Uphando lubonisa ukukhanya okutsha malunga neempawu zokuphuma komzimba
Kwixesha elide, iingcali ziye zaphawula ukuba ukutshisa okutshisa kunye neempawu ezidandathelanayo zinokubakho ngokukhawuleza ngexesha loxinzelelo lwesisu. Nangona kunjalo, kukho uphando olunqongophele oluhlanganisa iimpawu eziphazamisayo, ukutshisa okutshisayo, kunye nokuqeda umva kunye. Ngaphezu koko, imiba yale ndawo yokufunda ihlala ingqubuzana.
Ukukhanya okungakumbi kuye kwachithwa kwikhonkco phakathi kweempawu ezixinzeleleyo kunye nokuyeka , kunye nolwalamano phakathi kweempawu ezixinzeleleyo kunye nokutshisa okutshisa .
Ukunyuka kwexesha elichazwe
Ngokusekelwe kwiziphumo zobalo luka-2010, izigidi ezingama-41 ezili-151 zezigidi zaseMerika zazingama-55 okanye ngaphezulu. Uninzi lwaloo mabhinqa bekunokwenzeka okanye bebefuna ukufumana umva. Ngaphezu koko, ngenxa yokuba ulindelo lobomi luye landa ngexesha leminyaka emininzi edlulileyo-ngokuphawulekayo ngaphandle kuka-2015 -omama angalindela ukuba ahlale entloni enye yesithathu yobomi babo emva kokumisa umva.
Okuthakazelisayo kukuba, nangona ulindeleke ukuba uluntu lube lukhulile, ixesha eliye laqala ukuphuma kwimizuzu liye latshintshana ixesha elide. Umyinge oneminyaka yobudala yokumisa umama e-United States ngu-51.
Iingqalelo malunga nokuguqulwa kwamathambo kunye ne-hormonal ezihamba kunye nokuphela kwesisu ziye zachaphazelekayo kunyaka ngamnye odlulayo. Abasetyhini abazalwa ngexesha le-baby boom emva kweMfazwe yehlabathi yesibili bafuna unyango lokwenyuka komzimba kunye nezinye iimeko zendalo. Ukongezelela, uninzi lwaba bafazi besemsebenzini, okwenzela isicwangciso esicacileyo seemeko zentlalo.
I- climacteric yinkqubo yokuguga ngexesha apho umfazi eguquka ekuzaleni ukuzala. Nantsi ingxaki ye-climacteric:
- Ukuphela kwexesha yinto yokuguquka kwe-menopausal ye-climacteric ngexesha apho umfazi angalindela ukuba ixesha lakhe libe lingavamile. Ngethuba lexeshana, izikhalazo okanye iimpawu zokuziyeka komzimba ziqala ukubonakalisa, ezifana nokutshisa okutshisa.
- Ukunquma kwexesha kukubhekiselele kwixesha lokugqibela lokuya esikhathini.
- Ukuhamba emva kwendawo yokuma emva kokuma emva kwexesha kubhekisela ebomini emva kokumisa umva.
Nazi ezinye iimeko zeklinikhi ezidibaniswa ne-climacteric:
Iingubo Zama-night kunye ne-Hot Flashes
Phakathi kwama-60 no-80 ekhulwini kwabasetyhini abaguquka ngokuvalelwa kwexesha lokuzilalisa ebusuku kunye nokutshisa okutshisayo (okubizwa nangokuthi iifutha ezitshisayo okanye iimpawu ze-vasomotor ). Ubusuku busuku bubangela iziqwenga zokuphefumula kwaye ngokukhawuleza ukugubha. Kuloo mabhinqa abafumana ukutshisa okukhulu, iipesenti ezingama-82 zivuthayo ezithatha ixesha elingaphezu konyaka, kwaye phakathi kwama-25 no-50 ekhulwini bafumana amaxesha angaphezu kweminyaka emi-5.
Nangona i-hormone ixilongwa ukuba idlale indima, indlela yokuxhoma ukuphela komzimba kunye nokutshisa okutshisayo akukafaneki. Ngokukodwa, abafazi abanamazinga aphezulu e-FSH kunye namazinga e-estradiol aphantsi anokufumana ukukhanya okutshisayo. Ngaphezu koko, abo bashiya okanye abanama-BMI aphezulu nabo banomngcipheko omkhulu wokufumana ukutshisa okukhulu. Okuthakazelisayo, uphando lubonisa ukuba abafazi abamnyama banamafutha atshisayo ngakumbi kunabamhlophe abamhlophe; ngelixa, abafazi baseJapan nabaseTshayina bachaza ukutshisa okutshisa kunokuba ngabafazi abamhlophe.
