Ndichizoloŵezi chodziwika, koma chomwe chimafuna kuti dokotala ayambe kuwunika
Kutenga nthawi yakulira kapena yakulira kwa nthawi yosiya magazi-dzina lachipatala ndi menorrhagia-lingakhale loopsya komanso lopanda mitsempha. Ngakhale izi zimakhala zofala, kutaya kwa msinkhu wolemetsa kumafuna kupita kwa dokotala wanu, makamaka matenda anu a amayi .
Kodi Ndikumva Kudwala Kwambiri Kwambiri?
Njira yosavuta yodziwira ngati mukukumana ndi kutaya magazi kwambiri ndiko kuzindikira momwe mumayambira pod kapena padontho.
Ngati nthawi yanu ndi yolemetsa yokwanira kuti musinthe pad kapena kupitilira maola ola limodzi kwa maola angapo, kapena ngati muli ndi mwazi wamkati womwe umatha kuposa sabata lathunthu, mukukumana ndi kulemera kwa msambo.
Kuphatikiza paziwirizi, zizindikiro zina za kutaya magazi kwambiri zimaphatikizapo:
- Kuvala padothi loposa oposa imodzi kuti muthe kutuluka magazi
- Kuyenera kusintha tampon kapena phala pakati pa usiku
- Ngati mwazi wanu uli ndi mazenera omwe ali kukula kwa kotala kapena zazikulu
Kudziwa
Kuzindikira chifukwa cha kuchepa kwa msambo kungakhale kovuta kwambiri, choncho ndi bwino kukonzekera. Musanayambe kusankhidwa, yesetsani kuti muyambe kugwiritsa ntchito chitsanzo chanu m'miyezi ingapo yapitayo. Mwachitsanzo, ndi masiku angati omwe mwazizira mwezi uliwonse? Kodi ndi zingwe zingati zomwe mumayendetsa masiku anu omwe mukuyenda kwambiri?
Kuwonjezera apo, ndibwino kupanga mndandanda wa mankhwala anu onse, kuphatikizapo ma ARV, ma ARV, ndi mavitamini aliwonse kapena owonjezera pa mavitamini.
Pofuna kudziwa chifukwa chake mumakhala magazi kwambiri, musadabwe ngati dokotala akulamula mayesero angapo, kuphatikizapo kuyesa kuyeza magazi. Mayesero awa angaphatikizepo:
- Kuyezetsa mimba (ngati chithandizo cha mimba)
- Mayeso a magazi (mwachitsanzo, kuchuluka kwa magazi, kuchuluka kwa zitsulo, ndi mahomoni a chithokomiro)
- An ultrasound ya pelvis yanu
Dokotala wanu nayenso akhoza kuchita ndondomeko mu ofesi yotchedwa hysteroscopy kuti muwone momwe mkati mwa chiberekero chanu. Angatengenso zitsanzo za minofu ya uterine, yotchedwa endometrial biopsy, malingana ndi msinkhu wanu ndi zizindikiro zanu.
Zimayambitsa
Pali zifukwa zingapo zomwe zimayambitsa kutaya kwa msinkhu wolemera-zina zowononga (osati khansa) monga fibroids, ndi zina zowopsa ngati khansa ya chiberekero kapena chiberekero. Zina zimayambitsa zosamalidwe koma zimakhudzana ndi kusintha kwa mahomoni kapena kutaya magazi m'mthupi mwathu.
Kulephera kwa Ovulatory
Kulephera kwa ovulatory panthawi yaunyamata kapena kuperewera kwa thupi ndiko chifukwa chofala kwambiri cha kulemera kwa msambo. Panthawiyi, mayi akhoza kutulutsa (dzira) nthawi zonse, zomwe sizikutanthauza mwezi uliwonse kapena ayi. Izi zimabweretsa kuwonongeka kwa chipinda cha uterine ndi nthawi yolemetsa.
Kuvulala kwa ovulatory kungathenso kuchitika ndi matenda ena monga hypothyroidism, matenda a polycystic ovarian, ndi kulephera kusanayambe. Kulimbana ndi vutoli (mwachitsanzo, chithokomiro chosagwira ntchito) ndilofunika kwambiri kubwezeretsa chivundikiro chodziwika bwino komanso kuonetsetsa kuti nthawi yamayi ikuyendera.
