Ukukhanya Okushisayo Kuhlobene Kanjani Nezibonakaliso Ezicindezelayo?

by I-Naveed Saleh, MD, i-MS; Ibukezwe nguMeredith Shur, MD

Ucwaningo luveza ukukhanya okusha mayelana nezimpawu zokuya esikhathini

Sekuyiminyaka eminingi, ochwepheshe beqaphele ukuthi ukukhanya okushisayo nempawu yokucindezeleka kungenziwa ngokuhlanganyela phakathi nenqubo yokuya esikhathini. Kodwa-ke, kuye kwaba nokucwaninga okulinganiselwe okuhlanganisa izimpawu zokucindezeleka, ukukhanya okushisayo, nokunqamuka kwesikhashana ndawonye. Ngaphezu kwalokho, izici zale ndawo yokutadisha ziyaqhubeka ziphikisana.

Ukukhanya okungaphezulu kuye kwachithwa ekuxhumaneni phakathi kwezimpawu zokucindezeleka nokuya esikhathini , kanye nobuhlobo phakathi kwezimpawu zokucindezeleka nokukhanya okushisayo .

Ukumiswa kwesikhathi kuchazwe

Ngokusekelwe emibhalweni yokubalwa kwabantu ngo-2010, izigidi ezingama-41 zezigidi ezingama-151 zaseMelika zineminyaka engu-55 noma ngaphezulu. Abaningi balaba besifazane babenomdlavuza noma babezobhekana nokuya esikhathini. Ngaphezu kwalokho, ngoba izilingo zokuphila zenyukile phakathi neminyaka embalwa eyedlule-ngokuphawulekayo ngaphandle kuka-2015-abesifazane bangalindela ukuba baphile kancane ama-third of their lives emva kokumisa isikhashana.

Ngokuthakazelisayo, nakuba izilingo zokuphila zanda, isikhathi sokuqala kokuya esikhathini sishintshile kancane kancane ngokuhamba kwesikhathi. Isilinganiso seminyaka yokumisa esikhathini sase-United States sineminyaka engu-51.

Ukucubungula okuphathelene nezinguquko ze-metabolic and hormonal ezihambisana nokuya esikhathini sokuya esikhathini sezilokhu zihambisana nonyaka ngamunye odlule. Abesifazane abazalwa ngesikhathi sokuzalwa kwezingane ngemuva kweMpi Yezwe II bafuna ukwelashwa kokunqamuka kokuya esikhathini kanye nezinye izimo zasemakhaya. Ngaphezu kwalokho, iningi lalaba besifazane lisemsebenzini, okwenza isethi esiyingqayizivele yezimo zomphakathi.

I- climacteric yisigaba senqubo yokuguga lapho owesifazane eguquka kusukela ekuzaleni kwesimo esingenzi lutho. Nansi umkhondo we-climacteric:

Ukumiswa kwesikhashana kungukushintshwa kwe-menopausal kwe-climacteric lapho owesifazane angalindela khona izikhathi zakhe ukuba zingavamile. Ngesikhathi sokuqala, izikhalazo noma izimpawu zokunqamuka kwesikhashana zingase ziqale ukubonakalisa, njengokukhanya okushisayo.

Ukunqamuka kwesikhashana kusho isikhathi sokugcina sokuya esikhathini.
Ukuma ngemva kwesikhathi sokumama kusho ukuphila ngemuva kokumisa esikhathini.

Nazi ezinye izimo zomtholampilo ezihlotshaniswa nesimo sezulu:

Izimpungushe zasebusuku nokukhanya okushisayo

Phakathi kwamaphesenti angu-60 no-80 abesifazane abaguqula isimo sokuzikhandla kwamanzi ebusuku nokushisa okushisayo (okubizwa nangokuthi amahlumela ashisayo noma izimpawu ze-vasomotor ). Ukujula ebusuku kubangele iziqephu zengqondo yokuphefumula futhi kuphazamiseka kungazelelwe. Kulabo besifazane abathola ukushisa okushisayo, amaphesenti angu-82 ashisa kakhulu okudlula isikhathi esingaphezu konyaka, futhi amaphesenti angama-25 no-50 abhekana nabo iminyaka engaphezu kwengu-5.

