Progestogen-only contraceptive use among women with sickle cell anemia: a systematic review

The use of progestogen-only contraceptives among women with sickle cell anemia has generated concerns about possible hematological and other clinical complications. Based on the literature, we assessed whether use of progestogen-only contraceptives is associated with adverse health effects among women with sickle cell anemia. We searched the MEDLINE database for articles published in peer-reviewed journals between 1966 and September 2004 that were relevant to sickle cell anemia and use of progestogen-only contraceptives. Of the 70 articles identified through the search, 8 met the criteria for this review. These studies did not identify any adverse events or clinically or statistically significant adverse changes in hematological or biochemical parameters associated with the use of progestogen-only contraceptive methods. Six studies suggested that users experienced a decrease in clinical symptoms and less frequent and severe painful crises compared with nonusers. Although data are limited, these studies suggest that progestogen-only contraceptives are safe for women with sickle cell anemia.