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Reproductive Health

People with sickle cell disease may have special health needs when it comes to starting a family. Sickle cell disease can impact reproductive health in several different ways including delayed puberty, high-risk pregnancy, and even challenges during sex. SCD impacts both sexes in different ways, so it’s important to review the resources below. 

People with SCD should also remember that they can pass along their sickle hemoglobin genes to their children. They could have children with sickle cell disease if their partner also has a sickle hemoglobin gene. The chances can be 25%, 50%, or 100% chance of having a baby with sickle cell disease, depending on the genes that the parents have. Therefore, knowing about genetics and knowing your partner’s hemoglobin type are very important parts of reproductive health in sickle cell disease. 

Girls & Women

There is an organization called the Sickle Cell Reproductive Health Education Directive (SC RED) that helps people with sickle cell disease find resources and learn more about this topic. The mission of SC RED is to make sure people with sickle cell disease get high-quality health care when they want to have children. 

You can watch videos about this topic on the SC RED website. 

Puberty

Children with sickle cell disease may grow and develop more slowly than other kids. They usually start puberty later than their friends. For girls with sickle cell disease, this can mean getting their first period later than other girls.1 

The medicine hydroxyurea can significantly help people with sickle cell disease, but doctors are still learning how it affects when girls get their first period. 

Menstruation

Girls and women with sickle cell disease have more pain than boys and men. The biggest difference happens between ages 10-39, which is the time when many women get their period every month.1 

Getting your period can make sickle cell pain worse. Some studies show that 28-49% of women with sickle cell disease have pain episodes right before or during their period. This means they might have to go to the hospital more often. Many women with sickle cell disease also get very bad cramps during their period.2 

Birth control methods like pills, shots, or small devices put under the skin (implants) might help reduce period pain. Your sickle cell provider can help find a safe treatment that works for you. 

Fertility

Fertility is a person’s ability to have children. Many women with sickle cell disease are still able to have children. However, it’s important to understand the connection between certain SCD treatments and fertility. 

Hydroxyurea helps people with sickle cell disease by reducing the number of pain crises and helping with other symptoms. Some people worried it might make it harder for women to have children. But a new study shows that hydroxyurea doesn’t hurt a woman’s ability to have children. This means women don’t need to save their eggs before taking this medicine.3 

However, some stronger treatments can make it harder to have babies. Before getting a bone marrow transplant or gene therapy, patients have to go through chemotherapy. This medicine can sometimes make it hard for people to have children later. 

Not everyone will have trouble having children after these treatments, but it could happen. Many women choose to save their eggs or ovarian tissue before getting these treatments. Doctors freeze the eggs or tissue so women can use them later if they want to try to have children.4    

Sexual Health

Sexual health is an important part of staying healthy overall. Sexual health is also very important for those living with SCD. Learning how to prevent sexually transmitted infections (STIs), pick the right birth control, and talk openly with partners helps you make smart choices about your body and relationships. 

 

There are many types of birth control5 that you should talk about with a doctor or nurse.  

Here are some examples:  

  • Condoms - These create a barrier that stops pregnancy and STIs from spreading 
  • Hormonal methods - These include things like birth control pills or implants that change your body’s hormones 
  • Non-hormonal methods – these include things like copper intrauterine devices (IUDs) and natural family planning 

 

Hormonal birth control does more than just prevent pregnancy. It can also: 

  • Make period symptoms better 
  • Reduce cramping 
  • Make periods lighter 
  • Lower the chance of not having enough iron in your blood 
  • Help reduce pain episodes 

 

The CDC has suggestions6 about which birth control methods are safe for people with different health conditions. For example, some birth control methods increase the chance of getting blood clots, and people with SCD already have a higher risk of blood clots, heart attacks, and strokesWhile there are risks associated with certain birth control methods and SCD, pregnancy is also high-risk for people living with SCD. So, it’s important to always talk to your doctor about what’s best for you. 

