Umsebenzi ophilile we-thyroid ubalulekile ohlelweni lokuzala okunempilo kanye nekhono lakho lokukhulelwa ngokuphumelelayo, ukukhula ngokukhulelwa, nokuletha ingane enempilo. Nazi izinselele eziningana eziphathelene ne-thyroid ezingathinta ikhono lakho lokuba nomntwana onempilo.
1. Ukungabi nokuvuthwa
Uma unesimo sengculazi esingatholakali noma esingenakekelwa kahle, usengozini enkulu yokuthola lokho okuyaziwa ngokuthi "umjikelezo wokugcoba," umjikelezo lapho ungakhulumi iqanda.
Uma iqanda lingakhululwa, ukukhulelwa nokukhulelwa ngeke kwenzeke. Bese ukhumbula; usengakwazi ukuya esikhathini, ngisho nangenkathi yokugcoba. Kodwa awukwazi ukukhulelwa.
Uma izimo ze-thyroid zitholwa kahle futhi zelashwa kahle, ingozi yemigqa ye-anovulatory ingancipha.
Enye indlela yokuthola imijikelezo yokugubhuzelayo iwuhlelo lwe-ovulation predictor kit, olwenza ukuphakama kwamahomoni athile okwenzeka nxazonke. Ungase futhi usebenzise indlela yokuqapha yokukhiqiza inzalo noma ye-elekthronikhi, kufaka phakathi ukushisa kwezinga lokushisa, ukukhomba izimpawu ezingabonisa ukuvota.
Uma izinkinga zakho ze-thyroid zixazululwa, khumbula ukuthi kunezinye izizathu ezikhona zokujikeleza okugcoba okufanele uhlolisise nodokotela wakho. Lezi zizathu zibandakanya ukuncelisa; izinguquko ze-perimenopausal; ukungasebenzi kahle; i-anorexia; izinkinga ze-ovarian, kubandakanya ukugcinwa kwamaqanda aphansi, noma ukuhlasela okuzenzakalelayo kuma-ovari; kanye ne-polycystic ovary syndrome (PCOS), phakathi kwabanye.
2. Luteal Phase Defects
Uma unenkinga ye-thyroid engaziwa, engalashwa, noma engaphelele, usengozini enkulu yokukhubazeka kwesigaba se-luteal. Isigaba sakho sokuqamba isigaba sesibili sokujikeleza kwakho kokuya esikhathini, emva kokuvuthwa, nokuqala komjikelezo wakho wokuya esikhathini esizayo.
Kulolu hlelo lwesibhakela, ngemuva kokukhishwa kweqanda lakho, ukuthi liqala uhambo lwawo ngokusebenzisa ama-tubes, lapho kungase kukhule khona umuthi, ukuqala ukukhulelwa.
Ngaphansi kwezimo ezijwayelekile, lelo qanda elikhushulwayo liya esibelethweni, lapho lifaka khona emgodini we-uterine owaziwa ngokuthi i-endometrium-futhi ukukhulelwa kuyaqhubeka.
Isikhathi esidingekayo emva kokuvuthwa-ukulungiswa kwendwangu yesibindi, ukukhulelwa kweqanda, nokufakwa endaweni ephumelelayo-cishe izinsuku ezingu-13 kuya kwezingu-15. Uma kungenjalo iqanda elifakwe emanzini elifakwe emzimbeni, inqubo ye-hormone iyaqala ukusebenza, okubangela ukuchithwa kwegciwane lesisu njengesikhathi sakho sokuya esikhathini esijwayelekile.
Uma isigaba sakho sokulenga sifushane kakhulu, nokho, asikho isikhathi esanele sokuba iqanda elikhulile lifakwe ngempumelelo ngaphambi kokuba isibonakaliso se-hormonal sichithwe. Uma lokhu kwenzeka, naphezu kokukhulelwa okuphumelelayo, iqanda elikhulelwe alikwazi ukufaka futhi esikhundleni salokho liphela lixoshwa kanye negazi lokuya esikhathini.
Izisombululo zesigaba se-Luteal zingabonakala ngokufaka isiteji sokuzala- Ukubheka Umlobi Wakho Wokuzala U- Toni Wechsler unemithombo enhle kakhulu ukukusiza ukuthi ufunde indlela yokubonisa izimpawu zokuzala. Kwezinye izimo, udokotela wakho angase avivinye i-hormone ye-follicle-stimulating (FSH), i-hormone yokuqondisa (LH), namazinga we-progesterone, ukusiza ukukhomba amaphutha esigaba se-luteal.
