Isimo esivamile, kodwa esisodwa sivumela ukuhlolwa kukadokotela
Ukubona ukuphuma esikhathini esindayo noma okude isikhathi eside-igama lezokwelapha lingumama -rrgia-lingase lisabe futhi lisongele. Yize lokhu kuyinto evamile, ukuphuma kwezimpahla ezinzima kudinga ukuba uvakashele udokotela wakho, ikakhulukazi umjozi wakho wezifo .
Ingabe Ngibhekene Nokuqothuka Okuyisimangaliso Kakhulu?
Indlela elula yokwazi ukuthi ubhekene nokukhulelwa kokunyuka okunzima ukuthi uqaphele ukuthi ugibela kaningi kangakanani i-pad noma i-tampon.
Uma isikhathi sakho sisindayo ngokwanele ukuthi sidinga ukuguqula i-pad noma ukuchitha isikhathi ngasinye amahora amaningana, noma uma unegazi lokugoma elihlala isikhathi esingaphezu kwesonto eligcwele, ubhekene nokukhulelwa kokunyuka okunzima.
Ngaphandle kwalaba ababili, ezinye izibonakaliso zokuphuma kwezinyuka ezinzima zihlanganisa:
- Ukugqoka ngaphezu kweyodwa pad ngesikhathi ukuze ulawule ukuphuma
- Ukuba ushintshe i-tampon yakho noma i-pad phakathi nobusuku
- Uma igazi lakho lokuya esikhathini liqukethe izindwangu ezilingana nekota noma ezinkulu
Ukuxilongwa
Ukuqaphela imbangela yokuphuma esikhathini esiyingozi kungaba yinkambinkimbi enhle, ngakho-ke kungcono ukulungele. Ngaphambi kokuqokwa kwakho, zama ukunciphisa iphethini yakho yenkathi ezinyangeni ezimbalwa zokugcina. Isibonelo, zingaki izinsuku oye wachitha inyanga ngayinye? Zingaki amapayipi noma amathoni ohamba ngawo ezinsukwini zokugeleza kwakho esikhathini esiqine kakhulu?
Ngaphezu kwalokho, kuwumqondo omuhle ukwenza uhlu lwazo zonke izidakamizwa zakho, kuhlanganise nokulawulwa kwe-hormonal, noma yikuphi ukwelashwa kwe-hormone, nanoma yimaphi amavithamini noma izithako ezingaphezu kwe-counter.
Uma ucabanga ukuthi kungani uphepha kakhulu, ungamangazi uma udokotela wakho eyala uchungechunge lwezivivinyo, ngaphezu kokuhlola ukuhlolwa kwe-pelvic. Lezi zivivinyo zingafaka phakathi:
- Ukuhlolwa kokukhulelwa (uma i-premenopausal)
- Ukuhlolwa kwegazi (isibonelo, inani eliphelele legazi, ama-iron ama-hormone wegciwane)
- I-ultrasound ye-pelvis yakho
Udokotela wakho angenza futhi inqubo ehhovisi ebizwa ngokuthi i- hysteroscopy ukuze ubone ngeso lengaphakathi ngaphakathi kwesibeletho sakho. Angase futhi athathe isampula yezicubu zakho ze-uterine, okuthiwa i-endometrial biopsy, kuye ngokuthi uneminyaka yakho nezimpawu zakho.
Izimbangela
Kunezimbangela eziningi ezihlukahlukene zokuphuma kwezinkinga ezinkulu zokuya esikhathini-ezinye ezinobunzima (okungewona umdlavuza) njenge-fibroids, futhi ezinye ezingathí sina njengomdlavuza wesibeletho noma umlomo wesibeletho. Ezinye izimbangela azizona ezakhiweni kodwa zihlobene nezinguquko ze-hormone noma izinkinga zokugaya emzimbeni wakho.
Ukungasebenzi kwe-Ovulatory
Ukungasebenzi kwe-ovulatory ngesikhathi sokukhula noma ukuphela komzimba kuyimbangela evame kakhulu yokuphuma kweqile kokuya esikhathini. Ngalesi sikhathi, owesifazane angase avule (akhiphe iqanda) ngokungavamile, okusho ukuthi akuyona inyanga noma cha. Lokhu kuholela ekwanyeni kweminye yezinyosi kanye nezinkathi ezinzima.
Ukungasebenzi kahle kwe-ovulatory kungase kuvele nezimo ezithile zezokwelapha ezifana ne-hypothyroidism, i-polycystic ovarian syndrome, nokuhluleka kwe-ovarian ngaphambi kwesikhathi. Ukwelapha inkinga eyinkimbinkimbi (isibonelo, i-thyroid engasebenzi) ibalulekile ekubuyiseleni ukuvuthwa okujwayelekile nokujwayelekile isikhathi sezinsikazi.
