Kusamba

Kusamba ndi nthawi m'moyo wa mayi pamene msambo wake umasiya. Nthawi zambiri, ndimasinthidwe achilengedwe, abwinobwino amthupi omwe amapezeka nthawi zambiri azaka zapakati pa 45 mpaka 55. Akatha kusamba, mayi sangathenso kutenga pakati.

Pakutha kwa thupi, mazira a mayi amasiya kutulutsa mazira. Thupi limapanga mahomoni azimayi ocheperako estrogen ndi progesterone. Kuchepetsa kwa mahomoniwa kumayambitsa kusamba.

Nthawi zimachitika kawirikawiri ndipo pamapeto pake zimatha. Nthawi zina izi zimachitika mwadzidzidzi. Koma nthawi zambiri, nthawi zimayima pang'onopang'ono pakapita nthawi.

Kusamba kumatha pamene simunakhalepo ndi chaka chimodzi. Izi zimatchedwa kusintha kwa msinkhu. Kusamba kwa opaleshoni kumachitika pamene chithandizo cha opaleshoni chimayambitsa kugwa kwa estrogen. Izi zitha kuchitika ngati mazira anu onse awiri achotsedwa.

Kusamba nthawi zina kumayambanso chifukwa cha mankhwala omwe amagwiritsidwa ntchito pa chemotherapy kapena mankhwala a mahomoni (HT) a khansa ya m'mawere.

Zizindikiro zimasiyanasiyana mkazi ndi mkazi. Amatha zaka 5 kapena kupitilira apo. Zizindikiro zitha kukhala zoyipa kwambiri kwa azimayi ena kuposa ena. Zizindikiro za kusintha kwa msambo kwa opaleshoni kumatha kukhala koopsa ndikuyamba mwadzidzidzi.

Chinthu choyamba chomwe mungazindikire ndikuti nthawi zimayamba kusintha. Zitha kuchitika pafupipafupi kapena pafupipafupi. Amayi ena amatha kusamba masabata atatu aliwonse asanayambe kudumpha nyengo Mutha kukhala ndi nyengo yosasamba kwa chaka chimodzi kapena zitatu asanaleke.

Zizindikiro zofalikira za kusamba ndizo:

• Kusamba komwe kumachitika kawirikawiri ndipo pamapeto pake kumatha
• Mtima ukugunda kapena kuthamanga
• Kutentha kotentha, nthawi zambiri kumakhala koipa kwambiri pazaka 1 mpaka 2 zoyambirira
• Kutuluka thukuta usiku
• Khungu likuwuluka
• Mavuto akugona (kusowa tulo)

Zizindikiro zina zakusamba mwina ndi izi:

• Kuchepetsa chidwi pa kugonana kapena kusintha pakugonana
• Kuiwala (mwa akazi ena)
• Kupweteka mutu
• Kusintha kwa zinthu, kuphatikiza kukwiya, kukhumudwa, komanso kuda nkhawa
• Kutuluka kwa mkodzo
• Kuuma kwa nyini ndi kugonana kowawa
• Matenda a nyini
• Zowawa zophatikizana
• Kugunda kwamtima kosasintha (kugunda)

Mayeso amwazi ndi mkodzo atha kugwiritsidwa ntchito kuyang'ana kusintha kwa mahomoni. Zotsatira zoyesa zitha kuthandizira omwe amakuthandizani azaumoyo kudziwa ngati mwatsala pang'ono kusintha kapena ngati mwadutsa kale kusamba. Wopereka chithandizo angafunike kubwereza kuyesa kuchuluka kwa mahomoni anu kangapo kuti mutsimikizire ngati muli ndi nthawi yosamba.

Mayeso omwe angachitike ndi awa:

• Estradiol
• Hormone yolimbikitsa (FSH)
• Mahomoni a Luteinizing (LH)

Wopereka wanu ayesa mayeso m'chiuno. Kuchepetsa estrogen kungayambitse kusintha kwa nyini.

Kutaya kwa mafupa kumawonjezeka mzaka zoyambirira mutangomaliza kumene. Wopereka wanu atha kuyitanitsa kuyesa kwa kuchuluka kwa mafupa kuti ayang'ane kutayika kwa mafupa okhudzana ndi kufooka kwa mafupa. Kuyezetsa magazi kumeneku kumalimbikitsidwa kwa azimayi onse azaka zopitilira 65. Kuyesaku kungalimbikitsidwe posachedwa ngati muli pachiwopsezo chachikulu chofooka kwa mafupa chifukwa cha mbiri ya banja lanu kapena mankhwala omwe mumamwa.