Ukuxilongwa kahle kwe-thyroid kanye nokwelashwa kungase kuxazulule ukukhubazeka kwesigaba kwamanye amantombazane.
Kulaba besifazane abathile, noma kunjalo, i-progesterone enganeleyo ingase ibe yicala. I-progesterone iyadingeka ukuze kukhishwe uketshezi oluhle lwe-uterine. Kulezo zimo, i-progesterone eyongezelayo iye yasiza abanye besifazane ukuba baqhubeke nokukhulelwa okunempilo nengane.
3. Izinga eliphezulu leProlactin / Hyperprolactinemia
I-hypothalamus yakho ikhiqiza i-hormone ebizwa ngokuthi i-hormone ye-thyroid-release, noma i-TRH. Umsebenzi we-TRH ukugqugquzela i-pituitary gland ukukhiqiza i-hormone ye-thyroid etholakalayo noma i-TSH. I-TSH igqugquzela igciwane lakho le-thyroid ukuze likhiqize i-hormone engaphezulu ye-thyroid.
Uma i-thyroid ingasebenzi ngendlela efanele, amazinga aphezulu we-TRH angenziwa.
Le TRH eyengeziwe ingenza ukuthi i-pituitary iphinde ikhulule i-hormone okuthiwa i-prolactin. I-prolactin iyi-hormone ekhuthaza ukukhiqizwa ubisi.
Lesi simo-esaziwa ngokuthi i- hyperprolactinemia- singaba nemiphumela eminingi ekuzaleni kwakho, kufaka phakathi ukuvuthwa okungavamile nemijikelezo evuzayo. Kungamazinga aphezulu e-prolactin ngenkathi kuncelisa okusiza ekuvimbeleni abanye besifazane ukuba bakhulelwe ngenkathi belisa.
Ukudweba umjikelezo wakho wokuya esikhathini nokuvuna-kanye nokuhlolwa kwegazi okulinganisa izinga lakho le-prolactin-kungasiza udokotela wakho ukuthi ahlolisise i-hyperprolactinemia. Uma ukuxilongwa kwe-thyroid efanele futhi ukwelashwa akuxazululisi inkinga ye-prolactin, izidakamizwa eziningana-kuhlanganise ne-bromocriptine noma i-cabergoline-zinqunywe, futhi zingasiza amazinga e-prolactin aphansi futhi abuyisele imijikelezo yakho nokuvuthwa kube yinto evamile.
4. Ukumiswa kwesikhathi sokuqala / ukuphela kwesikhathi
Uma unesifo se-autoimmune esifana nesifo sikaHashimoto, ucwaningo lubonisa ukuthi ubhekene nobungozi obuncane bokuqala kokuya esikhathini sokuqala . E-United States, isilinganiso seminyaka yokuya esikhathini-esichazwe njengephuzu lapho sekuyisikhathi esigcwele kusukela esikhathini sokugcina sokuya esikhathini sakho-kungu-51. Ukumiswa kwesikhashana sekuchazwa ngokuthi yisikhathi lapho amazinga e-hormone ashintshela futhi ehla-ngezinye izikhathi ahlala isikhathi esingange-10 iminyaka-ngaphambi kokuya esikhathini. Kwabesifazane abathile abanezimo ze-thyroid ezingenakutholakali, ezingaphenduliwe noma ezingapheli, ukuqala kwesikhathi kungase kuqale ekuqaleni futhi ukuyeka esikhathini kungase kwenzeke ngesikhathi esifushane, ngaleyo ndlela kufinyelele iminyaka yokubeletha, futhi kubangele ukuzala okunciphise ngesikhathi esingaphambili.
Uma uhlangabezana nezinguquko ze-perimenopausal, ukuhlolwa okugcwele kokuzala, kufaka phakathi ukuhlolwa kwe-ovarian reserve, FSH, LH, namanye amahomoni, kungenziwa udokotela wakho ukuhlola isimo sakho sokuzala. Ngokusekelwe ekutholeni, udokotela wakho angenza izincomo mayelana nokuthi ungumuntu obhekene nomklamo wemvelo noma angase afune ukuphishekela ukukhiqizwa okusizwayo.
