Kodi mukuganiza za mankhwala otchedwa hormone therapy kuti muzindikire kuti mukulephera kusamba ? Kapena mwinamwake dokotala wanu akukupatsani chithandizo ichi kwa inu. Mulimonsemo, mwinamwake mukudandaula kwambiri podzatenga mahomoni. Sizodabwitsa kapena zachilendo ngati mukumva motere. Pali zambiri zambiri zabodza komanso chisokonezo kunja komwe, ngakhale pakati pa anthu azachipatala ponena za ngozi ndi phindu la kugwiritsa ntchito mahomoni kuti asamayambe kusamba.
Izi, mwatsoka, zasiya amayi ambiri kuti azivutika mosavuta ndi zizindikiro zoopsa za mimba.
Anthu ambiri, kuphatikizapo madokotala, adakalibe ndi zotsatira zoyambirira za kuyesedwa kwa WHI HT zomwe zinapangitsa kuti chiopsezo chiwonjezere makamaka makamaka pa khansa ya m'mawere yokhudzana ndi mankhwala a menopausal hormone. Koma, zambiri zaphunziridwa kuyambira pamenepo. Zotsatira zapachiyambi sizinangokhala zowonongeka, koma maphunziro atsopano achitidwa kuyang'ana pa chitetezo ndi kupambana.
M'mawu ake omwe alipo kwambiri 2017, North American Menopause Society imapanga mfundo zitatu zofunika kwambiri:
- Ubwino ndi wovuta kwambiri kuposa zoopsa za amayi omwe ali ndi vuto loyambitsa matenda a hormone pamene ali ndi zaka zoposa 60 kapena omwe ali ndi zaka 10 za kusamba.
- Thandizo la mahomoni liyenera kukhala palokha, kulingalira zowonetsera kapena zolinga zothandizira umboni, kulingalira za msinkhu wa mkazi ndi / kapena nthawi kuyambira kusamba poyenderana ndi kuyambitsa kapena kupitilira, zoopsa za umoyo wa mkaziyo ndi zofuna zake, ndi kuyerekezera kwake Zopindulitsa komanso zoopsa za mankhwala opanga mahomoni poyerekeza ndi mankhwala osakanizidwa kapena osakaniza.
- Mtundu wa mankhwala a mahomoni, zosankha zina, mlingo, ndi regimen ziyenera kukhala payekha, pogwiritsa ntchito kupanga chisankho chokhazikika ndi kukhazikitsidwa potsatira zidziwitso zosokoneza mauthenga ndi chitetezo chodziwika, pamodzi ndi zoopsa za amayi payekha ndi zofuna zawo.
Mwanjira ina:
- Ndibwino kwambiri kuyambitsa mankhwala a hormone kumayambiriro kwa kusamba.
- Kukula kwakukulu sikukwanira zonse. Ndondomeko zothandizira ma ARV zimayenera kukhala payekha.
- Kusankha mtundu wa mankhwala a mahomoni uyeneranso kukhala wapadera.
Izi ndi zosiyana kwambiri ndi momwe amayi anu amathandizira ma ARV pamene njira yokhayo inali mapiritsi ochokera ku mkodzo wa mahatchi oyembekezera. Masiku ano, pali mitundu yosiyanasiyana, mlingo, ndi mawonekedwe a mankhwala a mahomoni malinga ndi zosowa zanu. Pano pali ndondomeko yazomwe mungasankhe.
Tizilombo toyambitsa ma ARV
Mtundu uwu wa mankhwala a mahomoni umabwera mu mawonekedwe a mapiritsi. Ngakhale kuti choyambirira cha conjugated equine estrogen chimawonekabe, pali zina zambiri zogwiritsa ntchito maantirogeni omwe apangidwa. Magulu oterewa ndi ofanana kwambiri ndi estrogen opangidwa ndi ovary ndipo amalingalira kuti ndi ofanana. Pali mphamvu zingapo zosiyana, zomwe zimapereka zofunikira zosiyanasiyana. Ngati muli ndi chiberekero, muyeneranso kutenga mtundu wina wa progesterone kuti muteteze endometrium ku zotsatira za estrogen.
