Reproductive endocrine issues in men with sickle cell anemia

Abstract

In patients with sickle cell anemia, the sickling of red blood cells is known to cause end-organ damage by infarction. In some men who are affected by sickle cell anemia, the obstruction of venous outflow of the penis causes priapism, which could lead to erectile dysfunction. There is also evidence that the disease is linked to other reproductive issues in men-specifically delayed puberty, low testosterone, and sperm abnormalities-although the causes of these problems are less clear. Treatment of sickle cell anemia can have effects on the reproductive system as well. This review summarizes the findings from various publications pertaining to reproductive endocrinology, along with their conclusions and discrepancies.

Male sickle cell patients, compensated transpubertal hypogonadism and normal final growth

“…Regarding the classification of pubertal stage according to the Tanner criteria, two patients were classified as G3P3, and one was classified as G4P4, although all of these patients were older than 18 years. These data are consistent with the literature, which shows a significant delay in the onset of puberty in males with SCD and a lower bone age than that of others who are at their chronological age, with differences of up to 6 years being shown …”

“…Gonadal function disorders in SCD patients are well‐documented, although many questions remain about the pathophysiology of these disorders …”

“…This change would be due to the energy expenditure from erythropoietic hyperplasia and to the increase in cardiac workload in these individuals . Other factors, such as an inadequate and low caloric intake due to appetite suppression by inflammatory mediators and high energy expenditure related to physiological adaptations to haemolysis, changes in body composition resulting in a relative increase in fat‐free visceral mass and inflammation, were related to causes of the low nutritional status of patients …”

Hematopoietic stem cell transplantation for sickle cell disease: Progress and challenges

“…Episodic acute pain may evolve into chronic pain due to peripheral nerve injury, central sensitization, and psychosocial factors . Men with SCD experience priapism, testicular infarction, and gonadal dysfunction; women have high peripartum morbidity and mortality risks . Accumulated disease complications cause disability and low health‐related quality of life (HRQL) …”

“…[37][38][39] Men with SCD experience priapism, testicular infarction, and gonadal dysfunction; women have high peripartum morbidity and mortality risks. 40,41 Accumulated disease complications cause disability and low health-related quality of life (HRQL). [42][43][44] Adults with SCD face even greater challenges than children when navigating the US healthcare system.…”