(40) Dysmenorrhea and Chronic Pelvic Pain amongst Adolescents with Sickle Cell Disease: A Scoping Review

Background: While the potential relationship between menstruation, vaso-occlusive pain crisis, and dysmenorrhea in patients with Sickle Cell Disease (SCD) has been studied periodically, findings have been inconsistent. There are scarce treatment recommendations, particularly for adolescent populations. This rapid scoping review seeks to 1) examine the existing literature regarding dysmenorrhea and pelvic pain in adolescents with Sickle Cell Disease 2) understand current provider practices and 3) identify areas in need of further research to better serve the unique needs of this population in adolescent gynecology.

Methods: A search strategy was developed in collaboration with a Health Sciences Librarian (IV) using keywords and subject headings for the following two concepts: sickle cell disease and pelvic pain. Two databases, PubMed (NLM) and Web of Science (Clarivate), were searched during the month of April 2023. There were initially 4,277 results and after deduplication, 3,722 unique results were uploaded into Rayaan for abstract screening. After review, 31 studies met criteria for full-text evaluation and after full-text exploration, 8 met criteria for inclusion in final data extraction and qualitative analysis.

Results: Of the included studies, two were prospective/retrospective, two were literature reviews, and four were cross-sectional studies. Only two studies focused exclusively on adolescents. The included studies found that early menarche, dysmenorrhea, and abnormal menses were common in patients with SCD. The presence of dysmenorrhea was linked to worse quality of life metrics in these studies. Two studies mentioned management practices.

Conclusions: There is a paucity of research on the experience and treatment of adolescent patients with SCD with dysmenorrhea, dyspareunia, and/or chronic pelvic pain. This review outlines the limited existing literature - all of which suggests dysmenorrhea is common in adolescents with SCD and that better understanding of best practices may be beneficial.