Kafufuzidwe kamatithandiza kuzindikira zatsopano za kusamba kwa thupi
Kwa zaka zambiri, akatswiri azindikira kuti kutentha kwa moto ndi zizindikiro zachisoni zimatha kuchitika panthawi yopuma. Komabe, pakhala pali kafukufuku wochepa omwe amasonyezera zizindikiro zowopsya, kutentha kwa moto, ndi kutha msinkhu palimodzi. Komanso, mbali zina za phunziroli zikutsutsanabe.
Kuunika kwowonjezereka kwagwirizanitsa pakati pa zipsyinjo ndi kuchepa kwa mimba , komanso mgwirizano pakati pa zizindikiro zowawa ndi kutentha .
Kufotokozera Kusamba kwa Mimba
Malingana ndi zotsatira za chiwerengero cha 2010, amayi 41 miliyoni a ku America okwana 151 miliyoni anali ndi zaka 55 kapena kuposa. Ambiri mwa amayiwa anali ndi kapena anali pafupi kutha msinkhu. Kuwonjezera apo, chifukwa ziyembekezo za moyo zawonjezeka pazaka zingapo zapitazi-ndi zozizwitsa zokha za 2015-amayi amatha kuyembekezera kukhala amanyazi a gawo limodzi mwa magawo atatu a moyo wawo atatha kusamba.
Chochititsa chidwi n'chakuti ngakhale kuti ziyembekezo za moyo zawonjezeka, nthawi imene kuchepa kwa thupi kumayambira kwakhala kusintha pang'ono. Avereji ya msinkhu wa kusamba ku United States ali 51.
Mfundo zokhudzana ndi kusintha kwa mavitamini ndi mahomoni zomwe zikugwirizana ndi kutha msinkhu zakhala zogwirizana ndi chaka chilichonse. Azimayi omwe anabadwa panthawi ya nkhondo yachiwiri ya padziko lonse akufunafuna chithandizo cha kusintha kwa nthawi ndi miyoyo ina. Komanso, ambiri mwa amayiwa ali pantchito, akupanga malo apadera.
Chokhachokha ndi gawo la ukalamba pamene mkazi amasintha kuchoka ku kubala ndi kukhala wosavomerezeka. Pano pali njira yowonjezeramo:
- Kusintha kwa nthawi ndi kusintha kwa menopausal kwa nyengo yomwe amai amayembekezera nthawi yake kukhala yowonjezereka. Pakapita nthawi, madandaulo kapena zizindikiro za kutha kwa thupi zingayambe kuwonetsa, monga kutentha kwa moto.
- Kutha msinkhu kumatanthauza nthawi yomaliza ya kusamba.
- Kupuma kwa mthupi kumatanthauza moyo pambuyo pa kusamba.
Nazi zina mwazimene zimagwirizanitsidwa ndi climacteric:
Zophika usiku ndi Kuwala Kwambiri
Pakati pa 60 ndi 80 peresenti ya amayi amasintha kupyolera mwa kutha msinkhu usiku kutuluka ndi kutentha (kumatchedwanso kutentha kapena zizindikiro zapakati ). Kutuluka kwa usiku kumayambitsa matenda a thukuta ndipo mwadzidzidzi kumathamanga. Azimayi omwe amawotcha, 82 peresenti yatentha kwambiri ndipo amatha kupitirira chaka chimodzi, ndipo pakati pa 25 ndi 50 peresenti amakhala nawo kwa zaka zoposa zisanu.
Ngakhale kuti mahomoni amachititsa kuti ayambe kugwira ntchito, njira yothetsera kuchepa kwa thupi ndi kutentha kwake sikuyenera kufotokozedwa. Makamaka, amayi omwe ali ndi ma firitsi apamwamba ndi mazenera a m'munsi a estradiol ali ndi mwayi waukulu wokuwotcha. Komanso, omwe akusuta kapena ali ndi BMI apamwamba amakhala pachiopsezo chachikulu chotentha. Chochititsa chidwi, kafukufuku amasonyeza kuti akazi akuda amawotcha kwambiri kuposa akazi oyera; pamene, akazi a ku Japan ndi a ku China amanena kuti kuwala kochepa kumakhala kochepa kuposa akazi oyera.