Nakuba ama-hormone axoshwa ukuze athathe indima, indlela yokuxhumanisa ukuphela kokuya esikhathini nokushisa okushisayo akukacaci. Ngokuqondile, abesifazane abanamazinga aphezulu e-FSH namazinga e-estradiol aphansi banethuba lokubona ukushisa okushisayo. Ngaphezu kwalokho, labo abashisayo noma abane-BMIs ephakeme nabo bangengozi enkulu yokushisa. Ngokuthakazelisayo, ucwaningo lubonisa ukuthi abesifazane abamnyama bathola ukushisa okushisayo kunabesifazane abamhlophe; kanti abesifazane baseJapane nabaseShayina babika ukukhanya okuncane okwedlula ukwedlula abesifazane abamhlophe.

I-osteoporosis

I-osteoporosis yisimo samathambo lapho amathonsi amathambo, futhi amathambo eba buthakathaka futhi ajwayele ukuphuka.

Ngokuphathelene nokuya esikhathini, lokhu kulahlekelwa emathambo kufinyelela ekushintsheni kwamazinga e-hormone. Imithi ethile ingasetshenziselwa ukuvimbela nokwelapha i-osteoporosis, kubandakanya i-bisphosphonates, i-calcitonin, ne-raloxifene. Ngaphandle kwemithi, izithako ze-calcium, izithako ze-vitamin D, ukuyeka ukubhema, nokuvivinya umzimba kunokwazi konke.

I-Atrophy yamaVaginal

I-atrophy yama-vaginal ibhekisela ekunciphiseni, ukuvuvukala, nokumisa izindonga zangasese. Ukwehla kwamagciwane, ukushisa, ukukhipha, izikhalazo zomchamo kanye nobuhlungu phakathi kocansi kungenzeka. Ekuqaleni, izindonga zangasese zibonakala zibomvu ngenxa yokuphuka kwemithambo encane yegazi okuthiwa i-capillaries.

Njengoba ukulahlekelwa kwe-capillary okwandisiwe, izindonga zangasese zigcina zibushelelezi, zikhanyayo, ziphaphathekile. I-atrophy yama-vaginal iyenzeka kancane ekunciphiseni kwamazinga e-estrogen. I-atrophy yama-vaginal ingaphathwa ngamafutha noma ama-estrogen angama-topical, asetshenziswe esikhumbeni ngendlela yama-creams, izindandatho noma amaphilisi.

Ukusebenza ngokocansi

Ukusebenza ngokocansi kungasetshenziswa ngenxa yokunciphisa i-libido , izinguquko ze-hormone, nezinkolelo zenhlalo. I-atrophy yama-vaginal inikela ekunciphiseni ukusebenza kocansi. I-hormone therapy ihlolwe njengendlela yokwelashwa okunokwenzeka yokusebenza kocansi okunciphile.

Kunzima ukulala

Phakathi kwamaphesenti angu-30 no-60 abesifazane base-midlife bahlangabezana nokuphazamiseka kokulala. Ngokuqondile, laba besifazane banenkinga yokuwa nokulala. Nakuba ubudala budlala indima kulezi ziphazamiso zokulala, izinguquko ze-hormone, ukukhanya okushisayo, ukucindezeleka, nezimpawu zokucindezeleka nazo zihlobene nokuhlupheka ukulala.

I-Memory Loss

Ucwaningo lubonisa ukuthi amaphesenti angama-62 abesifazane base-midlife abhekene nobunzima bokukhumbula ngesikhathi sokushintsha kokuya esikhathini. Lezinkinga zememori zihlanganisa inkinga yokukhumbula izinombolo namagama nokukhohlwa. Ukuncipha e-estrogen kuyaxilongwa ukuze kudlale indima kulezinkinga zememori.

