Sickle cell disease (SCD) is a group of red blood cell disorders that cause the red blood cells to break down and morph into a “sickle” or “C” shape. Healthy red blood cells are round and contain a protein called hemoglobin that carries oxygen. In this way, red blood cells carry oxygen throughout the body.

SCD can cause red blood cells to die early, resulting in a shortage of healthy red blood cells known as sickle cell anemia. It can also sometimes block blood flow throughout the body which can prompt sickle cell crisis, a sudden pain that can last several hours to several days.

Men and women with SCD may suffer from sexual dysfunction. In men, SCD can contribute to priapism, an unwanted, painful, and long-lasting erection, due to blocked blood flow. Women with SCD may also experience sexual dysfunction, but there is limited research on the sexual functioning of women with this condition.

The authors of a recent study sought to add to the existing knowledge about the sexual function of women with SCD. To do this, they used the Female Sexual Function Index (FSFI) to assess the sexual functioning of 435 married Nigerian women with SCD and 406 married Nigerian women without SCD.

Additionally, they used the ENRICH Marital Satisfaction (EMS) to assess the marital satisfaction among all participants. Lastly, they asked the participants with SCD if they had ever experienced sex- or orgasm-induced sickle cell crisis, and if so, what factors they believed contributed to the episode.

Ultimately, they found that the women with SCD experienced sexual dysfunction and marital dissatisfaction at a higher rate than the women without SCD. While under 10% of the participants in the control group (9.4%) experienced dyspareunia, or painful intercourse, 39.1% of those in the SCD group had dyspareunia. Furthermore, the EMS scores of the women with SCD were significantly lower than the EMS scores of the women without SCD, indicating a significantly lower level of marital satisfaction for the women with SCD.

In all, 54.02% of the participants with SCD reported experiencing sex- or orgasm-induced sickle cell crisis. When asked what they thought the reason was, 46.38% said they believed it was due to over-exhaustion and 26.38% thought it was due to dehydration. Other reported potential causes were the chosen sex position, being in one sex position for too long, and feeling sick.

Importantly, most of the women with SCD in this study felt that drinking water before and after sexual activity was beneficial in preventing sex-induced sickle cell crisis. The majority also shared that they enjoyed the missionary position most during sex. Taking these habits into account could make for more comfortable, fulfilling sexual experiences for women with SCD, though further research on the subject would do a lot to expand on this information.

References:

• Adesoye, O.B., & Akhigbe, R.E. (2022). Predictors of Sex-Induced Crisis, Sexual Function and Marital Satisfaction in Women With Sickle Cell Disease. The Journal of Sexual Medicine, 19(11), 1625-1633. DOI: https://doi.org/10.1016/j.jsxm.2022.07.013