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Asociación longitudinal entre la dismenorrea en la adolescencia y el dolor crónico en la edad adulta: un estudio
Rachel Reid-McCann1, Omero B Poli-Neto2, Kate Stein3
1Nuffield Department of Women's and Reproductive Health, John Radcliffe Hospital, University of Oxford, Oxford, UK.
The Lancet. Child & adolescent health
|September 3, 2025
Resumen
La dismenorrea adolescente, o períodos dolorosos, aumenta significativamente el riesgo de desarrollar dolor crónico en la edad adulta. La identificación temprana y el manejo de períodos dolorosos son prioridades cruciales de salud pública.
Área de la Ciencia:
- Investigación del dolor
- Salud de los adolescentes
- Epidemiología del dolor crónico
Sus antecedentes:
- La dismenorrea (periodos dolorosos) es común en los adolescentes y a menudo no se trata adecuadamente debido a factores socioculturales.
- La dismenorrea adolescente está relacionada con el aumento de la sensibilidad sensorial en la edad adulta.
- Este estudio investiga el riesgo a largo plazo de dolor crónico asociado con la dismenorrea adolescente.
Objetivo del estudio:
- Para probar la hipótesis de que la dismenorrea adolescente conduce al desarrollo de dolor crónico general en la edad adulta.
- Para estimar el riesgo de dolor crónico a los 26 años después de la dismenorrea experimentada a los 15.
- Para explorar la relación dosis-respuesta entre la gravedad de la dismenorrea y el riesgo de dolor crónico.
Principales métodos:
- Se utilizaron datos de la cohorte de nacimiento del Estudio Longitudinal Avon de Padres e Hijos (ALSPAC).
- Se evaluó la dismenorrea anualmente desde los 8 a los 17 años y la gravedad a los 15 años.
- Dolor crónico medido (duración ≥3 meses) a la edad de 26 años utilizando datos autoinformados.
- Utilizó regresión logística multivariable, ajustando por factores de confusión, para calcular los riesgos relativos (RR).
- Investigó la ansiedad y los síntomas depresivos como posibles mediadores.
Principales resultados:
- La dismenorrea adolescente moderada y grave se asoció significativamente con un mayor riesgo de dolor crónico a los 26 años.
- Las RR ajustadas para el dolor crónico fueron de 1,65 para la dismenorrea moderada y de 1,76 para la dismenorrea grave en comparación con la ausencia de dismenorrea.
- Las diferencias de riesgo absoluto para el dolor crónico fueron del 12,7% para la dismenorrea moderada y del 16,2% para la dismenorrea grave.
- La ansiedad y los síntomas depresivos mediaron parcialmente la asociación, particularmente con la dismenorrea severa.
Conclusiones:
- La dismenorrea adolescente afecta negativamente el bienestar y aumenta el riesgo de dolor crónico en la edad adulta.
- La dismenorrea adolescente debe reconocerse como un problema de salud pública importante.
- Se recomienda la identificación temprana, el manejo efectivo y la mejora de la alfabetización menstrual.
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