Ngati kuvomereza kosavomerezeka ndi mbali ya momwe thupi limayankhira (mwachitsanzo, kutha msinkhu kapena kutha kwa nthawi), njira zothandizira odwala kapena mankhwala a mahomoni, motero, amatha kutulutsa magazi.
Uterine Fibroids
Mafibroid amawopsa (osakhala ndi khansa) omwe amakula kuchokera ku mimba ya chiberekero cha amayi ndipo amapezeka kwambiri pazaka 30 kapena 40 zazimayi. Ngakhale chifukwa cha uterine fibroids sichikudziwika, amadziwika kuti ndi ovomerezeka-estrogen. Ichi ndi chifukwa chake njira zina zowonetsera ma ARV monga mapiritsi oletsa kubereka zingathandize kuchepetsa kutaya kwa msambo wochokera ku fibroids. Mankhwala a Progestin-release intrauterine (mwachitsanzo, Mirena) amachepetsa kuchepa kwa msambo, koma samachepetsanso kukula kwa thupi.
Mankhwala ena nthawi zina amagwiritsidwa ntchito pochizira fibroids ndi gonadotropin-release hormone (GnRH) agonist, mankhwala omwe amachepetsa kukula kwa fibroids koma angagwiritsidwe ntchito kanthawi kochepa, chifukwa cha zotsatira.
Palinso mankhwala ambiri ochizira opaleshoni omwe amapezeka kuti athetse matenda a fibroids, kuphatikizapo myomectomy (kuchotsedwa kwa fibroid), kupuma kwa endometrial kwa tizilombo toyambitsa matenda (chiberekero cha chiberekero chawonongeka), ndi umtine wamadzimadzi omwe amagazidwe (magazi amachotsedwa) . Pa milandu yoopsa kwambiri, hysterectomy ikhoza kukhala yoyenera, momwe chiberekero chonsecho chichotsedwera kapena popanda mazira.
Kawirikawiri, pamene zizindikiro siziri zovuta kapena zovuta, ndikwanira kutenga "kuyembekezera ndi kuwona" kuyandikira ndi uterine fibroids. Ndipo pakapita nthawi, kusamba kumakhala kuchepa ndi kutha popanda mankhwala.
Uterine Polyps
Mapuloteni m'kati mwa chiberekero otchedwa endometrial polyps -omwe sali ndi khansa, kukula kwa mphesa komwe kumachokera ku chiberekero cha chiberekero. Zitha kuchitika pakati pa amayi omwe ali ndi amayi amodzi ndi amayi omwe amatha kudwala matendawa. Cholinga cha mapuloteni otchedwa endometrial polyps sichidziwika, ngakhale kafukufuku akusonyeza kugwirizana pakati pa mankhwala a hormone a postmenopausal ndi kunenepa kwambiri.
Kuchiza kwa mapuloteni a m'mimba kungaphatikizepo kuchotsa mapulogalamu. Lamulo la matenda likhoza kufufuza mapuloteni a endometrial kwa khansa atachotsedwa.
Uterine Adenomyosis
Mu chikhalidwe ichi, chiberekero chimakula chifukwa maselo a chiberekero amakula mu khoma la chiberekero, zomwe zimapweteka komanso zimachotsa magazi. Pamene magazi amatha kuchepetsedwa ndi njira zothandizira kubereka, njira yothetsera adenomyosis ndi hysterectomy.
Matenda Opaka Mafupa (PID)
Nthawi zambiri PID imayambitsidwa ndi matenda opatsirana pogonana, koma nthawi zina amatha kubereka, kuchotsa mimba, kapena njira zina zamagonana. Mu PID, chiwalo chimodzi kapena ziwalo zoberekera zili ndi kachilombo, monga chiberekero, mazira, kapena chiberekero. Chithandizo chovomerezeka cha PID ndi mankhwala oletsa maantibayotiki.
Khansara ya Chiberekero
Ichi ndi mtundu wa khansara yomwe imapezeka pamene maselo m'mimba ya chiberekero amakhala osadziwika, akuchulukanso kuchoka, komanso amawononga thanzi labwino. Papillomavirus yaumunthu (HPV) imayambitsa khansa yachiberekero yambiri. Chithandizo cha khansara ya chiberekero chimaphatikizapo opaleshoni, chemotherapy, ndi / kapena mankhwala ochizira.