Osteoporosis
I-Osteoporosis iyimeko ye-skeletal apho i-bone mass drops, kunye namathambo abe yintsholongwane kwaye iyancipha.
Ngokubhekiselele ekupheleni komntu, eli lahleko kwi-bone mass liye litshintsho kwii-hormone. Ezinye iziyobisi zingasetyenziselwa ukuthintela nokunyanga i-osteoporosis, kubandakanya i-bisphosphonates, i-calcitonin kunye ne-raloxifene. Ukongeza kwimiyeza, i-calcium supplement, i-vitamin D, ukuyeka ukutshaya, kunye nokunyamezela umzimba kunokunceda.
I-Atrophy yeVaginal
I-atrophy ye-vaginal ibhekisela ekutyaleni, ukuvuvukala, kunye nokumeka kweendonga zamanzi. Ukuxhalaba, ukutshisa, ukukhutshwa, izikhalazo zomchamo kunye nentlungu ngexesha lesondo lwenzeka. Ekuqaleni, iindonga zesisu zibonakala zibomvu ngenxa yokuphuka kwemithambo yamanzi ebizwa ngokuthi i-capillaries.
Ngenxa yokulahleka kwe-capillary, iindonga zelungu ekugqibeleni ziba zigugile, zikhazimule, zibala. I-atrophy ye-vaginal ivela ngasese ukuya kwehla kumanqanaba e-estrogen. I-atrophy ye-vaginal ingaphathwa ngamafutha okanye i-estrogens ye-topical, esetyenziselwa ulusu ngohlobo lwama-creams, izindandatho, okanye amaphilisi.
Ukusetyenziswa kwezesondo
Ukusebenza ngokwesondo kunokubakho ngenxa yokunciphisa i-libido , utshintsho lwe-hormone kunye neenkolelo zentlalo. I-atrophy ye-vaginal inegalelo ekunciphiseni ukusebenza kwezesondo. Ulwaphulo lweHormone luhlolisiswa njengonyango olunokwenzeka lokunciphisa ukusebenza kwesondo.
Kunzima ukulala
Phakathi kwama-30 no-60 ekhulwini kwabasetyhini abasetyhini bafumana ukuphazamiseka kokulala. Ngokukodwa, aba bafazi banenkathazo yokuwa nokuhlala belele. Nangona ubudala budlala indima kulezi ziphazamiso zokulala, ukutshintsha kwama-hormone, ukutshisa okutshisa, ukunyamezela, kunye neempawu ezixinzelelekileyo zidibaniswa nobunzima bokulala.
Imemori yokulahleka
Uphando lubonisa ukuba ama-62 ekhulwini kwabasetyhini abasetyhini bafumana ubunzima bokukhumbula ngexesha lokutshintsha kwexesha. Olu bunzima bokuba imemori luquka inkathazo ekhumbula iinombolo kunye namazwi kunye nokulibala. Ukuncipha kwi-estrogen kuxhomekeke ekuthandeni indima kule ngxaki.
Iimpawu ezixakekayo kunye nokunquma komntu
Ingaba ukunyuka komntu kusebenza njengengozi yokudakumba kukuxabana. Uninzi lwabasetyhini abasetyhini abanaso iimpawu ezinzima zoxinzelelo. Ngethuba lexesha lokunyuka kwesisu, phakathi kwama-20 no-30 ekhulwini kuma-women's midlife bafumana uxinzelelo lweklinikhi yokuqala okanye iziqulatho eziphindaphindiweyo zokudakumba. Umngcipheko wokudakumba ukhulu ngakumbi ngexesha lokuphela kwexesha kunye nokuhamba kwimizuzu emva kokuphambi kwe-climacteric.
