Adolescencia, menstruación y pediatría

Hoy me gustaría compartir con vosotrxs algunos puntos muy importantes que extraigo del artículo académico “Pediatricians’ knowledge, attitudes and practices surrounding menstruation and feminine products (por Miriam R. Singer, Nikita Sood, Eli Rapoport, Haelynn Gim, Andrew Adesman, Ruth Milanaik, 2019):

En este artículo, se recogen los resultados de un cuestionario muy breve (de 5 a 7 minutos) enviado a 2500 pediatras de Estados Unidos, de los cuales solo 518 lo completaron. De ellxs, 364 son mujeres (78.8%) y 366 se identifican como caucásicxs (79.2%).

La principal conclusión a la que llegan las autoras de este artículo es que “aunque el ciclo menstrual está siendo, cada vez más, reconocido como un componente crítico de la salud femenina, muchxs pediatras de atención primaria no siguen las recomendaciones clave de la AAP (Academia Estadounidense de Pediatría) sobre la menstruación en niñas y adolescentes”.

Estos hallazgos son particularmente preocupantes, dado que las niñas que no han recibido educación sobre la menarquia experimentan una mayor ansiedad en torno a la menstruación y no están preparadas para identificar problemas menstruales.

Las investigaciones muestran que, de manera similar a la presión arterial o la frecuencia cardíaca anormales, los patrones menstruales anormales pueden indicar problemas de salud graves. Por lo tanto, al no discutir rutinariamente la menstruación o pedir información clave sobre los ciclos menstruales de la paciente, lxs pediatras pueden perder información importante necesaria para evaluar completamente la salud de la paciente. Lxs encuestadxs también demostraron una falta de conocimiento sobre ciertas áreas de la menstruación, lo que puede obstaculizar aún más su capacidad para identificar patrones menstruales anormales y evaluar de manera integral la salud de la paciente.

La mayoría de los encuestados tampoco suelen ofrecer información sobre el correcto uso de los productos menstruales, ni siquiera informan sobre la copa menstrual, a pesar de su creciente utilización en los últimos años. Según las autoras del artículo, esto es muy preocupante ya que investigaciones previas demuestran que las adolescentes (generalmente) carecen de conocimiento sobre los productos femeninos, los cuales pueden presentar riesgos graves, como el síndrome de choque tóxico, si se usan incorrectamente. Si bien no está claro por qué los pediatras no educan de forma rutinaria a los pacientes sobre los productos femeninos, esto puede ser explicado por la falta de conocimiento en este área, ya que aquellos pediatras que tenían conocimientos sobre los tampones se muestran más predispuestos a discutir su uso y seguridad con las pacientes.

En comparación con las mujeres pediatras, es menos probable que los pediatras varones proporcionen orientación anticipatoria a las pacientes prememárquicas y a lxs tutores; que hablen sobre la menstruación con las pacientes posmenoárquicas; que evalúen el ciclo menstrual y analicen los productos femeninos. Los pediatras masculinos también obtuvieron puntajes de conocimiento medidos y autoevaluados significativamente más bajos para todos los temas evaluados relacionados con la menstruación. Estos hallazgos sugieren que las niñas y adolescentes atendidas por pediatras varones pueden tener incluso menos probabilidades de recibir atención médica que aborde componentes importantes de la salud femenina.

La medicina no puede dejar la educación menstrual solamente como responsabilidad de las madres o de la familia. Las investigaciones también demuestran que muchas madres de niñas y adolescentes también presentan desconocimiento sobre salud menstrual, algo que imposibilita informar debidamente a sus hijas. Si bien las niñas pueden aprender sobre estos temas en la escuela, la educación menstrual en los colegios suele ser mínima o ausente debido a las limitaciones de tiempo y el estigma asociado a la menstruación. Dadas estas barreras a la educación sobre la salud menstrual, es particularmente importante que lxs pediatras brinden información precisa a las adolescentes y a sus tutores sobre estos temas.

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