Uma ukuvuthwa okungajwayelekile kungengxenye yempendulo evamile yomzimba (isibonelo, ukukhulelwa noma ukuphela kwesikhashana), izindlela zokuvimbela ukubeletha noma ukwelashwa kwe-hormone, ngokulandelana, ngokuvamile kunganciphisa ukuphuma kwegazi.
Ama-Froid e-Uterine
Ama-fibroid ngokuvamile ahlambalaza (angewona umdlavuza) avela ebuhlungwini besibeletho sowesifazane futhi ajwayelekile kakhulu phakathi kwama-30s noma ama-40 wesifazane. Nakuba imbangela ye- uterine fibroids engacacile, yaziwa ukuthi ingaphansi kwesifo se-estrogen. Yingakho izindlela ezithile zokulawula i-hormonal zokuzalwa ezifana namaphilisi okulawula ukubeletha zingasiza ukunciphisa ukuphuma kwezilonda ezinzima kusuka ku-fibroids. Amadivayisi we-progestin-release intrauterine (isibonelo, i-Mirena) anganciphisa ukuphuma kwesikhatsi, kodwa empeleni anganciphisi usayizi we-fibroid.
Enye imithi ngezinye izikhathi esetshenziselwa ukwelapha i-fibroids i-horonone i-gonadotropin-release hormone (GnRH) i-agonist, imithi eyancipha ubukhulu be-fibroids kodwa ingasetshenziswa kuphela isikhathi esifushane, ngenxa yemiphumela emibi.
Futhi, ukwelashwa okuningana okutholakala kuyatholakala ukuze ukhethe ama-fibroids, kuhlanganise ne-myomectomy (ukususwa kwe-fibroid), ukunikezwa kwe-endometrile ye-fibroids encane (ubhejane bombele bubhujiswa), kanye nesisu somzimba wesibindi (ukunikezwa kwegazi kunqunywe kwi-fibroid) . Ezimweni ezimbi kakhulu, i-hysterectomy ingavunyelwa, lapho isisu sonke sisuswa khona noma ngaphandle kwama-ovari.
Ngokuvamile, uma izimpawu zingekho ezinzima noma ezinzima, kwanele ukuthatha "ukulinda nokubona" indlela nge-uterine fibroids. Futhi uma kwenzeka ukuphuma esikhathini, izicubu ngokuvamile ziyancipha futhi zinyamalale ngaphandle kokwelashwa.
Uterine Polyps
Ama-polyps esibelethweni-okuthiwa i-polyps-endometrium- ngokuvamile ayinomdlavuza, okukhula kwamagilebhisi okuvela emgqeni wesibeletho. Zingenzeka kuzo zombili abesifazane base-premenopausal kanye ne-postmenopausal. Imbangela ye-polyps ye-endometrium ayicacile, nakuba ucwaningo lubonisa ukuxhumana phakathi kwe- postmenopausal therapy ye-hormone nokukhuluphala.
Ukwelashwa kwamapolitiki we-endometrial kungabandakanya ukususwa kwe-polyp. Ibhulogi ye-pathology lizohlola amapolitiki e-endometrial ngomdlavuza ngemva kokususwa kwawo.
I-Adenomyosis yesisu
Kulesi simo, isibeletho siyakhuliswa ngoba amangqamuzana wesibeletho akhula abe ngodonga lwe-muscular of the womb, okwenza kube nokuphuza nokulimala okukhulu. Ngenkathi ukuphuma kwegazi kungancishiswa nge izindlela zokulawula ukuzalwa kwe-hormonal, ukwelashwa okucacile kwe-adenomyosis yi-hysterectomy.
Izifo Ezivuthayo Ze-pelvic (PID)
I-PID ivame ukubangelwa ukutheleleka ngokocansi okungaphenduliwe, kodwa ngezinye izikhathi kungenzeka ngemuva kokubeletha, ukukhipha isisu, noma ezinye izinqubo zokubeletha. Ku-PID, izitho eyodwa noma eziningi zokubeletha zitheleleke, njengesibeletho, amashubhu we-fallopian, noma umlomo wesibeletho. Ukwelashwa okuphakanyisiwe kwe-PID kuyindlela yokwelapha yama-antibiotic.
Umdlavuza wesibeletho
Lona uhlobo lomdlavuza owenzeka lapho amangqamuzana emgodini wesibeletho engavamile, athuluke ekulawuleni, futhi awonakele izingxenye ezinempilo zomzimba. I- papillomavirus yomuntu (i-HPV) yimbangela yobuningi besifo somdlavuza wesibeletho. Ukwelashwa komdlavuza wesibeletho kuhlanganisa ukuhlinzeka, ukwelashwa kwamakhemikhali, kanye / noma ukwelashwa kwemisebe.