Izimpawu Ezicindezelayo Nokunqamuka Kwemvelo

Kungakhathaliseki ukuthi ukuphuma komama kusebenza yini njengengozi yokucindezeleka kuyinkinga. Abaningi besifazane base-midlife abanaso izimpawu ezinzima zokucindezeleka. Phakathi nenqubo yokunqamuka kwesikhashana, phakathi kwamaphesenti angu-20 kuya kwangu-30 abesifazane base-midlife bahlangabezana nokucindezeleka kokuqala komtholampilo noma iziqephu eziphindaphindiwe zokucindezeleka. Ingozi yokucindezeleka inkulu ngesikhathi sokumiswa kwesimiso kanye nokuma ngemva kokuma ngemva kokuhamba komzimba kunanoma iyiphi ngaphambi kokuphela komzimba.

Izimpawu ezicindezelayo zihlanganisa okulandelayo:

ukukhathala
ukudabuka
unecala
ukulahlekelwa ukudla
ukulahlekelwa ukulala
izinkinga ngokuhlushwa
ukukhathazeka
ukulahlekelwa kwesithakazelo
imicabango yokuzibulala

Esifundweni se-2014 eshicilelwe ku- JAMA Psychiatry , u-Freeman kanye nozakwethu bahlola abesifazane abangu-203 be-midlife ngezibonakaliso zokucindezeleka ngesikhathi seminyaka engu-14 esondela esikhathini sokuya esikhathini (okusho, isikhathi sokugcina esikhathini). Laba besifazane babeyi-premenopausal futhi bafinyelelwa esikhathini sokuya esikhathini. Babheka futhi nezinguquko kumazinga e-hormone njengababikezeli bokucindezeleka ngesikhathi sokuphuma komama kanye nomlando odlule wokucindezeleka.

Nazi ezinye zeziphumo zabacwaningi:

Kulabo besifazane abanomlando wokucindezeleka, ingozi yokubhekana nezimpawu zokucindezeleka yayinamaphesenti angu-8 ngaphezulu ngemva kokuya esikhathini sokuya esikhathini kanye nokuphindwe izikhathi ezingu-13 kunabesifazane ngaphandle komlando wokucindezeleka.
Ngokuphathelene nokunqamuka kwesikhashana ngokwayo, ingozi yezibonakaliso zokucindezeleka yayiphezulu eminyakeni ngaphambi kokuya esikhathini sokuya esikhathini esingaphansi kweminyaka emva kokuya esikhathini sokuya esikhathini. Ngokuqondile, ingozi yempawu ezicindezelayo iminyaka eyishumi ngaphambi kweminyaka eyisishiyagalolunye emva kokumisa esikhathini sokunciphisa umthamo wehla ngamaphesenti angu-15 ngonyaka.
Kulabo besifazane abaqala ukuthola izimpawu zokucindezeleka ngokuya esikhathini sokuya esikhathini, izimpawu zokucindezeleka zahlehla ngesikhathi sokuphuma kwamaphesenti, futhi zahla kakhulu kakhulu ngonyaka wesibili wokuphuma komama ngemuva kokuya esikhathini.
Kwabesifazane ababengenalo umlando odlule wokucindezeleka, ingozi yezibonakaliso zokucindezeleka yayiphansi kweminyaka emibili noma ngaphezulu ngemva kokuya esikhathini sokuya esikhathini.
Ukunciphisa ekuboniseni ukucindezeleka kuboniswe izinguquko ze-hormonal.

Ngokusho kwabacwaningi, nansi impendulo ephakanyisiwe yalolu cwaningo:

Umtholampilo ubuyekeze izimpawu zokucindezeleka kuyadingeka ukuze unikeze ukwelashwa lapho izimpawu zikhubaza futhi zihlolisise umphumela wokucindezeleka kwezinye izifo ezinkulu, ezifana nesifo senhliziyo, isifo se-metabolic, kanye ne-osteoporosis. Abesifazane abanomlando wokucindezeleka bangase bazuze ku-anti-depressant noma psychotherapy efanelekile ngenxa yesifo esingelapheki. Kodwa-ke, abesifazane abangenalo umlando wokucindezeleka bangase babe nomngcipheko ophansi wezibonakaliso zokucindezeleka ngemva konyaka wesibili we-postmenopausal futhi bazuze ukwelashwa kwe-hormone yesikhathi esifushane noma ukwelapha okwesikhashana abanezinkinga zokucindezeleka eziye zabonisa ukuthi zisebenza kahle izimpawu zamadoda.