If you’re sexually active, you should get tested for STIs regularly. How often7 depends on your situation. People with multiple partners or partners they don’t know well should get tested more often. You can find testing locations online. Click here to find HIV, STI, and viral hepatitis testing and vaccine locations. 

Sometimes sickle cell disease can make it harder to enjoy sexual activity. This is called sexual dysfunction, and it happens to people without sickle cell disease too. Check out this article to read more about how SCD can impact sexual activity and intimacy. 

Pregnancy

When women with sickle cell disease get pregnant, it is considered “high-risk.” This means there’s a higher chance of problems happening, such as: 

  • High blood pressure during pregnancy (preeclampsia) 
  • Having the baby too early (premature birth) 
  • Having a baby that weighs less than normal 
  • Getting infections 
  • The baby dying before birth (stillbirth) 

 

Because of these risks, women with sickle cell disease who are pregnant need special care from two types of doctors: an obstetrician (a doctor who specializes in pregnancy and birth) and your regular hematologist or SCD specialist. 
 

Women living with SCD who want to have a baby should talk to their doctor before trying to get pregnant. The doctor will: 

  • Give advice about getting ready for pregnancy 
  • Check your history of blood transfusions (this can affect future treatments) 
  •  Talk about changing medications – especially if you take hydroxyurea 

With good planning and regular doctor visits, women with sickle cell disease can have healthy pregnancies.8 

The Sickle Cell Reproductive Health Education Directive (SCRED) offers a free, self-paced online course on preconception and pregnancy called, “Planning for Pregnancy with SCD.” 

SCD and Pregnancy Fact Sheets: 

 

Menopause

Menopause is when a woman’s periods stop forever. During menopause, the body stops releasing eggs, which means the woman can no longer get pregnant. Menopause usually happens when women are between 40 and 50 years old. Some common symptoms that happen during menopause include: 

  • Hot flashes  
  • Night sweats  
  • Vaginal dryness, which can lead to painful sex  
  • Sleep problems  
  • Mood changes  
  • Weight gain  
  • Thinning hair and dry skin  

 

Learn more about menopause here.9 

 

Sickle cell disease (SCD) can change how women go through menopause. Women with SCD may: 

  • Start menopause earlier than women without the disease
    • Have stronger symptoms like feeling very tired and having hot flashes
    • Have more or worse pain episodes because of hormone changes 

 

People with SCD are more likely to have early menopause. SCD treatments might help prevent early menopause. One study found that people taking hydroxyurea medicine regularly started menopause around age 50 while people not taking any SCD medicine started menopause around age 39.10 

 

Many women use hormone replacement therapy (HRT) to help with menopause symptoms. However, doctors usually don’t recommend HRT for people with SCD because it increases the chance of getting blood clots, and people with SCD already have a higher risk of blood clots, heart attacks, and strokes 

Always talk to your SCD doctor before trying any menopause treatments. 

Boys & Men

Puberty

Chronic anemia can slow down growth. Boys with SCD may also go through puberty later than other boys their age. They may be about 2-3 years behind in puberty. This means they might be later to develop: 

  • Body hair 
  • Facial hair 
  • Changes to genitals 
  • Voice changes (voice getting deeper) 
  • First time releasing semen 

 

Because of these delays, boys with sickle cell disease may: 

  • Be shorter or thinner than their classmates 
  • Look younger than other boys their age 
  • Start puberty changes when they’re older 

 

This is normal for boys with sickle cell disease, but it can sometimes make them feel different from their friends.11 

