I-Estrogen emiphilisi eminingi yokulawula ukubeletha iye yehliswa
Kungabe kuyingozi noma kuphumelele yini kwabesifazane abangaphezu kuka-40 ukusebenzisa ukulawulwa kwama-hormonal? UDkt. Andrew Kaunitz unikeza i-vignette elandelayo ehlokweni eshicilelwe eNew England Journal of Medicine :
Owesifazane onempilo oneminyaka engu-46 ubudala oneminyaka engu-46 ubudala oneminyaka engu-46 ubudala, ucela iseluleko mayelana nokukhulelwa kwengane. Uphawula ukuthi izikhathi zakhe zokuya esikhathini azivamile kangako ngaphambili, futhi ubika nokuphazamiseka okufudumele okushisayo. Usubuhlobo obusha ngemuva kwesahlukaniso, futhi usebenza ngokocansi. Ubuza ukuthi angaqala ukusebenzisa isisu somlomo . Yini ongayeluleka?
Izinketho Zokulawula Ukubeletha Kwabesifazane Ngaphezu kuka-40
Uma ungowesifazane oneminyaka engu-40 noma ngaphezulu, bese ulalela! Kuvezwe ukuthi izinketho zakho zokulawula ukubeletha zitholakale . Akusekho ukukhetha kwakho okunciphile kumakhondomu, izingxenxathela , kanye ne- tubal ligation .
UDkt. Kaunitz, ilungu loMnyango Wezitho Zokuzivikela Ne-Gynecology YaseYunivesithi yaseFlorida College of Medicine, ishicilelwe ucwaningo ngomqulu ka-Mashi 20, 2008 we- New England Journal of Medicine ohlola ukusetshenziswa kwabesifazane kokukhulelwa kwe-hormonal emva kweminyaka engu-40. U-Kaunitz uchaza ukuthi kusukela i-estrogen etholakala eziningi zamaphilisi okulawula ukuzalwa okuhlanganisiwe kuye kwancipha ngokuphawulekayo, iphilisi manje ibhekwa njengendlela ephephile yabesifazane abancane, abanempilo engaphezu kweminyaka engu-40.
Ezinye Izinzuzo Zokukhulelwa Kwama-Hormone Kwabesifazane Ngokweminyaka 40
UDkt. Kaunitz uphinde wabonisa ukuthi abesifazane abaningi bangase bathande iphilisi ngoba kungaba:
- Nciphisa ukuphuma kwendoda okungavamile
- Siza ukulawula ukukhanya okushisayo
- Usizo ukunciphisa ama-hip fractures
- Ncipha ingozi ye-ovarian, i-endometrial, nomdlavuza we-colorectal
Ingozi Yezingubo Zegazi Eziyingozi
Kodwa-ke, khumbula ukuthi ingozi yezindwangu zegazi eziyingozi ikhuphuka ngokunyuka eneminyaka engama-40 yabesifazane abasebenzisa amaphilisi okulawula ukubeletha okunesifo se-estrogen, kanti izibalo ezingamaphesenti angama-100 kubantu abayizigidi ezingu-100 (uma kuqhathaniswa namacala angu-25 ku-100,000 abantu abaneminyaka yobudala).
Futhi, ingozi ye-thromboembolism ene-venous iphindwe kabili ngaphezu kwabesifazane abakhulu kunabo bonke njengoba kuphakathi kwabesifazane abangama-nonobese abasebenzisa izisu zokubeletha ngomlomo .
Uma uneminyaka engama-40-plus-year ubudala onomzimba obuthakathaka, ugwayi ugwayi, unomugqa wekhanda, umfutho wegazi ophezulu , noma isifo sikashukela, ucwaningo lukaDkt. Kaunitz luveza ukuthi izici eziyingozi ezihambisana nokusetshenziswa kokulawula ukubeletha zibhekwa njengezigqamile izinzuzo. Kodwa, kusekhona izindaba ezinhle. Abesifazane abangaphezu kuka-40 nalezi zinto eziyingozi bangase babe yiziphakamiso ezinhle kakhulu kwi- ParaGard IUD , noma ngezinketho zokwelapha kuphela ze- progestin .
Ukusetshenziswa kokulawulwa kokuzalwa kwabesifazane abaneminyaka engama-40 kanye nabadala
Ukuvimbela ukubeletha kwe-hormone sekuyisikhathi esidingekayo kubantu abangu-40-kunikezwe ukuthi abesifazane abaningi bakhetha ukuyeka izingane kuze kube sesikhathini esilandelayo, ngakho-ke, inzalo, njengezibhamu eziboshwe, ingase ingabi yinto enhle. Ngokuthakazelisayo, izibalo ziveza ukuthi abesifazane abaneminyaka engama-40 kanye nalabo asebekhulile bangamathuba okusebenzisa ukulawula ukubeletha , nokho (kanye nentsha), laba besifazane asebekhulile banamanani aphezulu okukhipha isisu . Kodwa-ke, uDkt. Kaunitz ubika ukuthi abesifazane abangu-40 kanye nabesifazane abaneminyaka yobudala yokubeletha abasebenzisa ukukhulelwa ngokweqile "banamathuba okusebenzisa izakhi zokubeletha ngendlela efanele nangokweqile kunabesifazane abasebasha.
Ngakho-ke, abesifazane kule nkathi yobudala banamanani aphansi okuhluleka kokukhulelwa kunokuba abasha abasebasha. "
Ukwandiswa kokukhethwa kokukhulelwa kokubeletha kwabesifazane abangu-40 kuyothola abaningi besifazane bejabulela injabulo yocansi eyanelisayo ngaphandle kwesidingo sokukhathazeka ngokukhulelwa.
Umthombo:
Kaunitz, AM (2008, Mashi 20). Ukukhulelwa Kwamahomoni Kwabesifazane Abadala Abazali Abadala. I-New England Journal of Medicine, 358 (12) , 1262-1270.