle cell trait, there is a chance you may have a child with sickle cell disease.

Risks

Some medicines can be harmful to your baby during pregnancy and sickle cell treatment may need to change.

Genetic counselor

Genetic counselors can help determine the risk of your children inheriting sickle cell disease. They can also help with other options to pregnancy, such as:

• Using donor sperm from a man without sickle cell disease or trait

• In vitro fertilization and pre-implantation for selection of embryos without sickle cell disease

• Prenatal diagnosis, with the possibility of ending the pregnancy

• Adoption

• Using a surrogate. In surrogacy, your egg would be fertilized with your partner’s (or a donor’s) sperm, and the baby would be carried by another woman (a gestational surrogate). Or, another woman’s egg would be fertilized with your partner’s (or a donor’s) sperm, and she would carry the pregnancy (traditional surrogate).

During pregnancy and delivery

Since women with sickle cell disease are more likely to have problems during pregnancy, it is important to start prenatal care as soon as you find out that you are pregnant.

You will likely be seen by a provider that specializes in high-risk pregnancies. They will monitor you and the baby closely for complications.

Care during pregnancy includes:

During labor and delivery, you may expect to get fluids through a vein to prevent dehydration and/or oxygen through a face mask.

Menopause

Menopause is when your menstrual periods stop completely and you can no longer get pregnant. The menopause process or peri-menopause usually starts when you are in your mid to late 40s. Women are usually in this phase for about four years before their periods completely stop.

During this period, your hormone levels change, causing the menopause symptoms:

◦ Hot flashes

◦ Night sweats

◦ Trouble sleeping

◦ Mood swings

◦ Having periods at irregular intervals

◦ Vaginal dryness, which can lead to painful or uncomfortable sex

◦ Less interest in sex

Just like when you rest started having periods, the changing hormone levels can trigger sickle cell pain. Make sure you eat a healthy diet, drink plenty of fluids and get enough rest.