Fertility & Erectile Dysfunction

Fertility is a person’s ability to have children. There are several reasons why men with sickle cell disease might have trouble having children.  One major issue is called priapism. This happens when: 
  • A man has a painful erection that won’t go away 
  • Sickle cells block blood flow in the penis 
  • The erection lasts much longer than normal 
  If priapism isn’t treated by a doctor, it can cause problems with sexual function later. Men with sickle cell disease are more likely to have trouble with erections than other men.  
  • Men with SCD are 2.5 times more likely to have erectile dysfunction than men without SCD. 
  • Men with SCD who have had priapism are 5 times more likely to have erectile dysfunction 
  Visit Save the Male Trunks to sign up for educational materials on priapism and a care package.      Also, some of the treatments related to SCD might affect fertility. Taking hydroxyurea can cause lower sperm counts.12 Also, the chemotherapy used to prepare for treatments like bone marrow transplant or gene therapy can damage the cells that make sperm.   These treatments might cause infertility. Not everyone will become infertile, but there is still a risk. There are options to help men save their ability to have children: 
  • Sperm banking - Teenage boys and adult men can save their sperm before starting HU treatment 
  • Taking a break from HU - Men can stop HU for a short time so doctors can collect sperm (they might need monthly blood transfusions during this time) 
  • Saving testicular tissue - Young boys who haven’t started puberty or are unable to sperm bank can have testicular tissue frozen and saved.13 This is an experimental option and would only be used before bone marrow transplant or gene therapy.   

Sexual Health

Sexual health is an important part of staying healthy overall. Sexual health is also very important for those living with SCD. Learning how to prevent sexually transmitted infections (STIs), pick the right birth control, and talk openly with partners helps you make smart choices about your body and relationships. 

There are many types of birth control5 that you should talk about with your partner(s).  

Here are some examples:  

  • Condoms - These create a barrier that stops pregnancy and STIs from spreading 
  • Hormonal methods - These include things like birth control pills or implants that change your body’s hormones 
  • Non-hormonal methods – these include things like copper intrauterine devices (IUDs) and natural family planning 

 

Hormonal birth control does more than just prevent pregnancy. It can also: 

  • Make period symptoms better 
  • Reduce cramping 
  • Make periods lighter 
  • Lower the chance of not having enough iron in your blood 
  • Help reduce pain episodes 

 

If you’re sexually active, you should get tested for STIs regularly. How often7 depends on your situation. People with multiple partners or partners they don’t know well should get tested more often. You can find testing locations online. Click here to find HIV, STI, and viral hepatitis testing and vaccine locations. 

Sometimes sickle cell disease can make it harder to enjoy sexual activity. This is called sexual dysfunction, and it happens to people without sickle cell disease too. Check out this article to read more about how SCD can impact sexual activity and intimacy. 

  1. Stimpson SJ, Rebele EC, DeBaun MR. Common gynecological challenges in adolescents with sickle cell disease. Expert Rev Hematol. 2016;9(2):187-96. 
  2. Segbefia et al. Pain Frequency and Health care utilization patterns in women with sickle cell disease . J Wmen health, 2023. 
  3. Whetzel C. Hydroxyurea does not reduce ovarian reserve in female patients with SCD. Hematology.org. July 18, 2024. https://www.hematology.org/newsroom/press-releases/2024/hydroxyurea-does-not-reduce-ovarian-reserve.    
  4. Nickel RS, Maher JY, Hsieh MH, Davis MF, Hsieh MM, Pecker LH. Fertility after Curative Therapy for Sickle Cell Disease: A Comprehensive Review to Guide Care. J Clin Med. 2022;11(9):2318. Published 2022 Apr 21. doi:10.3390/jcm11092318  
  5. Centers for Disease Control and Prevention. Contraception and birth control methods. CDC.gov. August 6, 2024. https://www.cdc.gov/contraception/about/index.html  
  6. Centers for Disease Control and Prevention. Summary Chart of U.S. Medical Eligibility Criteria for Contraceptive Use (U.S. MEC). CDC.gov. https://www.cdc.gov/contraception/media/pdfs/2024/07/us-mec-summary-chart-color-508.pdf.   
  7. Centers for Disease Control and Prevention. Getting tested for Stis. CDC.gov. January 31, 2025. https://www.cdc.gov/sti/testing/   
  8. Sickle Cell Reproductive Health Education Directive. Handouts. SCRED. April 22, 2024. https://sicklecellred.org/resources/handouts/  
  9. NIH National Institute on Aging. What is menopause? October 16, 2024. https://www.nia.nih.gov/health/menopause/what-menopause.   
  10. Marwah Farooqui, Elisa Martinez, Kaitlin Sung, Marianna Vakaki, Kayla Gross, Xu Zhang, Victor R. Gordeuk, Gelila Goba; Menopause in Sickle Cell Disease: Unchartered Territory. Blood 2023; 142 (Supplement 1): 2509. doi: https://doi.org/10.1182/blood-2023-189968 
  11. Alleyne Arch Intern Med 1981, Serjeant Arch Dis Child 2001, Abbasi Ann of Int Med 1976, Nahoum Androl 1980, Osegbe D Lancet 1981, Modebe Fert & Ster 1995​ 
  12. Mariane De Montalembert, Pablo Bartolucci, Gonzalo De Luna, Anoosha Habibi, Scylia Alexis-Fardini, Maryse Etienne-Julan, Gylna Loko, Giovanna Cannas, Jean-Benoit Arlet, Latifatou Boukari, Sylvain Le Jeune, Laure Joseph; Puberty Onset and Preservation of Fertility in Male Patients with Sickle Cell Disease Treated with Hydroxyurea: Data from the European Sickle Cell Disease Cohort – Hydroxyurea Extension (ESCORT-HU Extension) Study. Blood 2023; 142 (Supplement 1): 145. doi: https://doi.org/10.1182/blood-2023-178219 
  13. Delgouffe E, Braye A, Goossens E. Testicular Tissue Banking for Fertility Preservation in Young Boys: Which Patients Should Be Included?. Front Endocrinol (Lausanne). 2022;13:854186. Published 2022 Mar 10. doi:10.3389/fendo.2022.854186  

