I-VV vs VV vs Medical Menopause: Isikhathi Sesikhashana Noma Esihlala Phakade
Uma uhlala nomdlavuza wesifuba, i-oncologist yakho kungenzeka ukuthi ikhulume nawe mayelana nesimiso sezinsizakalo zezokwelapha. Kusho ukuthini lokhu? Ihluke kanjani ekunqumeni kwamathuba emvelo kanye nokuya esikhathini sokuya esikhathini? Futhi kungenzeka ukuthi yesikhashana noma ingunaphakade?
Kungani Ukunqamuka Kwemithi Kubalulekile Ngomdlavuza Webele?
Kulabo besifazane abanama-premenopausal ngesikhathi sesifo somdlavuza wabo webele futhi banesifo se-estrogen se-receptor emihle , imithi (noma ukuhlinzwa) yokwenza ukuyeka komama ingacatshangelwa.
Sifunda ukuthi ukusetshenziswa kwe-aromatase inhibitors emva kokwelashwa kwe-tamoxifen kunganciphisa ingozi yokuphindaphinda, kodwa ama-inhibitors aromatase awakwazi ukusetshenziswa yibo abangakafiki esikhathini sokuya esikhathini.
Uma uye waba ne- chemotherapy cishe uyeke ukuba nezinkathi, ikakhulukazi uma usondela ekumeni esikhathini sokuqala ukuqala. Ngisho noma kunjalo, udokotela wakho angase ancoma ukuhlolwa ukuze abone ukuthi ngabe ungumama we-menopausal ngempela. Ukuze siqonde kangcono lokhu, ake sikhulume ngezinhlobo ezahlukene zokunqamuka kwesikhashana, umehluko phakathi kokumiswa kwesikhathi okwesikhashana nokuya esikhathini esizayo, nokuthi kungani kubalulekile kangaka.
Izinhlobo Ezihlukene Zokunqamuka Kwesimeni
Kukhona impela izinhlobo eziningana ezahlukene zokuhlanganiswa kwezinhlobo zokumisa esikhathini. Kuye ngohlobo, ukuphuma esikhathini kungase kube okwesikhashana noma okuphakade, futhi lokhu kubalulekile ekunqumeni mayelana nemithi yokwelapha yomdlavuza webele best uma isisu sakho singumamukeli we-estrogen.
Ukunqamuka kweMvelo ngokwemvelo
Ukunqamuka kwemvelo ngokwemvelo kuyinkambinkimbi kancane lapho ukuzala komfazi kunciphisa.
Ngesikhathi sokuya esikhathini semvelo, ama-ovaries wesifazane ayeke ukukhula amaqanda, futhi umzimba wakhe udala i-estrogen ne- progesterone encane , imijikelezo yakhe yokuya esikhathini iphela futhi igcine iphelile. Lapho inqubo yokukhipha esikhathini isiphelile, owesifazane akakwazi ukukhulelwa. Ukunqamuka kwemvelo ngokwemvelo cishe kuhlale kunomphela.
I-Menopause Yokuhlinzwa
Ukwelashwa kokuya esikhathini sokuhlinzwa kwenzeka uma owesifazane ekhishwa ama-ovaries, noma une-hysterectomy ephelele (ukususwa kwesibeletho nama-ovarie), futhi amazinga e-estrogen awela ngokuphawulekayo. Ngaphandle kwama-ovari noma isisu, owesifazane akavuthi. Ukunqamuka kokuya esikhathini sokuvamise ukuvama ukuvama kwegazi kuyinto ephawulekayo kunezimpawu zokumama esikhathini esizayo ngenxa yokungazelelwe kweshintsho. Ukunqamuka kwamamenyu okuhlinzwa kunomphela.
Ukwelashwa Kwemithi Yezokwelapha
Ukwelashwa kwemithi yokwelashwa kungumphumela wezokwelapha ezingase zilimaze ama-ovari womfazi noma zivimbele amazinga e-estrogen ne-progesterone. I-Chemotherapy, i-anti-estrogen hormone therapies, kanye nokwelashwa kwemisebe yomsindo kungabangela ukuwa kwe-hormone yabesifazane ngokuzumayo, okuholela ekuqedeni kwelanga okwesikhashana noma okuqhubekayo . Lolu hlobo lokunqamuka kwesikhashana lungathunyelwa ngokuthi:
- Ukwelashwa kwemithi yokwelashwa
- Ukuqeda ukusa esikhathini
- I-amenorrhea eyenziwe yi-chemotherapy
- Ukumiswa kwesikhathi kwe-Chemical
- Isisu
Ngemuva kwe-chemotherapy, abesifazane abaningi bahlangabezana nokuya esikhathini sokuya esikhathini, kepha kungaba okuguquguqukayo noma ngabe izinkathi zakho zizobuya noma cha. Uma ngabe usondelene nokuya esikhathini esiyimvelo lokhu kuncane kakhulu kunalokho uma usencane futhi ude nokuya esikhathini sokuxilongwa. Uma ukwelashwa kwemithi kungokwesikhashana, kunzima ukwazi (ngaphandle kwemfundo yebhu) kungakhathaliseki ukuthi ukuya esikhathini kuyesikhashana noma kunomphela, futhi isikhathi sesikhathi ngaphambi kokuthi wazi siyakwazi ukuhluka.
