Iimfumba ezidlulileyo kwizinto ezibalulekileyo ezizimeleyo
I-US Preventive Services Task Force-igunya eliyinkokheli yelizwe kwiinkonzo zokukhusela i-kliniki-liqinisekisile isiphetho sayo sangaphambili malunga ne-hormone yonyango ekutshintsheni kwimiqathango yokukhusela isifo esingapheliyo. Kwakhona, i-Task Force iye yakhupha eli sicwangciso ibhalana ye-"D," ebonisa isincophiso ngokuchasene nayo ngesiseko sobubungqina obukhoyo.
Ukusebenzisa imilinganiselo yayo ephakamileyo kunye nephakamileyo yobungqina, kunye nokujongana nombuzo othi ingaba ingekho indawo ye-hormone substitution (HR) inganconywa "ngokubanzi" kubo bonke abasetyhini ekukhuleni komzimba ekukhuselweni kwesifo senhliziyo, umhlaza, isifo sikashukela, isifo sengqondo somzimba, i-osteoporosis, kunye nomngcipheko wokufa kwangaphambi kwexesha elihambelana naluphi na olu, le Msebenzi usebenza ngokuqinisekileyo. Impendulo yaloo mbuzo kubungqina obukhoyo ngu: cha. Kukho iingeniso ezininzi ezinokuthi zithathelwe i-hormone, kodwa ezininzi ezinokuthi zibenokulimala ngokunjalo, kwaye ngokubanzi, idatha esuka kwizilingo ezinkulu kunye nezilungelelaniso ezingenakucatshulwa ngaphandle kwe-net benefit.
Kodwa ngelixa uMpendulo weBasebenzi oMsebenzi ungabonakali kakuhle, umbuzo wabo ngowomnye umba. Ngaba isiphelo sifinyelelwe malunga nokutshintshwa kwe-hormone ekutshatsheni kwindoda ngokuqhelekileyo, kubo bonke abafazi ngokubanzi, ngokuqinisekileyo baguqulela kwiingcebiso ezintle nawuphi na umfazi othile? Ngokombono wam, akunjalo. Kwaye, nangona i-Task Force iphetha ngokulandelelana ngokubakho ubungqina bemibandela yabo ephakamileyo, imida yaloo bungqina inokuphinda inselele.
Uninzi lwezinto ezibalulekileyo ezinokuthi zingakhange zihlanjululwe, zingakhange zifundwe, okanye zigqitywe nje elwandle yolwazi.
Izibonda ezine
Ngentlonelo yonke yoBasebenzi kunye nesiphetho sabo, ngoko, ndiyabelana ngombono osebenza nabo ukuba kukho inokulimaza kwisigwebo somtshintshi ngokutsha endaweni ye-hormone. Ngokukodwa, ndicinga ukuba i-Task Force isincomo ixhomekeke kwimivalo emine:
1) Ukulahla okungafaniyo nokuchithwa
Naluphi na ukutolika idatha malunga noluntu, zikhona izingozi ezingenakuphepha kwiindlela ezimbini eziphikisanayo: ukubola, nokwahlukana. Ukulahla xa amaqela ahlukeneyo eqela elikhulu ephathwa ngokufanayo. Ukuchithwa xa kulungiselelwa isibonelelo sokubaluleka kokuhluka phakathi kweqela, ngokubanzi ngokucwangciswa kweqela elincinane.
Ngenxa yokuba umsebenzi we-Task Force uza kukhupha isincophiso esichazela abantu ngokubanzi, okanye enye inxalenye enkulu, baxhomekeke kwiimfanelo zokuhlamba.
Ziziphi iimfanelo? Ewe, isigqibo sabo malunga nokutshintshwa kwe-hormone sisekelwe ikakhulu kwisilingo esisodwa esikhulu kunazo zonke kulo mbandela, iNkulumbuso yeMpilo yabasetyhini . Kodwa eso silingo sabhalisa abasetyhini abasetyhini nabancinci; abafazi abaqala i-HR emva kokumisa umva, kunye nalabo abaqalile emva kweminyaka elishumi; abafazi abaye bafumana i-hysterectomy kwaye, ngoko, banako ukuthatha i-estrogen yodwa; kunye nabasetyhini abanesibindi esilungileyo ababefuna ukudibanisa i-estrogen kunye neprogesterone.
