Sickle Cell and Reproductive Health Research
Roe Research Lab
Our mission is to understand, and ultimately improve, sex differences in health conditions like sickle cell disease. We focus on how changes during the menstrual cycle may trigger pain crises for women with sickle cell disease, and we work to find safe, effective contraceptive and hormonal options that can help prevent them. Through clinical research at Penn Medicine, we aim to improve quality of life and support care that is better tailored to women living with sickle cell disease.
Current Projects
![We are conducting a paid research study to see if women with sickle cell disease (SCD) experience any pain differences while using the birth control injection known as Depo, as compared to when not using it. Depo-Provera is already FDA-approved, safe to use, and lasts for 3 months.
The study duration is 6 months, with 4-5 in-person visits that include a urine[AR2.1] pregnancy test, blood draw, and surveys. Participants will also complete weekly surveys asking about pain and their menstrual cycle, and will be compensated up to $715 for completing all parts of the study. In-person visits will be conducted at 3737 Market Street, Philadelphia, PA.
We are seeking women who are between the ages of 18 and 50 who have been diagnosed with SCD, have a regular menstrual cycle, and experience at least one vaso-occlusive pain episode per month.
If this is something you may be interested in learning more about, please click here to fill out a survey or contact us at (267) 785 – 8044](https://static.wixstatic.com/media/c5d859_523fcfba034040bdbb0c87f4f4147023~mv2.jpg/v1/fill/w_348,h_450,al_c,q_80,usm_0.66_1.00_0.01,enc_avif,quality_auto/c5d859_523fcfba034040bdbb0c87f4f4147023~mv2.jpg)
Publications
C-reactive Protein and the Menstrual Cycle in Females with Sickle Cell Disease
Blood Vessels, Thrombosis & Hemostasis, 2025
In 31 females with sickle cell disease, C-reactive protein levels were significantly higher among those in the follicular phase (the first half) of the menstrual cycle, compared to those in the luteal phase (the second half) of the menstrual cycle. This study suggests that inflammation may vary across the menstrual cycle, which may help explain why some individuals with sickle cell disease tend to have pain episodes associated with their periods.
Sex as an Independent Risk Factor for Venous Thromboembolism in Sickle Cell Disease: A Cross-Sectional Study
Journal of Women's Health, 2022
In a cohort of 597 individuals with sickle cell disease at Penn Medicine, 25% had a history of venous thromboembolism (deep vein thrombosis or pulmonary embolism). Twice as many females had a venous thromboembolism than males. This study shows that females with sickle cell disease are at higher risk for blood clots than males, which is particularly relevant as females consider pregnancy and certain types of contraception, which can also increase risk of blood clots.
Induced and Spontaneous Abortion Outcomes among Individuals with Sickle Cell Disease
Contraception, 2025
In 71 pregnancies among individuals with sickle cell disease undergoing abortion or miscarriage at Penn Medicine, the majority had a procedure (rather than medication) for management, and surgical complications were uncommon. The most common complication was presentation to the emergency department within 30 days for vaso-occlusive pain. This study demonstrates the overall safety of procedural management of abortion and miscarriage for those with sickle cell disease; medication management remains understudied.
Contraceptive Attitudes and Beliefs of Women With Sickle Cell Disease: A Qualitative Study
Women's Health Issues, 2024
In qualitative interviews with 20 reproductive-aged women with sickle cell disease, participants described skepticism about hormonal contraception, concerns about adverse effects of contraception, inconsistent counseling by health care providers, and limited reproductive autonomy. This study highlights the need for coordinated, patient-centered contraceptive counseling for individuals with sickle cell disease.
Contraceptive Use and Preferences among Females with Sickle Cell Disease
Contraception, 2022
In this survey of 48 adult females with sickle cell disease at Penn Medicine, 56% were not using contraception, a substantially higher proportion than in the general U.S. population. The depot medroxyprogesterone injection and intrauterine device were the most contraceptives used. When asked about important characteristics in a contraceptive method, participants prioritized contraceptive effectiveness, personal control over use, and minimizing side effects. This study shows that individuals with sickle cell disease make contraceptive choices and have preferences that differ from the general population in the U.S.
Our Team
Andrea Roe, MD, MPH
Principal Investigator
Dalia Karim
Clinical Research Coordinator
Felicitas Tananibe
Clinical Research Coordinator
Susanna Ostrowski
Clinical Research Coordinator