Chithandizo chitha kuphatikizira kusintha kwamachitidwe kapena HT. Chithandizo chimadalira pazinthu zambiri monga:

• Zizindikiro zanu ndi zoipa bwanji
• Thanzi lanu lonse
• Zokonda zanu

CHithandizo CHA HORMONE

HT ingakuthandizeni ngati muli ndi zotentha kwambiri, thukuta usiku, zovuta zam'mimba, kapena kuuma kwa nyini. HT ndi chithandizo chokhala ndi estrogen ndipo, nthawi zina, progesterone.

Lankhulani ndi omwe akukuthandizani za zabwino ndi zoopsa za HT. Wothandizira anu ayenera kudziwa mbiri yanu yonse yazachipatala ndi banja asanalembe HT.

Kafukufuku wowerengeka adafunsira zaumoyo ndi zovuta za HT, kuphatikiza chiwopsezo chokhala ndi khansa ya m'mawere, matenda amtima, sitiroko, ndi magazi kuundana. Komabe, kugwiritsa ntchito HT kwa zaka 10 mutatha kusamba kumalumikizidwa ndi mwayi wochepa wakufa.

Zotsatira zamakono zikuthandizira kugwiritsa ntchito HT pochizira moto. Malangizo apadera:

• HT itha kuyambika mwa azimayi omwe angolowa kumene kusamba.
• HTHS sayenera kugwiritsidwa ntchito kwa amayi omwe adayamba kusamba zaka zambiri zapitazo, kupatula mankhwala amtundu wa estrogen.
• Mankhwalawa sayenera kugwiritsidwa ntchito kwa nthawi yayitali kuposa momwe amafunikira. Amayi ena angafunike kugwiritsa ntchito estrogen kwa nthawi yayitali chifukwa cha kuwotcha koopsa. Izi ndizabwino mwa amayi athanzi.
• Amayi omwe amatenga HT ayenera kukhala pachiwopsezo chochepa cha matenda opha ziwalo, matenda amtima, magazi kuundana, kapena khansa ya m'mawere.

Kuti muchepetse kuopsa kwa mankhwala a estrogen, omwe akukuthandizani angakulimbikitseni:

• Mlingo wocheperako wa estrogen kapena kukonzekera kosiyanasiyana kwa estrogen (mwachitsanzo, kirimu kumaliseche kapena chigamba cha khungu osati mapiritsi).
• Kugwiritsa ntchito zigamba kumawoneka ngati kotetezeka kuposa oral estrogen, chifukwa kumapewa chiopsezo chowonjezeka cha magazi omwe amawagwiritsa ntchito pakamwa pa estrogen.
• Mayeso omwe amapezeka pafupipafupi, kuphatikiza mayeso a m'mawere ndi mammograms

Amayi omwe adakali ndi chiberekero (ndiye kuti, sanachitidwe opareshoni kuti awachotse pazifukwa zilizonse) ayenera kumwa estrogen pamodzi ndi progesterone yoletsa khansa yolumikizana ndi chiberekero (khansa ya endometrium).

ZINTHU ZINA KWA CHITHANDI CHA HORMONE

Palinso mankhwala ena omwe angathandize pakusintha kwamaganizidwe, kutentha kwambiri, ndi zizindikilo zina. Izi zikuphatikiza:

• Ma anti-depressants, kuphatikiza paroxetine (Paxil), venlafaxine (Effexor), bupropion (Wellbutrin), ndi fluoxetine (Prozac)
• Mankhwala a kuthamanga kwa magazi otchedwa clonidine
• Gabapentin, mankhwala osokoneza bongo omwe amathandizanso kuchepetsa kutentha

KUSINTHA KWA MOYO NDI KUSINTHA

Zomwe mungachite kuti muchepetse kusintha kwa kusamba ndikuphatikizapo:

Kusintha kwa zakudya:

• Pewani caffeine, mowa, ndi zakudya zonunkhira.
• Idyani zakudya za soya. Soy ali ndi estrogen.
• Pezani calcium ndi vitamini D wambiri mu zakudya kapena zowonjezera.

