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The term sickle cell disease refers to a group of red blood cell disorders. The most common type is sickle cell anemia.

Made in bone marrow, red blood cells carry oxygen throughout the body with the help of a protein called hemoglobin. Instead of being shaped like a disk, red blood cells in people with sickle cell disease are crescent-shaped like a sickle. Sickle cells are also less flexible than normal red blood cells.

Because of their shape, sickle cells can get stuck going through small blood vessels, impairing the path of needed oxygen. Sickle cells also have abnormal hemoglobin, and have a shorter life span compared to typical red blood cells.

Sickle cell disease is a lifelong illness that is passed down genetically in families. Symptoms include pain, dizziness, and fatigue.

People with sickle cell disease may also experience pain crises. These sudden bouts of severe pain occur when red blood cells accumulate and block blood vessels.

Sickle Cell Disease and Men’s Sexual Health

Men with sickle cell disease are at higher risk for priapism, an often-painful erection lasting for over four hours. Usually, these erections aren’t related to sexual activity. Priapism develops in an estimated 40% of men with sickle cell disease.

Some men with sickle cell disease develop “stuttering” priapism (recurrent ischemic priapism). With this type of priapism, erections typically last for less time, but occur more often.

Priapism is a medical emergency. Left untreated, priapism can lead to tissue damage and erectile dysfunction (ED) – the inability to get an erection rigid enough for sexual activity.

In a 2015 Journal of Sexual Medicine study of 59 men, scientists found that men with sickle cell disease were twice as likely to develop ED compared to men without sickle cell disease. The rate was even higher when the researchers considered factors like duration and frequency of priapism episodes.

Men with sickle cell disease might also have painful erections, especially if they experience frequent pain crises.

Women and Sickle Cell Disease

Women who have chronic pain or frequent pain crises might also have pain during sex. Opioids prescribed to manage the pain may lead to hormonal imbalances, which can also contribute to painful sex.

Women with sickle cell disease should be cautious when using hormonal contraceptives, such as birth control pills. Medications that use a combination of hormones could increase the frequency of pain crises. Contraceptives that use a single hormone are often a better choice.

If you or your partner are coping with sickle cell disease, stay in close touch with your doctor. Don’t hesitate to ask questions about your sexual health. Many sexual problems can be treated.

Men with sickle cell disease should take priapism seriously. If you or your partner have an erection that lasts longer than usual, go to your local emergency clinic immediately.

Resources

American Academy of Family Physicians

“Sickle Cell Disease”
(Last updated: April 1, 2020)

https://familydoctor.org/condition/sickle-cell-disease/

International Society for Sexual Medicine

“Sickle Cell Men are Five Times More Likely to Develop ED with Recurrent Ischemic Priapism”

(March 9, 2015)

https://www.issm.info/news/sex-health-headlines/sickle-cell-men-are-five-times-more-likely-to-develop-ed-with-recurrent-isc/

The Journal of Sexual Medicine

Anele, Uzoma A., MD and Arthur L. Burnett, MD, MBA

“Erectile Dysfunction after Sickle Cell Disease–Associated Recurrent Ischemic Priapism: Profile and Risk Factors”

(Full-text. March 2015)