Izimpawu ezixakekayo ziquka ezi zilandelayo:
- ukukhathala
- buhlungu
- netyala
- ukulahleka kwesidlo
- ukulahleka kokulala
- iingxaki ngokugxininisa
- ukuxhalaba
- ukulahlekelwa ngumdla
- iingcinga zokuzibulala
Kwisifundo se-2014 esashicilelwe kwi- JAMA Psychiatry , i-Freeman kunye noogxa bavavanya abafazi abangama-203 abaphakathi kwimiba ecinezelekileyo ngexesha leminyaka elishumi elinama-14 ecaleni lokuphela kwesisu (oko kukuthi, ixesha lokugqibela lokuya esikhathini). La mabhinqa ayengama-foremenopausal aze afumane ukuyeka. Kwakhona bajonge utshintsho kumazinga e-hormone njengengqikelela yokudakumba ngexesha lokuphuma emva kwexesha kunye neembali zangaphambili zokudandatheka.
Nazi ezinye zeziphumo zabaphandi:
- Kwimabhinqa eneembali zokudakumba, ingozi yokufumana iimpawu zokudandatheka yayinamathuba angama-8 emininzi emva kokumiswa komntu kunye namaxesha angaphezu kwama-13 angaphezu kweyabasetyhini ngaphandle kwembali yokudakumba.
- Ngokumalunga nokuphuphuma komzimba ngokwawo, umngcipheko weempawu zoxinzelelo ziphezulu kwiminyaka ngaphambi kokuphuma kwindoda kunye nokunciphisa kwiminyaka emva kokumisa umva. Ngokukodwa, umngcipheko weempawu zokudandatheka kwiminyaka eyi-10 ngaphambili ukuya kwiminyaka eyi-8 emva kokumisa umxhesho kwehle ukuhla kweepesenti ezili-15 ngonyaka.
- Kubasetyhini abaqala ukufumana iimpawu zokudandatheka malunga nokuphela komzimba, iimpawu ezidandathelweyo zancipha ngexesha lokuhamba emva kwexesha, kwaye zancipha kakhulu kwinani lesibili emva kokuphuma kwimizuzu yokuhamba emva kwexesha.
- Kubasetyhini abangenakho ngaphambili kwimbali yokudandatheka, umngcipheko weempawu zokudandatheka wawungaphantsi kwe-2 okanye ngaphezulu kweminyaka emva kokumiswa komzimba.
- Ukuncipha kwiimpawu ezixinezelekileyo ziboniswe utshintsho lwe-hormonal.
Ngokwabaphandi, zikho iziphumo eziphakanyisiweyo zolu cwaningo:
Ukugqithwa kweempawu zoxinzelelo kuyadingeka ukubonelela unyango xa iimpawu zonakalisa kwaye zivavanya umphumo wokudakumba kwezinye iimeko eziphambili, ezifana nesifo senhliziyo, isifo se-metabolic, kunye ne-osteoporosis. Abasetyhini abanembali yokudakumba bangenelwa kwi-antidepressant okanye i-psychotherapy efanelekileyo yesifo esingapheliyo. Nangona kunjalo, abasetyhini abangenayo imbali yokudakumba banokuba nengxaki ephantsi yokubonakaliswa kweempawu emva kowesibili kunyaka lwama-postopaopausal kwaye bazuze kwixesha elifutshane eliyonyango le-hormone okanye unyango olufutshane kunye neengxaki zokuxhatshazwayo eziye zabonisa ukuphumelela kwimiqondiso ye-menopausal.
Ukutshisa okutshisa kunye neziMpawu eziThuzayo
Uninzi lwezifundo eziye zavavanya ikhonkco phakathi kokutshisa okutshisa kunye neempawu zokudandatheka ziye zaphutha ngeendlela ezimbalwa.
Okokuqala, ukuqinisekiswa kovavanyo kukhankanywe, kunye nabaphandi abasebenzisa amanyathelo afanelekileyo ukuhlola ukutshisa okutshisa. Okwesibini, abahloli bajonge nayiphi na iqondo lokutshisa okutshisayo kunokuba baxakeke ngokukhawuleza. Ngokufanayo, abaphandi baye bafumana ingxaki ekuhloliseni iimpawu ezixinzelelekileyo zeklinikhi . Okwesithathu, inani labathathi-nxaxheba kwiingxelo ezihlolisayo ikhonkco phakathi kokutshisa okutshisayo kunye nokuyeka umyeni sele ziphantsi, kwaye ufuna abantu abaninzi banomtshintshi ngendlela efanelekileyo yokumela ngokwenene abantu ovavanyayo.
