Understanding Sickle Cell Pain in Women

April 6, 2023

Dr. Zachary Ramsay received the 2021 FWGBD Research Fellowship Award with a special focus on Blood Disorders. His project – The Influence of Sex Hormones and Menses on Sickle Cell Pain in Women – is being executed with the mentorship of Professor Monica Asnani and Dr. Deva Sharma.

The overall goal of the study is to understand the association of sex hormones with mechanical and thermal pain thresholds and self-reported pain (acute, chronic and neuropathic) in menstruating women with sickle cell disease,” explains Ramsay.

He and his project team will determine the associations between estradiol, testosterone and progesterone with each pain type. Additionally, they will examine the effect of psychosocial and biological variables like sleep, depression and anxiety.

“We will determine the associations between the sex hormones with thermal and pressure pain thresholds measured by quantitative sensory testing,” he adds. “We will also determine the changes in these pain thresholds during the follicular and luteal phases of the menstrual cycle by repeating measurements at baseline and then at exit visits.”

This study is anticipated to identify endocrine and other biological factors that may either be protective or risky when it comes to pain among women with sickle cell disease. If successful, Ramsay hopes to identify novel strategies to reduce pain-related morbidity and improve health-related quality of life for women with sickle cell disease.

“Our previous published work showed that women with sickle cell disease had higher odds of neuropathic pain, were more sensitive to painful heat and pressure stimuli, and had worse health-related quality of life compared to men with the disease,” Ramsay explains. “I was inspired to explore these findings further, and determine the associated mechanisms and factors.”

Dr. Ramsay’s long-term goal is to further his career as a clinical epidemiologist and help alleviate the pain suffered by women with sickle cell disease through future interventional studies. FWGBD is pleased to support Dr. Ramsay in his work to help this underserved population.