Njira zolimbitsa thupi ndi kupumula:

• Muzichita masewera olimbitsa thupi.
• Chitani masewera olimbitsa thupi a Kegel tsiku lililonse. Amalimbitsa minofu ya nyini ndi m'chiuno mwanu.
• Yesetsani kupuma pang'onopang'ono, ndikuzama kupuma pakangoyamba kutentha. Yesani kupuma 6 pamphindi.
• Yesani yoga, tai chi, kapena kusinkhasinkha.

Malangizo ena:

• Valani mopepuka komanso mosanjikiza.
• Pitirizani kugonana.
• Gwiritsani ntchito mafuta opangira madzi kapena mafuta okometsera panthawi yogonana.
• Onani katswiri wa kutema mphini.

Amayi ena amataya magazi kumaliseche atatha kusamba. Izi nthawi zambiri sizoyenera kuda nkhawa. Komabe, muyenera kuuza omwe akukuthandizani ngati izi zichitika, makamaka ngati zimachitika koposa chaka mutatha kusamba. Kungakhale chizindikiro choyambirira cha mavuto monga khansa. Yemwe amakupatsani mwayi wogwiritsa ntchito chiberekero amadzipangiranso chiberekero kapena ukazi wa ultrasound.

Kuchepetsa kuchuluka kwa estrogen kwalumikizidwa ndi zovuta zina kwakanthawi, kuphatikiza:

• Kutaya mafupa ndi kufooka kwa mafupa kwa azimayi ena
• Kusintha kwa mafuta m'thupi komanso chiopsezo chachikulu cha matenda a mtima

Itanani omwe akukuthandizani ngati:

• Mukuwona magazi pakati pa nthawi
• Mwakhala ndi miyezi 12 motsatizana popanda nthawi ndipo kutuluka magazi kumaliseche kapena kuwona kumayambiranso mwadzidzidzi (ngakhale magazi ochepa)

Kusamba ndi gawo lachilengedwe la kukula kwa mkazi. Sichiyenera kupewa. Mutha kuchepetsa mavuto omwe angakhalepo kwa nthawi yayitali monga kufooka kwa mafupa ndi matenda amtima pochita izi:

• Sungani kuthamanga kwa magazi, cholesterol, ndi zina zomwe zingayambitse matenda amtima.
• Osasuta. Kugwiritsa ntchito ndudu kumatha kubweretsa kusamba msanga.
• Muzichita masewera olimbitsa thupi nthawi zonse. Zochita zolimbikira zimathandizira kulimbitsa mafupa anu ndikuwongolera bwino.
• Lankhulani ndi omwe amakupatsirani zamankhwala omwe angakuthandizeni kuti mafupa anu asathenso kufooka ngati muwonetsa zisonyezo zoyambirira za kutayika kwa mafupa kapena muli ndi mbiri yolimba yokhudza kufooka kwa mafupa.
• Tengani calcium ndi vitamini D.

Kusintha kwa nthawi; Kusamba Kwam'mbuyo

• Kusamba
• Mammogram
• Ukazi wakunyumba

American College of Obstetricians ndi Gynecologists. ACOG Yesetsani Bulletin Na. 141: kuwongolera zizindikiritso za kutha msinkhu. Gynecol Woletsa. 2014; 123 (1): 202-216. PMID: 24463691 www.ncbi.nlm.nih.gov/pubmed/24463691. (Adasankhidwa)

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.

Lamberts SWJ, van de Beld AW. Endocrinology ndi ukalamba. Mu: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, olemba. Buku la Williams la Endocrinology. Wolemba 13. Philadelphia, PA: Elsevier; 2016: chap 27.

Moyer VA; Gulu Lankhondo Loteteza ku US. Vitamini D ndi calcium supplementation kupewa kuphulika kwa akulu: Ndemanga ya US Preventive Services Task Force. Ann Intern Med. 2013; 158 (9): 691-696. PMID: 23440163 www.ncbi.nlm.nih.gov/pubmed/23440163.

Bungwe la North American Menopause Society. Mauthenga a 2017 othandizira ma hormone a The North American Menopause Society. Kusamba. 2017; 24 (7): 728-753. PMID: 28650892 www.ncbi.nlm.nih.gov/pubmed/28650892. (Adasankhidwa)

Skaznik-Wikiel ME, Traub ML, Santoro N. Kutha msambo. Mu: Jameson JL, De Groot LJ, de Kretser DM, et al, olemba. Endocrinology: Akuluakulu ndi Ana. Wachisanu ndi chiwiri. Philadelphia, PA: Elsevier Saunders; 2016: chap 135.