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Indicators of an Emergency Situation

Patients and families should watch for the following conditions that need an urgent medical evaluation:
• Fever of 101° F or higher
• Chest pain
• Shortness of breath
• Increasing tiredness
• Abdominal swelling
• Unusual headache
• Any sudden weakness or loss of feeling
• Pain that will not go away with home treatment
• Priapism (painful erection that will not go down)
• Sudden vision change

Learn more about sickle cell disease

Reproductive Health

People with sickle cell disease may have special health needs when it comes to starting a family. Sickle cell disease can impact reproductive health in several different ways including delayed puberty, high-risk pregnancy, and even challenges during sex. SCD impacts both sexes in different ways, so it’s important to review the resources below. 

People with SCD should also remember that they can pass along their sickle hemoglobin genes to their children. They could have children with sickle cell disease if their partner also has a sickle hemoglobin gene. The chances can be 25%, 50%, or 100% chance of having a baby with sickle cell disease, depending on the genes that the parents have. Therefore, knowing about genetics and knowing your partner’s hemoglobin type are very important parts of reproductive health in sickle cell disease. 

Girls & Women

There is an organization called the Sickle Cell Reproductive Health Education Directive (SC RED) that helps people with sickle cell disease find resources and learn more about this topic. The mission of SC RED is to make sure people with sickle cell disease get high-quality health care when they want to have children. 

You can watch videos about this topic on the SC RED website. 

Puberty

Children with sickle cell disease may grow and develop more slowly than other kids. They usually start puberty later than their friends. For girls with sickle cell disease, this can mean getting their first period later than other girls.1 

The medicine hydroxyurea can significantly help people with sickle cell disease, but doctors are still learning how it affects when girls get their first period. 

Menstruation

Girls and women with sickle cell disease have more pain than boys and men. The biggest difference happens between ages 10-39, which is the time when many women get their period every month.1 

Getting your period can make sickle cell pain worse. Some studies show that 28-49% of women with sickle cell disease have pain episodes right before or during their period. This means they might have to go to the hospital more often. Many women with sickle cell disease also get very bad cramps during their period.2 

Birth control methods like pills, shots, or small devices put under the skin (implants) might help reduce period pain. Your sickle cell provider can help find a safe treatment that works for you. 

Fertility

Fertility is a person’s ability to have children. Many women with sickle cell disease are still able to have children. However, it’s important to understand the connection between certain SCD treatments and fertility. 