I-Cancer Endometrial
Lo mdlavuza uvela lapho amangqamuzana angavamile e-endometrium (i-lining of the uterus) ayanda ukulawula futhi awonakele isibeletho nezinye izitho. Nakuba imbangela yesifo somdlavuza we- endometrial engaziwa, abesifazane abatholakala ukuthi banalolu hlobo lomdlavuza bavame ukuba phakathi nawo-60s. Ukwelashwa kokuqala komdlavuza we-endometrial ngokuvamile i-hysterectomy, okungenzeka ilandelwe yi-chemotherapy kanye / noma imithi yokwelashwa.
Ukuphazamiseka kwezibilini
Nakuba kunezinhlobo eziningana zokuphazamiseka kwegazi, uhlobo oluvame kakhulu kubantu besifazane yi- von Willebrand isifo (VWD). Ukwelashwa kwesifo se-von Willebrand kuhilela ukukhululwa kwezinto ezigciniwe ezigciniwe egazini noma, ezimweni ezimbi kakhulu, ukufaka esikhundleni se-clotting factor nge-intravenous (through the vein) ukwelashwa noma nge- spray ekhethiwe .
Ezinye izinkinga zokuphuma kwegazi ezifana nokuba ne-platelet ephansi (ama-platelet abandakanyeka ekugubungeni futhi akhiqizwa emnothweni wamathambo) noma egazini elincinci njengeCoumadin (i-warfarin sodium) ingaba yilokho okubangelwa ukuphuma kwezinkinga ezinzima.
Ezinye Izimbangela Zokuqhafaza Okukhulu Kwokuya esikhathini
Ezinye izimbangela ezingabangela ukwelapha okunzima kokuya esikhathini kwabesifazane abangenawo abakhulelwe zihlanganisa i-endometriosis kanye ne- intrauterine device (IUD) njenge-Mirena, ikakhulukazi ngonyaka wakho wokuqala wokusetshenziswa, kodwa uhlu alugcini lapho. Lokhu kugcizelela ukubaluleka kokubona udokotela wakho ukuxilongwa nokuhlolwa okufanele.
Lapho Ukuqeda Ukuya esikhathini kuyisimo esibucayi sezokwelapha
Uma unesifo esinzima, ukuphuma kwegazi elimangalisayo, kungase kudingeke uhambe ekamelweni eliphuthumayo. Isibonakaliso siyoba uma uhamba emaphethini amane noma ngaphezulu noma amathoni esikhathini esiyihora ezimbili. Uma ukhulelwe, funa ukunakekelwa okusheshayo kwezokwelapha nganoma yikuphi ukuphuma kwegazi.
Izwi elivela
Ukufinyelela ekugcineni kokuphuma kwegazi okuqakathekileko akubalulekile nje kuphela ngekhwalithi yakho yokuphila kodwa nempilo yakho. Ukulahlekelwa kwegazi okunzima, kungakhathaliseki imbangela, kungabangela ukungabi nalutho kwe-iron, okungenza ungapheli amandla, ukhathele, futhi udizizi. Uma kokubili ukuphuma kwegazi kanye nezimpande zokuphuma kwegazi kukhulunywa futhi uphathwe, ungathuthuka futhi uzizwe kahle-uyakufanelwe.
> Imithombo:
> I-American College ye-Obstetrics ne-Gynecology. I-Committee Opinion No. 557. Ukuphathwa Kwegazi Lokungavamile Okungavamile Kwabesifazane Ababelethi Abazali Abazali Abadala Abazali Abazali Abazali Ababelethi. I-Obstetrics & Gynecology . 2013; 121 (4): 891-896. Iqinisekisiwe ngo-2017. ini: 10.1097 / 01.aog.0000428646.67925.9a.
> I-American College ye-Obstetrics ne-Gynecology. Imibuzo Ebuzwa Ngokuphindaphindiwe: Ukweqa Okuyisimiso Okukhulu.
> Hauk L et al. I-ACOG ikhishwa izinkombandlela ekuphathweni kwegazi lokungajwayelekile elingavamile elihambisana nokusebenza komzimba we-Ovulatory. Am Fam Physician. 2014 Jun 15; 89 (12): 987-88.
> Kaunitz AM. Indlela yokuphuma kwegazi elingavamile emantombazaneni angenasibalo sokuzala. Ku: UpToDate, Barbieri RL, Levine D (Eds), UpToDate, Waltham, MA.