Ngaba bonke aba bahlukeneyo bafazi baneziphumo ezifanayo kwi-HR? Kude kuyo. Oogxa kwaye ndapapasha uhlalutyo ngo-2013 kwi- American Journal ye-Health Health , ngokusekelwe kwidatha esuka kwi-Women's Health Initiative, kodwa igxininise kwiziphumo zangexesha elide kwabasetyhini abaye bafumana i-hysterectomy kwaye babethatha i-estrogen yedwa.
Xa aba bafazi beqala ulwabiwo lwe-estrogen okanye ngaphambi kokudala iminyaka engama-50, ixesha elide lokuxhoma kwexesha, bafumana ukunciphisa kakhulu kwizinto ezibangelwa ukufa. Ukutolika kwethu kukuba le nqela yabesifazane, ukubala kwinkulungwane yezigidi e-United States, ukungaphumeleli kokusebenzisa indawo yesterngen kubangela amashumi amawaka ekufeni kwangaphambi kweminyaka yonke. Ezi zinto, ke, ziyingozi zokulahla.
2) yooMntwana kunye neBhati yamanzi
Umngcipheko ohambelanayo kakhulu ukuhluleka ukwahlula umntwana kunye namanzi okuhlamba endleleni eya kwisigwebo somfanekiso. Idatha evela kwiimvavanyo apho i-Task Force isincomo isekelwe ukugqamisa ukubaluleka kweminyaka yobudala ngexesha le-hormonal substitution, ixesha elixhomekeke ekuqaleni kwesikhashana, nokuba ingaba i-estrogen ne-progesterone kufuneka idibaniswe.
Nangona iinconywa kubo bonke abafazi ukuba basebenzise i-HR bayakuhluleka ukucima amanzi ahlamba, isiluleko esenziwe ngokubanzi ngokuchasile ukusindisa umntwana.
3) UMthetho weThathu kaNewton
Umthetho wesithathu wendwendwe owaziwayo kukuba: kuzo zonke izenzo, ukusabela okulinganayo nokuphambene . Kwixesha leminyaka edluleyo, siye siphumelela ekusebenziseni i-hormone substitution, ukusabalalisa intshiseko ngokubhekiselele kwizilingo zokuqwalasela, ukubuyela kwi-reticence ekhuselekileyo ngenxa yesilingo esicwangcisiweyo. Ngethuba elowo uhambo oluthile lwe-pendulum lukwaziswa ngolwazi olukhoyo kunye nedatha, kwakhona, ngokuyinxalenye, ukusabela kwi-swing ngaphambili. Iingcamango zenzululwazi mayingenakunyamekela ngokupheleleyo kulo mthetho olula wokunyuka njengebhokisi le-flotsam, kodwa imbono yam ayigxininanga nayo, nokuba kunjalo.
4) Ukungabikho kobufakazi kunye nobufakazi bokungabikho
Imigangatho ephakamileyo yophando eqwalaselwe yiSigqeba soQinisekiso seMisebenzi yokuba ubungqina abasebenzisayo buya kuba luhle. Kodwa ziphi na iziqinisekiso ezinikwe malunga nokungabikho kobungqina obubalulekileyo kwisigqibo esipheleleyo? Akukho, ngokwenene. Ngokuqinisekileyo, iQela leMisebenzi kufuneka linqume ukuba ubungqina obukhoyo bubanelekile ukuxhasa isiphetho esicacileyo, kwaye banokuba namabhalana amabhalana ukubonisa ukuba akunjalo. Kodwa kunjalo, inkqubo yobugqithiso ubuyekeze ngokukhawuleza ukungabikho kobungqina obungqina bokungabikho.
Oko kuthetha ukuthini kulo mxholo othile ukuba yonke into elandelwayo yolu vavanyo ebizwa ngokuthi "i-hormone substitution" ngokuqhelekileyo, eqinisweni, ixhomekeke kwinto ethile ethile, eyona nto iphosakeleyo i-hormone substitution: ukusetyenziswa kwe-Premarin (uhlobo lwe-estrogen ukusuka kumahashe, kungekhona abantu), kunye neProvera (i-medroxyprogesterone acetate, iprogesterone ehlanganisiweyo kunye ne-high-potency potency). Ukudibanisa kwezi ziyaziwa ngokuba yi "Prem / Pro." Ngaba into esiyaziyo malunga nama hormone athile asixelela ngokupheleleyo malunga nabanye? Hayi, akukho-apho apho ubungqina abukho khona. I-Task Force iye yaphatha ukuba "ubungqina obungabikho" njengokuba sinokuqiniseka ukuba ihambelana nombono wokuthi kukho ubungqina obunokwenene bokungabikho kwi-hormone substitution, nangona xa kusetyenziswe amalungiselelo angcono. Inyaniso elula kukuba, asiyazi ngokwenene.