Hydroxyurea helps people with sickle cell disease by reducing the number of pain crises and helping with other symptoms. Some people worried it might make it harder for women to have children. But a new study shows that hydroxyurea doesn’t hurt a woman’s ability to have children. This means women don’t need to save their eggs before taking this medicine.3 

However, some stronger treatments can make it harder to have babies. Before getting a bone marrow transplant or gene therapy, patients have to go through chemotherapy. This medicine can sometimes make it hard for people to have children later. 

Not everyone will have trouble having children after these treatments, but it could happen. Many women choose to save their eggs or ovarian tissue before getting these treatments. Doctors freeze the eggs or tissue so women can use them later if they want to try to have children.4    

Sexual Health

Sexual health is an important part of staying healthy overall. Sexual health is also very important for those living with SCD. Learning how to prevent sexually transmitted infections (STIs), pick the right birth control, and talk openly with partners helps you make smart choices about your body and relationships. 

 

There are many types of birth control5 that you should talk about with a doctor or nurse.  

Here are some examples:  

  • Condoms - These create a barrier that stops pregnancy and STIs from spreading 
  • Hormonal methods - These include things like birth control pills or implants that change your body’s hormones 
  • Non-hormonal methods – these include things like copper intrauterine devices (IUDs) and natural family planning 

 

Hormonal birth control does more than just prevent pregnancy. It can also: 

  • Make period symptoms better 
  • Reduce cramping 
  • Make periods lighter 
  • Lower the chance of not having enough iron in your blood 
  • Help reduce pain episodes 

 

The CDC has suggestions6 about which birth control methods are safe for people with different health conditions. For example, some birth control methods increase the chance of getting blood clots, and people with SCD already have a higher risk of blood clots, heart attacks, and strokesWhile there are risks associated with certain birth control methods and SCD, pregnancy is also high-risk for people living with SCD. So, it’s important to always talk to your doctor about what’s best for you. 

If you’re sexually active, you should get tested for STIs regularly. How often7 depends on your situation. People with multiple partners or partners they don’t know well should get tested more often. You can find testing locations online. Click here to find HIV, STI, and viral hepatitis testing and vaccine locations. 

Sometimes sickle cell disease can make it harder to enjoy sexual activity. This is called sexual dysfunction, and it happens to people without sickle cell disease too. Check out this article to read more about how SCD can impact sexual activity and intimacy. 

Pregnancy

When women with sickle cell disease get pregnant, it is considered “high-risk.” This means there’s a higher chance of problems happening, such as: 

  • High blood pressure during pregnancy (preeclampsia) 
  • Having the baby too early (premature birth) 
  • Having a baby that weighs less than normal 
  • Getting infections 
  • The baby dying before birth (stillbirth) 

 

Because of these risks, women with sickle cell disease who are pregnant need special care from two types of doctors: an obstetrician (a doctor who specializes in pregnancy and birth) and your regular hematologist or SCD specialist. 
 

Women living with SCD who want to have a baby should talk to their doctor before trying to get pregnant. The doctor will: 

  • Give advice about getting ready for pregnancy 
  • Check your history of blood transfusions (this can affect future treatments) 
  •  Talk about changing medications – especially if you take hydroxyurea 

With good planning and regular doctor visits, women with sickle cell disease can have healthy pregnancies.8 

The Sickle Cell Reproductive Health Education Directive (SCRED) offers a free, self-paced online course on preconception and pregnancy called, “Planning for Pregnancy with SCD.” 