Kwisifundo seMatshi 2017 esashicilelwe kwiNcwadi yeMpilo yabaseTyhini , iWorsley kunye nabo basebenzisana nezi mpazamo ngokuhlalutya ngokukhawuleza ama-2,020 aseAustralia abasetyhini phakathi ko-40 no-65. Abaphandi basebenzisa imibuzo efanelekileyo kunye nommeleli ukuvavanya abathathi-nxaxheba ngokutshisa okutshisa, ukulinganisela ukuxinezeleka okukhulu, ugwayi ukusetyenziswa, ukusetyenziswa kotywala, kunye neyeza zonyango.
Emva kokulungiswa kwezinto ezininzi, ezibandakanya ubudala, umsebenzi kunye ne-BMI, abaphandi bafumanisa ukuba xa kuthelekiswa nabasetyhini abangenawo okanye ukutshisa okufudumeleyo, abafazi abanomlinganiselo ofanelekileyo wokutshisa ukutshisa kakhulu bekunokuthi babe neemodareyitha ezixinzelelekileyo kwiimpawu zokucindezeleka, nazo.
Ukongezelela, abafazi ababenempawu ezidityanisiweyo kwiimpawu zokudandatheka kakhulu banokuthi bathathe unyango lweengqondo, umsi kunye nokusela ngotywala.
Amandla amakhulu esi sifundo kukuba yayivavanya abathathi-nxaxheba abamele uluntu lwase-Australia yonke. Ngokukodwa, abathathi-nxaxheba kulolu cwaningo babefana nabantu abavavanywa ngobalo-mabango base-Australia ngokubhekiselele kubuhlanga, imfundo, isimo somlingani kunye nomsebenzi. Esinye isingqinisiso solu cwaningo kukuba sisebenzise amanyathelo okuzimela (imibuzo).
Ngokutsho kwabaphandi, apha ziyimpembelelo enje kwesi sifundo:
Ngokubonakalisa intlangano phakathi kwe-VMS enesimo esicatshulwayo [ukutshisa okutshisa] kunye neempawu ezidityanisiweyo ezixinzelelekileyo, olu pho nonongo lubonisa ubungakanani bombono we-etiology ekwabelwana phakathi kwe-VMS kunye nokudakumba. Ukongezelela ekuphuculeni i-VMS, unyango lwe-estrogen lunokuphucula imvakalelo ekuphumeni komntwana kwangaphambili.
Ngamanye amazwi, ngokubhekiselele kwiziphumo zophando lwabo, abaphandi bacinga ukuba izibangela zokutshisa kunye nokuxinezeleka kunokufana noko, kwaye loo thintelo ye-hormone inokuphakamisa iimpawu ezixinezelekileyo kulabo bafumana ukuphela kwesisu.
> Imithombo:
> Bromberger, JT, et al. Iimpawu ezixakekayo ngexesha lokuguquka kweMenopausal. Ichaphazela ukungavumelani. 2007; 103 (1-3): 267-272.
> Freeman, EW, et al. Isibonelo sexesha elide leMpawu zoNyantyikisayo malunga nokuNyuka kweNdalo. JAMA Psychiatry . 2014; 71 (1); 36-43.
> Karvonen-Gutierrez C, iHarlow SD. Ukuxhoma kweMesopause kunye ne-Midlife Health Changes. Ku: I-Halter JB, i-Ouslander JG, i-Studenski S, i-KP ephezulu, i-Asthana S, i-Supiano MA, i- Ritchie C. eds. I-Gazethi ye-Geriatric Medicine neGerontology, i-7e eNew York, i-NY: i-McGraw-Hill;
> Manson JE, Bassuk SS. Ukunquma kwexesha kunye ne-Postmenopausal Hormone Therapy. Ku: Kasper D, Fauci A, Hauser S, uLongo D, Jameson J, Loscalzo J. eds. Imigaqo yeHarrison ye-Medicine yangaphakathi, i-19e eNew York, i-NY: i-McGraw-Hill; 2014.
> UNathan L. Isahluko 59. Ukuqeda ukuxhoma kwexesha kunye nexesha lokuhamba emva kwexesha. Ku: DeCherney AH, Nathan L, Laufer N, Roman AS. eds. UKUPHATHWA KWEZINDAWO NOKUPHATHWA KWEZINDAWO: I-Obstetrics & Gynecology, 11e eNew York, NY: McGraw-Hill; 2013.
> Worsley, R, et al. Umbhalo weMpilo yabasetyhini. Matshi 6, 2017. Epub ngaphambi kokuprinta.