Kusankha zamankhwala othandizira mahomoni

Hormone therapy (HT) imagwiritsa ntchito mahomoni amodzi kapena angapo kuti athetse vuto lakutha.

Pa kusintha:

• Thumba losunga mazira la mkazi limasiya kupanga mazira. Amapanganso estrogen ndi progesterone yocheperako.
• Msambo umatha pang'onopang'ono pakapita nthawi.
• Nthawi zimatha kutalika kwambiri kapena kusiyanasiyana. Izi zitha kukhala zaka 1 mpaka 3 mukayamba kudumpha.

Kutha msambo kumatha kuima mwadzidzidzi pambuyo pa opareshoni kuchotsa mazira, chemotherapy, kapena mankhwala ena a mahomoni a khansa ya m'mawere.

Zizindikiro za kusamba kwa thupi zimatha zaka 5 kapena kupitilira apo, kuphatikizapo:

• Kutentha ndi thukuta, nthawi zambiri kumakhala koyambirira kwa 1 mpaka 2 zaka mutangomaliza kumene
• Kuuma kwa nyini
• Maganizo amasintha
• Mavuto ogona
• Chidwi chochepa pa kugonana

HT itha kugwiritsidwa ntchito pochiza matenda akusamba. HT imagwiritsa ntchito mahomoni a estrogen ndi progestin, mtundu wa progesterone. Nthawi zina testosterone imawonjezedwanso.

Zizindikiro zina zakusamba zimatha kuyendetsedwa popanda HT. Mankhwala ochepetsa ukazi wa estrogen ndi ukazi zitha kuthandiza kuwuma kwa nyini.

HT imabwera ngati mapiritsi, chigamba, jakisoni, zonona kapena piritsi, kapena mphete.

Kutenga mahomoni kumatha kukhala ndi zoopsa zina. Mukamaganizira za HT, phunzirani momwe zingakuthandizireni.

Mukamamwa mahomoni, kutentha kwambiri ndi thukuta usiku kumachitika kawirikawiri ndipo kumatha kutha pakapita nthawi. Pochepetsa kuchepa kwa HT kumatha kupangitsa kuti zizindikirazi zizikhala zosavutitsa.

Thandizo la mahomoni lingathandizenso kuthetsa:

• Mavuto akugona
• Kuuma kwa nyini
• Nkhawa
• Kukhazikika komanso kukwiya

Nthawi ina, HT idagwiritsidwa ntchito kuthandiza kupewa kupukuta mafupa (kufooka kwa mafupa). Izi sizili choncho. Dokotala wanu akhoza kukupatsani mankhwala ena ochizira kufooka kwa mafupa.

Kafukufuku akuwonetsa kuti HT siyithandiza kuchitira:

• Matenda a mtima
• Kusadziletsa kwamikodzo
• Matenda a Alzheimer
• Kusokonezeka maganizo

Onetsetsani kuti mwalankhula ndi dokotala wanu za kuopsa kwa HT. Zowopsa izi zitha kukhala zosiyana kutengera msinkhu wanu, mbiri yazachipatala, ndi zina.

MALO A MWAZI

Kutenga HT kumatha kuwonjezera ngozi yanu yamagazi. Chiwopsezo chanu chamagulu am'magazi chimakhalanso chachikulu ngati muli onenepa kwambiri kapena mukasuta.

Chiwopsezo chanu chamagazi chingakhale chotsika mukamagwiritsa ntchito zigamba za estrogen m'malo mwa mapiritsi.

Chiwopsezo chanu chimakhala chotsika ngati mugwiritsa ntchito mafuta amphongo ndi mapiritsi komanso mphete ya estrogen yochepa.

KHANSA YA m'mawere

• Akatswiri ambiri amakhulupirira kuti kutenga HT kwa zaka 5 sikuwonjezera chiopsezo cha khansa ya m'mawere.
• Kutenga estrogen ndi progestin limodzi kwazaka zopitilira 3 mpaka 5 kumatha kukulitsa chiopsezo cha khansa ya m'mawere, kutengera mtundu wa progestin womwe wakupatsani.
• Kutenga HT kumatha kupanga chithunzi cha mammogram cha mabere anu kuwoneka mitambo. Izi zitha kupangitsa kuti kukhale kovuta kupeza khansa ya m'mawere koyambirira.
• Kutenga estrogen yokha kumalumikizidwa ndi kuchepa kwa chiopsezo cha khansa ya m'mawere. Komabe, ngati mutenga estrogen ndi progestin limodzi, chiopsezo chanu cha khansa ya m'mawere chingakhale chachikulu, kutengera mtundu wa progesterone womwe mumatenga.

KHANSA YA ENDOMETRIAL (UTERINE)

• Kutenga estrogen yokha kumawonjezera chiopsezo chanu cha khansa ya endometrial.
• Kutenga progestin ndi estrogen kumateteza ku khansara. Ngati muli ndi chiberekero, muyenera kutenga HT ndi onse estrogen ndi progestin.
• Simungakhale ndi khansa ya endometrial ngati mulibe chiberekero. Ndizotetezeka ndikulimbikitsidwa kugwiritsa ntchito estrogen yokha pankhaniyi.

MATENDA A MTIMA

HT ndi yotetezeka kwambiri ikatengedwa musanakwanitse zaka 60 kapena zaka 10 mutayamba kusamba. Ngati mwasankha kumwa estrogen, kafukufuku akuwonetsa kuti ndibwino kwambiri kuyamba ndi estrogen atangopezeka kuti akusamba. Kuyambira estrogen zaka zopitilira 10 kutha kwa kusamba kumawonjezera ngozi ya matenda amtima.