SCD and Pregnancy Fact Sheets: 

 

Menopause

Menopause is when a woman’s periods stop forever. During menopause, the body stops releasing eggs, which means the woman can no longer get pregnant. Menopause usually happens when women are between 40 and 50 years old. Some common symptoms that happen during menopause include: 

  • Hot flashes  
  • Night sweats  
  • Vaginal dryness, which can lead to painful sex  
  • Sleep problems  
  • Mood changes  
  • Weight gain  
  • Thinning hair and dry skin  

 

Learn more about menopause here.9 

 

Sickle cell disease (SCD) can change how women go through menopause. Women with SCD may: 

  • Start menopause earlier than women without the disease
    • Have stronger symptoms like feeling very tired and having hot flashes
    • Have more or worse pain episodes because of hormone changes 

 

People with SCD are more likely to have early menopause. SCD treatments might help prevent early menopause. One study found that people taking hydroxyurea medicine regularly started menopause around age 50 while people not taking any SCD medicine started menopause around age 39.10 

 

Many women use hormone replacement therapy (HRT) to help with menopause symptoms. However, doctors usually don’t recommend HRT for people with SCD because it increases the chance of getting blood clots, and people with SCD already have a higher risk of blood clots, heart attacks, and strokes 

Always talk to your SCD doctor before trying any menopause treatments. 

Boys & Men

Puberty

Chronic anemia can slow down growth. Boys with SCD may also go through puberty later than other boys their age. They may be about 2-3 years behind in puberty. This means they might be later to develop: 

  • Body hair 
  • Facial hair 
  • Changes to genitals 
  • Voice changes (voice getting deeper) 
  • First time releasing semen 

 

Because of these delays, boys with sickle cell disease may: 

  • Be shorter or thinner than their classmates 
  • Look younger than other boys their age 
  • Start puberty changes when they’re older 

 

This is normal for boys with sickle cell disease, but it can sometimes make them feel different from their friends.11 

Fertility & Erectile Dysfunction

Fertility is a person’s ability to have children. There are several reasons why men with sickle cell disease might have trouble having children.  One major issue is called priapism. This happens when: 
  • A man has a painful erection that won’t go away 
  • Sickle cells block blood flow in the penis 
  • The erection lasts much longer than normal 
  If priapism isn’t treated by a doctor, it can cause problems with sexual function later. Men with sickle cell disease are more likely to have trouble with erections than other men.  
  • Men with SCD are 2.5 times more likely to have erectile dysfunction than men without SCD. 
  • Men with SCD who have had priapism are 5 times more likely to have erectile dysfunction 
  Visit Save the Male Trunks to sign up for educational materials on priapism and a care package.      Also, some of the treatments related to SCD might affect fertility. Taking hydroxyurea can cause lower sperm counts.12 Also, the chemotherapy used to prepare for treatments like bone marrow transplant or gene therapy can damage the cells that make sperm.   These treatments might cause infertility. Not everyone will become infertile, but there is still a risk. There are options to help men save their ability to have children: 
  • Sperm banking - Teenage boys and adult men can save their sperm before starting HU treatment 
  • Taking a break from HU - Men can stop HU for a short time so doctors can collect sperm (they might need monthly blood transfusions during this time) 
  • Saving testicular tissue - Young boys who haven’t started puberty or are unable to sperm bank can have testicular tissue frozen and saved.13 This is an experimental option and would only be used before bone marrow transplant or gene therapy.   

Sexual Health

Sexual health is an important part of staying healthy overall. Sexual health is also very important for those living with SCD. Learning how to prevent sexually transmitted infections (STIs), pick the right birth control, and talk openly with partners helps you make smart choices about your body and relationships. 

There are many types of birth control5 that you should talk about with your partner(s).  

Here are some examples:  

  • Condoms - These create a barrier that stops pregnancy and STIs from spreading 
  • Hormonal methods - These include things like birth control pills or implants that change your body’s hormones 
  • Non-hormonal methods – these include things like copper intrauterine devices (IUDs) and natural family planning 

 

Hormonal birth control does more than just prevent pregnancy. It can also: 

  • Make period symptoms better 
  • Reduce cramping 
  • Make periods lighter 
  • Lower the chance of not having enough iron in your blood 
  • Help reduce pain episodes 

 

If you’re sexually active, you should get tested for STIs regularly. How often7 depends on your situation. People with multiple partners or partners they don’t know well should get tested more often. You can find testing locations online. Click here to find HIV, STI, and viral hepatitis testing and vaccine locations. 