Osteoporosis
Osteoporosis ndi chigoba chimene mafupa amathyoka, ndipo mafupa amakhala ofooka kwambiri ndipo amatha kupasuka.
Ponena za kutha kwa kutha kwa imfa, kuperewera kwa mnofu kumaphatikizapo kusintha kwa mahomoni. Mankhwala ena angagwiritsidwe ntchito popewera ndi kuchiza matenda odwala matendawa, kuphatikizapo bisphosphonates, calcitonin, ndi raloxifene. Kuphatikiza pa mankhwala, calcium supplements, vitamini D zowonjezereka, kusuta fodya, ndi kuwonetsa zolemera kungathandize.
Vaginal Atrophy
Vaginal atrophy amatanthauza kupukuta, kutupa, ndi kuyanika kwa makoma. Matenda achikazi, kuyaka, kukhuta, kukakamiza kwamakono, ndi ululu panthawi ya kugonana zikhoza kuchitika. Poyamba, makoma amawonekera ngati ofiira chifukwa cha kutuluka kwa mitsempha yaing'ono yotchedwa capillaries.
Powonjezera kutayika kwa capillary, makoma a abini amatha kukhala ofewa, owala, ndi otumbululuka. Vuto la athaini limakhala lachiwiri ndi kuchepa kwa mayendedwe a estrogen. Vuto la atrophy lingachiritsidwe ndi mafuta kapena masitrogeni, omwe amagwiritsidwa ntchito khungu ngati mawonekedwe, mphete kapena mapiritsi.
Kugwiritsa ntchito kugonana
Kugonana kungakhale kosayenera chifukwa cha kuchepa kwa libido , kusintha kwa mahomoni, ndi zikhulupiliro za chikhalidwe. Atrophy yamagetsi imathandizira kuchepetsa kugwiritsira ntchito kugonana. Mankhwala opanga mahomoni akufufuzidwa ngati mankhwala othetsera kugonana kosachepera.
Zovuta Kugona
Pa pakati pa 30 ndi 60 peresenti ya amayi a midlife amavutika ndi kugona tulo. Mwachindunji, akaziwa amavutika kugwa ndi kugona. Ngakhale kuti usinkhu umasokoneza zowonongeka, kugwedezeka kwa mahomoni, kutentha kwambiri, nkhawa, ndi zizindikiro zachisoni zimagwirizananso ndi vuto la kugona.
Kutayika kwa Memory
Kafukufuku akusonyeza kuti 62 peresenti ya amayi a midlife amavutika kukumbukira nthawi ya kusintha kwa msambo. Mavuto awa amakumbukira vuto kukumbukira manambala ndi mawu ndi kukumbukira. Kutaya mu estrogen kumagwiritsidwa ntchito kuti ikhale ndi mbali muzovuta za kukumbukira.
Zizindikiro Zochititsa Chidwi ndi Kusamba Kwachilengedwe
Kaya kusuta kwapita kumakhala chinthu chowopsya chothetsera vuto ndizovuta. Amayi ambiri a midlife samakhala ndi zipsyinjo zowawa kwambiri. Pakati pa kusamba, pakati pa 20 ndi 30 peresenti ya amayi a midlife amakumana ndi vuto loyamba la matenda ovutika maganizo kapena zochitika zosautsa. Kuopsa kwa kupsinjika maganizo kumakhala kovuta kwambiri panthawi yomwe imakhalapo nthawi yomwe imakhalapo komanso nthawi yamasana amatha kupuma kusiyana ndi nyengo yomwe imakhalapo.