5. Izinkinga zokuguqulwa kwe-Pregnenolone
Ihomoni ye-thyroid idlala indima ebalulekile ekuguquleni i-cholesterol ibe yi-hormone ukukhulelwa. I-Pregnenolone iyi-hormone esandulela i-progesterone, i-estrogen, i-testosterone, ne-DHEA. Uma ungenayo i-hormone ye-thyroid eyanele, ungase ube nokuphutha kulawa amanye ama-hormone ayisihluthulelo. Ukuntuleka kwe-progesterone ne-estrogen, ikakhulukazi, kungaphazamisa ukusebenza kahle komjikelezo wesimiso futhi kuphazamise ukuzala kwakho.
Izivivinyo ze-pregnenolone, i-progesterone, i-estrogen, i-testosterone, ne-DHEA ingahlola ukuhluleka kula ma-hormone, futhi uma uzama ukukhulelwa futhi ube nephutha eliphawulekayo, udokotela wakho angancoma ukushintshwa kwe-hormone njengesekelo emizamweni yakho yokukhulelwa okuphephile.
6. I-Estrogen ne-Your Thyroid
Isixhumanisi phakathi kwe-estrogen nomsebenzi we -roid kuyinkimbinkimbi. U-Estrogen uphikisana ne-hormone ye-thyroid ukuze unamathisele kumasayithi we-receptor we-thyroid kuwo wonke umzimba wakho. Uma une-estrogen ngokweqile, ingakwazi ukuvimbela ikhono lakho le-hormone ye-thyroid ukuthi lingene emangqamuzaneni akho. Kungakhathaliseki ukuthi uthatha imithi kadokotela efaka i-estrogen, noma une ukungalingani ku-estrogen eyaziwa njenge-estrogen dominance, ukudlula i-estrogen kungaphazamisa ukulinganisela kwakho kwe-thyroid ne-hormone futhi kuphazamise ukuzala kwakho, ngisho noma amazinga okuhlolwa kwegazi lakho ejwayelekile .
Ukuhlolwa kwamazinga e-estrogen ne-progesterone kungenziwa ngudokotela wakho, futhi uma une-estrogen engaphezu kwalokho, udokotela wakho anganikeza isiqondiso kanye nokwelashwa ukubuyisela leli hormone ukuba lilinganise, ukusiza ukuthuthukisa ukuzala kwakho namathuba okukhulelwa okuphumelelayo.
7. I-Sex Hormone Binding Globulin (SHBG) Ukungalingani
Uma ungenayo i-hypothyroidism engahlosiwe noma engapheli, ungase futhi ube namazinga we-hormone ebopha i-globulin, eyaziwa njenge-SHBG. I-SHBG iyiprotheni ehambisana ne-estrogen. Uma i-SHBG yakho iphansi, amazinga e-estrogen akho angakhuphuka kakhulu. I-estrogen eyedlulele, ngaphezu kokudala ukungalingani okukhulunywe ngakho, kungaphazamisa nokukhula kwezintambo zakho, futhi kuphazamise ukuqhuma kwe-FSH ne-LH ehambisana nokuvuthwa. Uma ungenayo i-hyperthyroidism engaziwa noma engafanelekanga, i-SHBG yakho ingaphakanyiswa, enganciphisa iphresterone yakho, isimo esingaholela ekubuseni kwe-estrogen.
I-SHBG ingalinganiswa nokuhlolwa kwegazi, ukuhlola ukuthi ukulahlekelwa noma ukugqithisa kuthinta ukuzala kwakho.
8. Inselelo yokuqala yeThrojani yeThrojani
Ngesikhathi sokukhulelwa, i-gland evamile yegciwane ikwandisa kulokhu iyakwazi ukukhiqiza ihomoni ye-thyroid engaphezu komama nomntwana. I-hormone ye-thyroid ibalulekile ekuthuthukiseni kwengane yengqondo nokuthuthukiswa kwengqondo futhi kubaluleke kakhulu phakathi nenyanga yokuqala lapho ingane yakho isathuthukisa ingubo yegciwane ekwazi ukukhiqiza i-hormone yayo. Ngaleso sikhathi sokuqala, ingane ixhomeke kuwe yonke into edingekayo yehomoni yegciwane. Ngemuva kwamasonto angama-12 kuya kwangu-13, i-fetal thyroid gland iyakhiwa, futhi ingane yakho izokhiqiza i-hormone ye-thyroid, kanye nokuthola i-hormone ye -roid evela kuwe, nge-placenta. Uma ukhulelwe, isidingo esikhulu se-hormone yegciwane siyaqhubeka kuze kube yilapho ingane yakho izalwa.