Sometimes sickle cell disease can make it harder to enjoy sexual activity. This is called sexual dysfunction, and it happens to people without sickle cell disease too. Check out this article to read more about how SCD can impact sexual activity and intimacy. 

  1. Stimpson SJ, Rebele EC, DeBaun MR. Common gynecological challenges in adolescents with sickle cell disease. Expert Rev Hematol. 2016;9(2):187-96. 
  2. Segbefia et al. Pain Frequency and Health care utilization patterns in women with sickle cell disease . J Wmen health, 2023. 
  3. Whetzel C. Hydroxyurea does not reduce ovarian reserve in female patients with SCD. Hematology.org. July 18, 2024. https://www.hematology.org/newsroom/press-releases/2024/hydroxyurea-does-not-reduce-ovarian-reserve.    
  4. Nickel RS, Maher JY, Hsieh MH, Davis MF, Hsieh MM, Pecker LH. Fertility after Curative Therapy for Sickle Cell Disease: A Comprehensive Review to Guide Care. J Clin Med. 2022;11(9):2318. Published 2022 Apr 21. doi:10.3390/jcm11092318  
  5. Centers for Disease Control and Prevention. Contraception and birth control methods. CDC.gov. August 6, 2024. https://www.cdc.gov/contraception/about/index.html  
  6. Centers for Disease Control and Prevention. Summary Chart of U.S. Medical Eligibility Criteria for Contraceptive Use (U.S. MEC). CDC.gov. https://www.cdc.gov/contraception/media/pdfs/2024/07/us-mec-summary-chart-color-508.pdf.   
  7. Centers for Disease Control and Prevention. Getting tested for Stis. CDC.gov. January 31, 2025. https://www.cdc.gov/sti/testing/   
  8. Sickle Cell Reproductive Health Education Directive. Handouts. SCRED. April 22, 2024. https://sicklecellred.org/resources/handouts/  
  9. NIH National Institute on Aging. What is menopause? October 16, 2024. https://www.nia.nih.gov/health/menopause/what-menopause.   
  10. Marwah Farooqui, Elisa Martinez, Kaitlin Sung, Marianna Vakaki, Kayla Gross, Xu Zhang, Victor R. Gordeuk, Gelila Goba; Menopause in Sickle Cell Disease: Unchartered Territory. Blood 2023; 142 (Supplement 1): 2509. doi: https://doi.org/10.1182/blood-2023-189968 
  11. Alleyne Arch Intern Med 1981, Serjeant Arch Dis Child 2001, Abbasi Ann of Int Med 1976, Nahoum Androl 1980, Osegbe D Lancet 1981, Modebe Fert & Ster 1995​ 
  12. Mariane De Montalembert, Pablo Bartolucci, Gonzalo De Luna, Anoosha Habibi, Scylia Alexis-Fardini, Maryse Etienne-Julan, Gylna Loko, Giovanna Cannas, Jean-Benoit Arlet, Latifatou Boukari, Sylvain Le Jeune, Laure Joseph; Puberty Onset and Preservation of Fertility in Male Patients with Sickle Cell Disease Treated with Hydroxyurea: Data from the European Sickle Cell Disease Cohort – Hydroxyurea Extension (ESCORT-HU Extension) Study. Blood 2023; 142 (Supplement 1): 145. doi: https://doi.org/10.1182/blood-2023-178219 
  13. Delgouffe E, Braye A, Goossens E. Testicular Tissue Banking for Fertility Preservation in Young Boys: Which Patients Should Be Included?. Front Endocrinol (Lausanne). 2022;13:854186. Published 2022 Mar 10. doi:10.3389/fendo.2022.854186  

Indicators of an Emergency Situation

Patients and families should watch for the following conditions that need an urgent medical evaluation:
• Fever of 101° F or higher
• Chest pain
• Shortness of breath
• Increasing tiredness
• Abdominal swelling
• Unusual headache
• Any sudden weakness or loss of feeling
• Pain that will not go away with home treatment
• Priapism (painful erection that will not go down)
• Sudden vision change

Learn more about sickle cell disease