Ukushisa Okushisayo Nezimpawu Ezicindezelayo

Iningi lezifundo eziye zahlola ukuxhumana phakathi kokushisa okushisayo nezibonakaliso zokucindezeleka kuye kwaphutha ngezindlela ezimbalwa.

Okokuqala, ukuqinisekiswa kokuhlolwa kuye kwasolakala, kanti abacwaningi abasebenzisi izinyathelo ezifanele zokuhlola ukushisa okushisayo. Okwesibili, abahloli baye babheka noma yikuphi ukushisa okushisayo kunokuba bahlukumeze ngempela. Ngokufanayo, abacwaningi baye bahlupha ukuhlola izimpawu zokucindezeleka eziphathelene nomtholampilo . Okwesithathu, inani labahlanganyeli ezifundweni ezihlolisisa ukuxhumanisa phakathi kokushisa okushisayo nokumisa esikhathini sezintambo sekuphansi, futhi udinga abantu abaningi ukuba basampula ngendlela efanele yokumela abantu obahlolayo.

Esifundweni sangoMashi 2017 eshicilelwe kwi- Journal of Women's Health , i-Worsley kanye nosebenza nabo baqeda lezi ziphutha ngokuhlaziya ngokungahleliwe abesifazane abangu-2,020 base-Australia phakathi kuka-40 no-65. Abacwaningi basebenzisa imibuzo evumelekile neyemele ukuhlola abahlanganyeli ngokushisa okushisayo, ngokulinganisela ekucindezelekeni okukhulu, ugwayi ukusetshenziswa, ukusetshenziswa kotshwala, kanye nemithi yokwelapha.

Ngemuva kokulungiswa kwezinguquko eziningana, kufaka phakathi iminyaka, umsebenzi, kanye ne-BMI, abacwaningi bathola ukuthi uma kuqhathaniswa nabesifazane abangenawo ukukhanya okushisa okuncane noma okuncane, abesifazane abalinganiselwe ekukhanyeni okukhulu okushisayo cishe babe nokulinganisela ekuboniseni ukucindezeleka okukhulu, futhi.

Ngaphezu kwalokho, abesifazane ababenezimpawu ezicindezelekile ezicindezelayo babe namathuba amaningi okuthatha imithi yengqondo, ukubhema nokuphuza ngokweqile.

Amandla amakhulu kulolu cwaningo kwakuwukuthi bahlola abahlanganyeli abamele umphakathi wase-Australia yonke. Ngokuqondile, abahlanganyeli kulolu cwaningo babefana nabantu abahlolwayo ngo-2011 wokubalwa kwabantu base-Australia ngokuqondene nobuhlanga, imfundo, isimo somlingani, nomsebenzi. Okunye okulinganiselwa kulolu cwaningo ukuthi kusetshenziswe izinyathelo zokubika ezizimele (imibuzo).

Ngokusho kwabacwaningi, nakhu okunye okushiwo kulolu cwaningo:

Ngokubonisa ubudlelwane obuphakathi kwe-VMS eyinkimbinkimbi [ukushisa okushisayo] nezimpawu ezicindezelayo zokucindezeleka, lolu cwaningo lunezela ngokwengeziwe umqondo we-etiology ehlanganyelwe phakathi kwe-VMS nokucindezeleka. Ngaphezu kokuthuthukisa i-VMS, ukwelashwa kwe-estrogen kungathuthukisa isimo sengqondo esikhathini sokuqala esikhathini sokuqala.

Ngamanye amazwi, ngokusekelwe emiphumeleni yokutadisha kwabo, abacwaningi bacabanga ukuthi imbangela yokushisa nokushisa okushisayo kungase kube okufanayo, futhi lokho ukwelashwa kwe-hormone kungase kuphakamise izimpawu zokucindezeleka kulabo ababhekana nokuya esikhathini sokuqala.

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