Uma i-thyroid yakho ingaphumeleli ngandlela-thile-ngokwesibonelo, i-atrophied ngenxa yesifo sikaHashimoto futhi ayikwazi ukukhulisa nokukhiqiza i-hormone engaphezulu ye-thyroid-i-thyroid ingase ingakwazi ukunikeza i-hormone eyanele yengane. Lokhu kubangela ukwanda komama we-hypothyroidism wesifazane, isimo esithinta ingozi eyandayo yokukhulelwa kwesisu, ukubeletha, nokuqala komsebenzi.
Isiqondiso esiyinhloko yukuthi, isifo se-thyroid kufanele sitholwe futhi siphathwe kahle ngaphambi kokukhulelwe. Futhi uma uphathwa nge-hypothyroidism futhi uhlela ukukhulelwa ngaphambi kokuba ukhulelwe, wena nodokotela wakho kufanele nithole uhlelo lokuqinisekisa ukukhulelwa kwakho ngangokunokwenzeka, futhi ukwandise umthamo wakho we-hormone ye-thyroid ngokushesha uma ukukhulelwa kuqinisekisiwe .
9. Isidingo se-Iodine
Iodine yokudla iyisakhi esiyinhloko sokwakhiwa komzimba wakho wehomoni yegciwane. Njengoba kuxoxwa, ukukhulelwa kudinga ukuthi i-thyroid yande ngosayizi, futhi ukwandise umkhiqizo wehomoni ye-thyroid ukuze uhlangabezane nezidingo zomama nomntwana. Ucwaningo lubonisa ukuthi owesifazane okhulelwe unyuke ukwanda kwamaphesenti angu-50 kwi-iodine yakhe yansuku zonke, ukuze akwazi ukwandisa ukukhiqizwa kwe-hormone ye -roid.
Nakuba iningi labesifazane abaneminyaka yokubeletha e-United States alinayo i-iodine engenamakhono, iphesenti elikhulayo. Ngokusho kweNational Health and Nutrition Examination Survey (NHANES), cishe amaphesenti angu-15 abesifazane besifazane abaneminyaka yobudala yokubeletha njengamanje ayilutho, futhi ezinye izifundo zithole amazinga aphezulu ezindaweni ezithile zesizwe.
I-endocrinologists incoma ukuthi abesifazane bafaka okungenani ama-150 mcg we-iodine, kusukela ekuqaleni ngaphambi kokuncelisa. Indlela elula yokuqinisekisa ukuthi uthola i-iodine eyanele ukuthi uqale ukuthatha i- vitamin yokubeletha equkethe i-iodine ekuqaleni uma uqala ukuhlela ukukhulelwa futhi uqhubeke uyithatha uze usuqedile ukubeletha.
Odokotela abahlanganisayo bavame ukuncoma ukuthi unamazinga e-iodine ahlolwe ngaphambi kokuba ukhulelwe, futhi uxazulule noma yikuphi ukukhubazeka kwe-iodine ngaphambi kokuba uzame ukukhulelwa.
Inothi elibalulekile: Ngokungaqondakali, iningi lamavithamini okubeletha ngaphambi kokubeletha kanye namavithamini amaningi angaphezulu kokubeletha akuqukethe iodini. Kuzodingeka uhlole amalebula ngokucophelela, ukuqinisekisa ukuthi i-vitamin yakho yokubeletha iqukethe i-iodine.
Futhi, khumbula ukuthi amanye amavithamini okubeletha nawo ane-iron ne-calcium. Uma kunjalo, uzodinga ukuthatha okungenani amahora amathathu kuya ku-4 ngaphandle kwemithi yakho ye-thyroid, ukuvimbela noma yikuphi ukuxhumana nemithi yakho ye-thyroid eyanciphisa ukumuncwa nokusebenza kahle.