Zizindikiro zoopsa zimaphatikizapo zotsatirazi:
- kutopa
- chisoni
- kudziimba mlandu
- kusowa kwa njala
- kusowa tulo
- mavuto ndi ndende
- kusokonezeka
- kusowa chidwi
- maganizo odzipha
Mu phunziro la 2014 lomwe linatulutsidwa mu JAMA Psychiatry , Freeman ndi anzake adayesa amayi 203 a midlife chifukwa cha zizindikiro zachisoni pazaka 14 zomwe zimayandikira kusamba kwa nthawi (ie, kumapeto kwa msambo). Azimayi awa anali ammopaopausal ndipo anafika msinkhu. Anayang'ananso kusintha kwa ma hormone monga zowonongeka za kuvutika maganizo pa nthawi ya kusamba kwa thupi komanso mbiri yakale ya kuvutika maganizo.
Nazi zina mwazofukufuku:
- Kwa amayi omwe ali ndi mbiri ya kupsinjika maganizo, chiopsezo chokumana ndi zipsyinjo zachisokonezo chinali kasanu ndi katatu wamkulu pambuyo pa kutha kwa thupi komanso nthawi 13 kuposa zonse zomwe amayi alibe mbiri yachisoni.
- Pokhudzana ndi kutha msinkhu wokha, chiopsezo cha zizindikiro za kupsinjika mtima chinali chachikulu muzaka zisanayambe kusamba komanso kuchepa kwa zaka pambuyo pa kusamba. Mwachindunji, chiopsezo cha zipsinjo zachisokonezo zaka khumi zisanafike zaka zisanu ndi zitatu pambuyo pa kuchepa kwa thupi kunachepera 15 peresenti patsiku.
- Kwa amayi amene poyamba anali ndi zizindikiro zachisoni pafupi ndi kutha kwa thupi, zizindikiro zachisokonezo zinachepa panthawi ya kuchepa kwa thupi, ndipo zinachepa kwambiri muchaka chachiwiri chaka chakumapeto kwa nthawi.
- Kwa amayi omwe analibe mbiri yakale ya kupsinjika maganizo, chiopsezo cha zipsyinjo zachisokonezo chinali chochepa 2 kapena zaka zambiri pambuyo pa kusamba.
- Kuchepa kwa zizindikiro zowawa zimayendera kusintha kwa hormonal.
Malinga ndi ochita kafukufuku, apa pali zina zomwe zatanthawuza za phunziro ili:
Wachipatala akuwonetsa zizindikiro zachisoni kuti apeze chithandizo pamene zizindikiro zikufooketsa ndi kuyesa zotsatira za kuvutika maganizo pa zovuta zina zazikulu, monga matenda a mtima, matenda a kagayidwe kake, ndi matenda a mitsempha. Azimayi omwe ali ndi mbiri ya kuvutika maganizo angapindule ndi matenda opatsirana pogonana kapena a psychotherapy omwe akuyenera kukhala ndi matenda aakulu. Komabe, amayi omwe alibe mbiri ya kuvutika maganizo akhoza kukhala ndi chiopsezo chochepa cha zizindikiro zachisoni pambuyo pa chaka chachiwiri chakumbuyo kwa am'mawa ndipo amapindula ndi mankhwala ochepa a ma hormone kapena mankhwala achidule omwe ali ndi matenda olepheretsa kugonana omwe asonyeza kuti ali ndi mphamvu zochizira matenda a menopausal.
Kuwala Kwambiri ndi Zizindikiro Zowopsya
Kafukufuku ambiri amene awonetsa kugwirizana pakati pa kuwala kwa moto ndi zizindikiro za kupsinjika kwalakwitsa mwa njira zingapo.
Choyamba, kutsimikiziridwa kwayesedwa kwawopsyeza, ndi ofufuza osagwiritsa ntchito mayendedwe oyenerera kuti aone kuwala kotentha. Chachiwiri, oyeza ayang'ana mafunde otentha m'malo mowotcha kwambiri. Mofananamo, ochita kafukufuku akhala akuvuta kuwona zizindikiro zoyipa za kuchipatala . Chachitatu, chiwerengero cha ophunzira pa kufufuza chiyanjano pakati pa kutentha ndi kusintha kwa msambo kwachepa, ndipo mukusowa anthu ochuluka omwe akuyesa njira yoyenera kuti awonetsere anthu omwe mukuwayesa.