Chithandizo cha Transroermal Estrogen
Mankhwala oterewa amadalira khungu la mahomoni mmalo mopangira pakamwa. Izi zili ndi phindu pang'ono. Chifukwa sichiyenera kutengeka m'matumbo anu, chikhoza kuwerengedwa m'mitengo yochepa.
Amakhalanso ndi mlingo wolimba kwambiri wa ma hormone m'thupi lanu, zomwe zingakhale zofunikira nthawi zina, makamaka ngati mukudwala mutu wa mutu wa migraine. Komanso, chifukwa kudutsa khungu lanu sikuyenera kudutsa chiwindi, sizimayambitsa triglycerides (cholesterol choipa) ndipo zingachepetse chiwopsezo cha zotsatira zokhudzana ndi ndulu. Mitundu ya zosankha zowonjezereka zikuphatikizapo:
- Mapazi
- Gels
- Masamu emulsions
- Kupopera
Kutentha kwa transdermal estrogen kungakhale kosiyana malingana ndi mtundu ndi momwe iwo amagwiritsidwira ntchito. Kachiwiri, Ngati muli ndi chiberekero muyenera kutenge mtundu wina wa progesterone kuti muteteze endometrium ku zotsatira za estrogen.
Chithandizo chamankhwala cha Estrogen
Mtundu uwu wa mankhwala otchedwa hormone mankhwala ndiwo zotsatira mu m'munsi mwa estrogen m'magazi anu. Chifukwa chaichi, nthawi zambiri zimagwiritsidwa ntchito pochizira matenda opatsirana pogonana -zinthu monga ukazi wouma, kugonana kowawa, ndi zizindikiro zina za chikhodzodzo. Mmodzi yekha ndi mlingo wapamwamba wa mphete wa Femring. Matenda a estrogens alipo:
- Zikondamoyo
- Mapiritsi
- Miyendo
Kuwonjezera pa mlingo wapamwamba, mavitaminiwa akhoza kugwiritsidwa ntchito mosavuta popanda progesterone ngakhale mutakhala ndi chiberekero chanu.
Kutsatsa Progesin-Progesterone
Ngati mukuyamba tizilombo toyambitsa matenda ndipo mutakhala ndi chiberekero muyenera kugwiritsa ntchito progesin kapena progesterone kuti muteteze chiberekero cha chiberekero chanu. M'kupita kwa nthawi, estrogen, yomwe imatenga estrogen popanda kuigwirizanitsa ndi progesterone, ikhoza kuwonetsa endometrial hyperplasia kapena khansa ya endometrial. Mungathe kugwiritsa ntchito progestin yokhala ngati zomwe zimagwiritsidwa ntchito panthawi ya kulera kapena mungagwiritse ntchito progesterone weniweni yomwe ili yofanana ndi progesterone yomwe imapangidwa ndi ma ovari. Zosankha za progesin / progesterone zilipo monga:
- Mapiritsi
- Mazira achikazi
- Zolemba zamaginja
Ma prodicin okhala ndi IUDs ndiwonso angasankhe.
Mgwirizano wa Estrogen ndi Progestin Therapy
Kwa amayi ena, zingakhale bwino kugwiritsa ntchito mankhwala a mahomoni omwe ali ndi mahomoni onse palimodzi. Mtundu uwu wa mankhwala a mahomoni umapezeka mawonekedwe onse a mapiritsi komanso ngati chigawo cha transdermal.
Mawu Ochokera
Ngakhale kutaya kwaokha sikuli nthendayi, kusintha kwa mahomoni komwe kumakhudzana ndi ukalamba wachibadwa uku kungapangitse kwambiri zizindikiro zomwe zingatheke ndi mankhwala a homoni. Mankhwala opangira mahomoni angalimbikitsidwenso kuti muteteze matenda odwala matenda a osteoporosis makamaka ngati muli pangozi yaikulu. Zilibe zifukwa zanu zogwiritsira ntchito mankhwala a hormone dokotala angakuthandizeni kupanga zosankha zabwino zomwe zingakuthandizeni kuti mukhale ndi moyo mwabwino kwambiri panthawi yopuma.
> Chitsime:
> North American Menopause Society (2017). Chithandizo cha Hormone cha 2017 Chikhalidwe Chachikhalidwe cha North American Menopause Society. Kusamba kwa nthawi, 24, 728-753.