10. Ukukhiqizwa kwe-Thyroid nokuNcediswa
Uma uphishekela imithi yokwelapha kanye nokusiza ukukhiqiza (ART), qaphela ukuthi i-ART ibeka umthamo owengeziwe ku-thyroid yakho. Ucwaningo luye lwabonisa ukuthi isidingo sokwandisa i-hormone yegciwane senzeke ngaphambili, futhi sikhulu kakhulu, kwabesifazane abasebenzisa ama-ART, uma kuqhathaniswa nomklamo ongaqinisekisiwe. Uma ngabe i-hypothyroid kanye nokwelapha kwe-hormone esikhundleni sakho, uhlelo lokuqinisekisa ukuthi isisindo sakho se-thyroid sishintsha ngokushesha futhi njengoba kunokwenzeka ngangokunokwenzeka kufanele kukhulunywe kusengaphambili nodokotela wakho wokuzala.
Inothi elibalulekile: ungacabangi ukuthi udokotela wakho wokuzala uzoba ngaphezulu kwezindaba zakho ze-thyroid. Ngokumangazayo, odokotela abathile bokubeletha kanye nemitholampilo abazinaki ukuhlolwa kwe-thyroid, noma ukuphathwa kwesifo segciwane ngesikhathi sokukhulelwa ngaphambi kwesikhathi, i-ART, noma ukukhulelwa kokuqala. Kuzodingeka uqiniseke ukuthi udokotela wakho wokubeletha noma umtholampilo uyi-thyroid-savvy, nokuthi banesimiso esikuyo ukuqinisekisa ukuthi i-thyroid yakho ayiphazamisi impumelelo ye-ART noma ukukhulelwa okuphephile.
Izinyathelo Ezilandelayo
Enye yezinyathelo ezingcono kakhulu ongayithatha ukuqinisekisa ukuthi isazi sakho sezinzimbangela-isazi sezinzwa zegazi, udokotela we-thyroid-nodokotela, uma kusebenza-kukhona ulwazi mayelana nesifo se-thyroid, futhi uzosebenzisana nawe kuzo zonke izinyathelo zokuqinisekisa impilo enhle ye-thyroid .
Ucwaningo luye lwabonisa ukuthi izithiyo eziningi ze-obstetricians azikona ngokukhethekile ngokuphatha ukukhulelwa kweziguli ze -roid. Eqinisweni, ucwaningo oluthile lwezinkinga zesifo sezifo-gynecologists 'lathola ukuthi kuphela amaphesenti angu-50 odokotela abazwa ukuthi bathole ukuqeqeshwa "okwanele" ekulawuleni izinkinga zegciwane ngesikhathi sokukhulelwa. Abaningi be-endocrinologists abafanelanga ukulungisa isifo segciwane ezigulini zabo ezikhulelwe. Ungase ufune ukuphenya ukuthi ube ne-endocrinologist yokubeletha eqenjini lakho lezokwelapha, njengoba labachwepheshe bevame ukuba nolwazi oluningi mayelana nokuthi i-thyroid ithinta kanjani ukuzala nokukhulelwa.
> Imithombo:
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> I-American College yezidakamizwa namaGynecologists. 2002. "Isikhombisi-ndlela: Izifo Zegciwane Ekukhulelweni." I-Practice Bulletin No. 37 100 (2) (Agasti): 387-96. http://journals.lww.com/greenjournal/Fulltext/2002/08000/ACOG_Practice_Bulletin_No_37_Thyroid_Disease_in.47.aspx.
> Braverman, Lewis E., noRobert D. Utiger. 2005. Werner and Ingbar's The Thyroid: Umbhalo Oyisisekelo Nokwelashwa, 9th ed. I-Philadelphia: Lippincott Williams & Wilkins.
> Carp, HJ, C. Selmi, noY. Shoenfeld. "I-Autoimmune Bases of Infertility nokukhulelwa kokukhulelwa." I-Journal of Autoimmunity 38 (2-3) (Meyi 2012.): J266-J274. i-doi: 10.1016 / j.jaut.2011.11.016.
> De Groot, Leslie, et. al. "Ukulawulwa Kwezinkinga Ze-Thyroid ngesikhathi sokukhulelwa kanye ne-Postpartum: I-Endocrine Society Guideline Practice Guideline." I-Journal of Clinical Endocrinology & Metabolism 97 (8) (Agasti 2012): 2543-65. i-doi: 10.1210 / jc.2011-2803.
> Leung, Angela M., Elizabeth N. Pearce, noLee E. Braverman. 2009. "Okuqukethwe kwe-Iodine yama-multivitamini engakazalwa ngaphambi kwe-United States." I-New England Journal of Medicine 360 (February): 939-40. doi: 10.1056 / NEJMc0807851.