Levels of Estrogen, Progesterone and Follicle Stimulating Hormone among Nigerian Females Living with Sickle Cell Anaemia

Background: Sickle cell Anaemia (SCA) is an inherited disorder characterized by abnormality in sexual development and reduced fertility which may be due to derangement in the level of sex hormones. This study aimed to evaluate the levels of estrogen, progesterone and follicle stimulating hormone (FSH) among adult females with SCA (HbSS).

Methods: A cross-sectional study of adult female patients with HbSS as well as individuals with sickle cell trait (HbAS) and normal adult haemoglobin (HbAA) was done. Hemoglobin phenotype was determined using electrophoretic method. Estrogen, progesterone and FSH levels were assayed using enzyme-linked immunosorbent assay (ELISA) technique, full blood count was determined using Hematology autoanalyzer while disease severity was evaluated using an objective scoring system.

Results: Seventy females with mean age of 23.8 ±4.9 years were studied. They included 30 (42.8%) HbSS participants in steady state and 40 controls [20 (28.6%) HbAS and 20 (28.6%) HbAA]. There was significant decrease in mean serum levels of estrogen in individuals with HbSS compared to those of HbAS and HbAA (P<0.05). Also, there was significant decrease in progesterone level when HbSS were compared to HbAS participants (p< 0.05), but the difference didn’t reach significance level when HbSS were compared with HbAA participants (P>0.05). There was higher mean serum level of FSH in HbSS when compared to HbAS and HbAA, though not significant (P>0.05). FSH levels was also found to be inversely correlated with disease severity in individuals with HbSS, though not significant.

Conclusion: Female individuals with HbSS have significantly lower mean levels of estrogen and progesterone compared to Hb AA and HbAS individuals but higher FSH levels compared to HbAS and HbAA individuals, though not significant. Among HbSS individuals, FSH level correlated inversely with disease severity, though not significant.