Kansa ya Endometrial
Khansara iyi imapezeka pamene maselo osadziwika mu endometrium (chiberekero cha chiberekero) amakula kuchokera ku mphamvu ndikuwononga chiberekero ndi ziwalo zina. Ngakhale vuto la khansa ya m'magazi silidziwika, amayi omwe amapezeka kuti ali ndi khansa imeneyi amakhala pakati pa zaka za m'ma 60s. Chithandizo choyamba cha khansa ya endometrial kawirikawiri ndi hysterectomy, mwinamwake kotsatiridwa ndi chemotherapy ndi / kapena mankhwala ochizira mazira.
Kusokonezeka Kwambiri
Ngakhale pali mitundu yambiri ya matenda otha magazi, mtundu wochuluka mwa akazi ndi von Willebrand matenda (VWD). Kuchiza kwa matenda a von Willebrand kumaphatikizapo kutulutsidwa kwa zida zosungidwa m'magazi kapena, nthawi zambiri, m'malo mwachisamalirocho ndi mankhwala opatsirana (kudzera m'mitsempha) kapena mankhwala opatsirana .
Matenda ena omwe amatuluka m'magazi monga kukhala ndi chiwerengero chochepa cha mapiritsi (mapuloletiti amachititsa kuti puloteni ikhale yotsika ndipo amapangidwa m'mafupa) kapena kukhala ndi magazi ochepa monga Coumadin (warfarin sodium) angakhalenso chifukwa cha kuchepa kwa msambo.
Zifukwa Zina Zowononga Kwambiri Kwambiri Kusamba
Zina zomwe zingayambitse kuchepa kwa msinkhu kwa amayi osakhala ndi pakati ndi endometriosis komanso kukhala ndi chipangizo cha intrauterine (IUD) monga Mirena, makamaka m'chaka chanu choyamba cha ntchito, koma mndandanda sumaima pamenepo. Izi zikugogomezera kufunika koonana ndi dokotala wanu kuti apeze matenda oyenerera komanso kuunika.
Pamene Kusamba Kwambiri Kumene Ndizovuta Kwambiri
Ngati mukukhala ndi magazi oopsa kwambiri, mungafunike kupita ku chipinda chodzidzimutsa. Chizindikiro chikanakhala ngati mukuyendetsa pakadala anayi kapena kuposera maola awiri. Ngati muli ndi pakati, funsani chithandizo chamankhwala mwamsanga ndi magazi alionse.
Mawu Ochokera
Kufika pansi pa kulemera kwa msambo kwanu kumakhala kofunika osati pa umoyo wanu wokha komanso kwa thanzi lanu. Kutaya magazi kwakukulu, mosasamala kanthu za chifukwa, kungayambitse kusowa kwa magazi kwa chitsulo, chomwe chingakupangitseni kupuma, kutopa, ndi chizungulire. Mukatuluka magazi komanso mzizi wa magazi anu, mutha kupita patsogolo ndikukumverera bwino.
> Zotsatira:
> American College of Obstetrics ndi Gynecology. Maganizo a Komiti No. 557. Kusamalira Kuchetsa kwachiberekero kosayembekezereka kwa Akazi Okalamba omwe sali obadwa. Zovala zamaliseche & Gynecology . 2013; 121 (4): 891-896. Inatsimikiziridwa 2017. do: 10.1097 / 01.aog.0000428646.67925.9a.
> American College of Obstetrics ndi Gynecology. Mafunso Omwe Amadzifunsa Kawirikawiri: Kusamba Kwambiri Kwambiri Kwambiri.
> Hauk L et al. ACOG Imatulutsa Malangizo Othandizira Kukonza Kosakaniza Kwambiri kwa Uterine Ogwirizana ndi Ovulatory Dysfunction. Am Phys Physician. 2014 Jun 15; 89 (12): 987-88.
> Kaunitz AM. Kufikira magazi osachiritsika achiberekero azimayi osabereka. Mu: UpToDate, Barbieri RL, Levine D (Eds), UpToDate, Waltham, MA.