• HT imatha kuwonjezera chiopsezo chokhala ndi matenda amtima mwa amayi achikulire.
• HT imatha kukulitsa chiopsezo kwa azimayi omwe adayamba kugwiritsa ntchito estrogen zaka zopitilira 10 kuchokera kumapeto kwawo.

KUKHALA

Amayi omwe amatenga estrogen yokhayo komanso omwe amatenga estrogen ndi progestin amakhala pachiwopsezo chowopsa cha sitiroko. Kugwiritsa ntchito chigamba cha estrogen m'malo mwa mapiritsi amlomo kumachepetsa chiopsezo. Komabe, chiopsezo chikhoza kuwonjezeka poyerekeza ndi kusamwa mahomoni aliwonse.Kuchepetsa kwa HT kumachepetsanso chiopsezo cha sitiroko.

MAGALALI

Kutenga HT kumachulukitsa chiopsezo chanu chokhala ndi miyala yamtengo wapatali.

KUOPSA KUKHALA (KUFA)

Kufa kwathunthu kumachepetsedwa mwa amayi omwe amayamba HT m'ma 50s. Chitetezo chimatha pafupifupi zaka 10.

Mkazi aliyense ndi wosiyana. Amayi ena sasokonezedwa ndi zizindikilo za kusintha kwa msambo. Kwa ena, zizindikiro ndizovuta ndipo zimakhudza miyoyo yawo kwambiri.

Ngati zizindikiro zakutha msinkhu zikukuvutitsani, lankhulani ndi dokotala wanu za maubwino ndi zoopsa za HT. Inu ndi dokotala wanu mutha kusankha ngati HT ingakhale yoyenera kwa inu. Dokotala wanu ayenera kudziwa mbiri yanu yazachipatala musanapereke HT.

Simuyenera kutenga HT ngati:

• Wadwala sitiroko kapena matenda amtima
• Khalani ndi mbiri yamagazi m'mitsempha mwanu kapena m'mapapu
• Wakhala ndi khansa ya m'mawere kapena ya endometrial
• Khalani ndi matenda a chiwindi

Zosintha zina pamoyo wanu zimatha kukuthandizani kusintha kusintha kwa kusamba musanatenge mahomoni. Zitha kuthandizanso kuteteza mafupa anu, kukonza thanzi la mtima wanu, komanso kukuthandizani kukhala athanzi.

Komabe, kwa amayi ambiri, kutenga HT ndi njira yabwino yochizira matenda osamba.

Pakadali pano, akatswiri sakudziwa kuti muyenera kutenga nthawi yayitali bwanji HT. Magulu ena akatswiri amati mutha kutenga HT pazizindikiro zakusamba kwa nthawi yayitali ngati palibe chifukwa chamankhwala chosiya mankhwala. Kwa amayi ambiri, kuchepa kwa HT kumatha kukhala kokwanira kuthana ndi zovuta. Mankhwala ochepa a HT amakhala ndi zovuta zochepa.

Izi ndi zovuta kukambirana ndi omwe amakuthandizani pa zaumoyo.

Ngati muli ndi magazi ukazi kapena zizindikiro zina zachilendo pa HT, itanani dokotala wanu.

Onetsetsani kuti mupitilize kukaonana ndi dokotala wanu nthawi zonse.

HRT - kusankha; Estrogen m'malo mankhwala - kusankha; ERT- kusankha; Timadzi m'malo mankhwala - kusankha; Kusamba - kusankha; HT - kusankha; Thandizo la mahomoni a menopausal - kusankha; MHT - kusankha

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Cosman F, wochokera kwa Beur SJ, LeBoff MS, et al. Upangiri wazachipatala popewa komanso kuchiza matenda a kufooka kwa mafupa. Osteoporosis Int. 2014; 25 (10): 2359-2381. PMID: 25182228 pubed.ncbi.nlm.nih.gov/25182228/.

de Villiers TJ, Hall JE, Pinkerton JV, ndi al. Ndemanga Yowunikiridwa Yapadziko Lonse yokhudzana ndi kutha kwa mahomoni. Chikhalidwe. 2016; 19 (4): 313-315. PMID: 27322027 adatulutsidwa.ncbi.nlm.nih.gov/27322027/.

Lobo RA. Kusamba kwa thupi ndi chisamaliro cha mkazi wokhwima: endocrinology, zotsatira zakusowa kwa estrogen, zovuta zamankhwala othandizira mahomoni, ndi njira zina zamankhwala. Mu: Lobo RA, Gershenson DM, Lentz GM, Valea FA, olemba. Gynecology Yambiri. Wachisanu ndi chiwiri. Philadelphia, PA: Elsevier; 2017: mutu 14.

Magowan BA, Owen P, Thomson A. Kusamba kwa mankhwala ndi kusintha kwa mahomoni. Mu: Magowan BA, Owen P, Thomson A, eds. Zachipatala Obstetrics ndi Gynecology. Wolemba 4. Zowonjezera; 2019: chaputala 9.

Stuenkel CA, Davis SR, Gompel A, ndi al. Kuchiza kwa zisonyezo zakusamba: Buku la Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2015; 100 (11): 3975-4011. (Adasankhidwa) PMID: 26444994 pubed.ncbi.nlm.nih.gov/26444994/.

• Thandizo Lobwezeretsa Hormone
• Kusamba