Abanye besifazane bahlangabezana nokuya esikhathini samasonto okwesikhashana ngaphambi kokuba babe yi-premenopausal futhi baphinde baqale isikhathi sabo.
Lokhu kubangela ubunzima uma i-oncologist yakho ifisa ukubeka imithi esetshenziselwa kuphela abantu abangama-postmenopausal. I-Aromatase inhibitors ingase iphumelele kakhulu kune-tamoxifen ekuvimbeleni ukuphindaphindiwe, kodwa uma u-premenopausal ayanele ngokwanele ukunciphisa amazinga e-estrogen yakho kanye ne-tamoxifen iyadingeka ngaphandle kokuthi uthola futhi ukwelapha okukhipha i-ovarian
Ukwelashwa Kwemithi Yesikhashana Yesikhashana / Ukwelashwa Kwe-Ovarian
Uma usondela esikhathini sokusuka esikhathini, i-oncologist yakho ingenza ukuhlolwa kwegazi ukuze uzame ukuthola ukuthi ngempela uyisimiso sokuphela komuntu noma cha.
Uma ungowesifazane osemusha we-premenopausal, ukwelashwa okwesikhashana kwezokwelapha nge-ovarian suppression therapy kungase kubekiwe. Ukuze ugcine izinga lakho le-estrogen ne-progesterone liphansi, kodwa namanje ugcine ama-ovari akho enempilo, unganikezwa izidakamizwa "ukuvala" ama-ovari akho.
(Esikhathini esedlule, ukukhishwa kwesikhashana kokuhlinzwa ngokukhipha ama-ovari ngokuvamile kwakunconywa. Akuyona nje inqubo eyingozi, kodwa isusa ithuba lokuba abesifazane baphishekele ukukhulelwa esikhathini esizayo emva kokwelashwa.)
Ukwelashwa kwe-Ovarian ukwelashwa kuvumela abesifazane ukuba bathathe inhibitor ye-aromatase futhi bavune izinzuzo zalolu cwaningo. Lezi zidakamizwa zivimbela ama-hormone akhululwa emgodini we-pituitary futhi atshele ama-ovari ukukhiqiza i-estrogen. Uma lezi zidakamizwa zimiswa, umjikelezo wakho wokuya esikhathini ungaqala kabusha.
Ukwelashwa Phakathi Nesikhathi Sezinyanga Zokugula
Kubalulekile ukuthi usebenzise ukuvimbela ukubeletha ngesikhathi ukwelashwa umdlavuza wesifuba, noma ngabe uhlangabezana nesimiso semithi yokwelashwa. Kukhona ithuba elincane lokuthi ungakhulelwa ngesikhathi ukwelashwa, futhi asiqondi ngokugcwele imiphumela yalezi zidakamizwa ekukhulelwe kokuqala. Ungasebenzisi amaphilisi okulawula ukubeletha noma yiluphi uhlobo lwezokwelapha zokubeletha kwe-hormonal . Izinketho zingabandakanya i- copper , i- condoms , i- spermicide , noma ezinye izindlela zokuvimbela ukukhulelwa.
Ingabe Unesimiso Sokunqamuka Kwesilisa Kungenzeka Ube Nesikhathi Sokuqeda Isikhathi?
Uma usendaweni yokwelashwa kwemithi yokwelashwa, lokhu kusho ukuthi ungase udingeke ube nesimiso sokumisa kabili? Impendulo ixhomeke kakhulu kuneminyaka yakho nokuthi usondelene kangakanani nokuya esikhathini. Uma usekupheleni kweminyaka engu-40 ngesikhathi utholakala futhi uphila nge-chemotherapy, ukwelashwa kwakho kwe-menus kungakusiza ekuthumeni kwesikhathi sokuya esikhathini ngaphandle kokuphindaphinda umjikelezo wakho wokuya esikhathini. Uma uneminyaka engama-30 ngesikhathi sokuxilongwa, noma kunjalo, ungase uhlangabezane nokuya esikhathini esizayo. Uma okungenani uneminyaka emihlanu ukusuka ekumeni kwemvelo, izikhathi zakho zingabuya ngemuva kokwelashwa futhi ukuzala kwakho kungase kuvuseleleke. (Funda kabanzi mayelana nokuthi ukwelapha umdlavuza webele kungathinta kanjani ukuzala kwakho .) Okungenani uma isikhathi sesibili sizungezile, uzobe usulungele ngokwengeziwe ngamasu akho wokubhekana, usuvele usinda esikhathini sokubeletha.
> Imithombo:
> Jerzak, K., noK. Pritchard. Ukunciphisa i-Ovarian kwabesifazane base-Premenopausal abane-Estrogen Receptor-Positive Cancer Breast Cancer: Impumelelo ye-2016 Umhlahlandlela we-ASCO wezokwelapha. I-ASCO Post 06 / 1- / 16.
> Lambertini, M., Del Mastro, L., Viglietti, G. et al. Umsebenzi we-Ovarian Ukuxoshwa kwabesifazane base-Premenopausal abane-Cancer Stage Cancer Stage. Izinketho zamanje zokwelashwa ku-Oncology . 2017. 18 (1): 4.