Ukugqiba oko kulungile kuwe
Njengale mijelo engentla, kubonakala ukuba isinconywa seMisebenzi yeQela singaphumeleli ingqwalaselo ebalulekileyo kwizinto eziphambili ezibalulekileyo-eziphambili ezikwazi ukwazisa zakho, ukuzenza izigqibo:
1) Nento yintoni na?
Iingcali zivumi kakhulu ukuba amalungiselelo ehommone ahluke kakhulu kwimiphumo yazo. Idatha yezilingo ezingenakulinganiswa nje ayifumanekanga kumaninzi amalungiselelo ezinjalo iingcali ezicetyiswayo. Ngelixa singenakukwazi ngokuqinisekileyo ukuba amanye amalungiselelo ancitshiswa ngokukhawuleza kwisifo esingapheliyo sesifo xa i-Prem / Pro ingenjalo, izilingo ze-Prem / Pro azikwazi ukulawula loo nzuzo. Ngaphandle kwedatha ekhoyo, imiphumo ye-estrogen kunye neprogesterone, ngokumelene ne-estrogen yodwa, iyahluka ngokuthe ngqo.
2) Nini na?
Imiphumo yokutshintsha i-hormone ihluke ngokuchanekileyo ngexesha. Ukusetyenziswa ngabasetyhini abasebancinci, kufuphi nexesha lokumisa isikhashana, unikeza inzuzo eninzi kunye nomngcipheko omncinane kunokuba kusetyenziswe emva koko. Izilingo ezinkulu ezinemihla ngemihla zazibandakanya ukusetyenziswa kwexesha elidlulileyo, ngelixa ukuhlahlela idatha ukusuka kula maqela kunye.
3) Ngubani na?
Abafazi abaye bafumana i-hysterectomy bangathatha i-estrogen ngaphandle kweprogesterone. Ekuqaleni ukuqala kokunyuka kwesikhashana, oku kubonakala kunokwenzeka ukuba inzuzo ye-hormonal substitution. Isiphumo somnxeba kumngcipheko wobuqu ungase uhluke kwimbali yentsapho kunye neprofayili yomngcipheko. Ngoxa i-Task Force inyanzelekile ukubonelela ngesikhokelo sabantu, le nto ingxaki xa indlela efanelekileyo yokukhusela iphakamileyo. Yona kanye isigqibo esifikelelwe yimibutho ehamba phambili enikezelwa kwimpilo yabasetyhini, kunye nombuzo othize weengozi ezinxulumene nokuyeka umyeni.
Ekugqibeleni, i-HR isoloko isetyenziselwa ukunyanga iimpawu, kunokunciphisa ingozi engapheliyo yesifo. Isiphakamiso esiphakamileyo esiphathelene nokusetyenziswa kwe-HR kumnye singenakuqonda, kwaye singenakulungile, bathethe bobabini abasetyhini kunye noogqirha babo ngaphandle kokusetyenziswa kwalo. Nangona i-HR ingathethi ngokuthembekileyo umngcipheko wesifo esingapheliyo kwabasetyhini ngokubanzi, ayinakwandisa kakhulu; kungoku "ukuhlamba." Ezinye izingozi zikhuphuka, ezinye zihla. Ukusetyenziswa kwexesha elifutshane kwe-HR ukukhulula iimpawu zesifo se-menopausal kusekho okufanelekileyo, okunengqiqo, kwaye ngokuqhelekileyo okukhethwa yingozi.
Ukufuduka kuzo zonke le nto kukuba ngelixa uMbutho Weqela wenzelwe impendulo ethembekileyo, engqinelana nobufakazi kumbuzo owenziwe malunga nabesifazane ngokubanzi, loo mbuzo unokungabi yinto efanelekileyo kuyo nayiphi na ibhinqa ngokukodwa. Ukuthembela kwindlela yokuphila yokunciphisa umngcipheko wesifo esingapheliyo kunconywa kubo bonke, kodwa i-HR inokukhuthazwa kwabanye. Indlela eyona ndlela yokulungiselela impendulo eyenziwa ngumntu ukubuza umgqirha wakho malunga noko kuqondakala kungengabemi, kodwa kuwe.