Mu phunziro la March 2017 lofalitsidwa mu Journal of Women's Health , Worsley ndi anzake amagonjetsa zofooka izi mwa kufufuza mwadzidzidzi amayi 2,020 a ku Australia pakati pa 40 ndi 65. Ofufuzawa anagwiritsa ntchito mayankho ovomerezeka ndi ovomerezeka kuti ayese ophunzira pa kutentha, kusuta fodya kugwiritsa ntchito, kumwa mowa, ndi mankhwala a maganizo.
Pambuyo pokonza zosiyana siyana, kuphatikizapo zaka, ntchito, ndi BMI, ofufuza adawona kuti poyerekeza ndi akazi omwe alibe kuwala kapena kutentha pang'ono, amayi omwe ali ndi mazira otentha kwambiri ndi ovuta kwambiri amakhala ndi zizindikiro zosautsa kwambiri.
Komanso, amayi omwe anali ndi zipsyinjo zovuta kwambiri zosautsa kwambiri amakhala ndi mankhwala osokoneza bongo, utsi, ndi zakumwa zoledzeretsa.
Mphamvu yayikulu ya phunziroli ndi yakuti inayesa ophunzira omwe amaimira gulu la Australia lonse. Mwachindunji, ophunzira mu phunziroli anali ofanana ndi anthu omwe anawerengedwa muwerengero wa australia ku 2011 pokhudzana ndi mtundu, maphunziro, chiyanjano, ndi ntchito. Zomwe zingathetseretu phunziroli ndizogwiritsira ntchito njira zodzidziwitsa okha (mafunso).
Malingana ndi ochita kafukufuku, apa pali zotsatira zina za phunziro ili:
Mwa kusonyeza mgwirizano pakati pa VMS zovuta [zozizira zotentha] ndi zizindikiro zosautsa zoopsa, phunziroli limaphatikizapo chidziwitso cha lingaliro logawidwa pakati pa VMS ndi kuvutika maganizo. Kuwonjezera pa kukonzanso VMS, mankhwala a estrogen angathandize kusintha kwa msambo.
Mwachilankhulo china, pogwiritsa ntchito zotsatira za phunziro lawo, ofufuza amaganiza kuti zomwe zimayambitsa kutentha ndi kupsinjika maganizo zingakhale zofanana, ndipo mankhwala oterewa angapangitse zizindikiro zowopsya kwa iwo omwe akuyamba kusamba.
> Zotsatira:
> Bromberger, JT, et al. Zizindikiro Zowopsya Pa Kusintha kwa Mwamuna. J Zimakhudza Kusokonezeka. 2007; 103 (1-3): 267-272.
> Freeman, EW, et al. Chitsanzo cha Kutalika kwa Zizindikiro Zowopsya Pakati pa Kusamba Kwachilengedwe. JAMA Psychiatry . 2014; 71 (1); 36-43.
> Karvonen-Gutierrez C, Harlow SD. Kusamba kwa mimba ndi Midlife Kusintha kwaumoyo. Mu: Halter JB, Ouslander JG, Studenski S, High KP, Asthana S, Supiano MA, Ritchie C. eds. Hazzard's Geriatric Medicine and Gerontology, 7e New York, NY: McGraw-Hill;
> Manson JE, Bassuk SS. Kutuluka kwa mimba ndi Postmenopausal Hormone Therapy. Mu: Kasper D, Fauci A, Hauser S, Longo D, Jameson J, Loscalzo J. eds. Mfundo za Harrison za Internal Medicine, 19e New York, NY: McGraw-Hill; 2014.
> Nathan L. Mutu 59. Kusamuka kwa Mimba & Kutha kwa nthawi yopuma. Mu: DeCherney AH, Nathan L, Laufer N, Roman AS. eds. Kuzindikira ndi Kuchiza Kuchulukira: Zovala Mimba ndi Gynecology, 11e New York, NY: McGraw-Hill; 2013.
> Worsley, R, et al. Journal of Women's Health. March 6, 2017. Epub patsogolo kusindikiza.