Indlela yempilo

Un indlela yokuphila enempilo isiza ekunciphiseni ukushuba kwezimpawu zokunqamuka kokuya esikhathini, ithuthukisa impilo yenhliziyo nemithambo yegazi namathambo, futhi inikeza ezinye evikelwe ngokumelene nezinkinga eziningana zempilo.

Ukudla

Ukwehlisa ukukhanya okushisayo

• Esikhundleni sokudla oku-3 okuyinhloko, nciphisa izingxenye futhi uhlele ukudla okulula okunempilo phakathi kokudla;
• Ukuphuza amanzi amaningi;
• Gwema noma wehlise kakhulu ukusebenzisa kwakho izikhuthazi: iziphuzo ezishisayo, ikhofi, utshwala, izitsha ezibabayo;
• Yehlisa ukudla kwakho ushukela ogxilile;
• Yidla ukudla okunothe nge-phytoestrogens njalo.

Ukuzivocavoca umzimba

Noma yiluphi uhlobo lokuzivivinya umzimba lungcono kunokungawuvivinyi umzimba. Kubo bonke abesifazane, futhi ikakhulukazi labo abangena kulesi sikhathi soshintsho, iukuzivocavoca nsuku zonke inikeza izinzuzo ezimbalwa ezibalulekile:

- gcina noma uzuze isisindo esinempilo;

- gcina isimiso senhliziyo sisesimweni esihle;

- ukunciphisa ukuncipha kwamathambo kanye nengozi yokuwa;

- ukunciphisa ingozi yomdlavuza webele;

– vuselela inkanuko yocansi.

Ngaphezu kwalokho, ucwaningo lubonisa ukuthi abesifazane abangazivocavoci banamathuba amaningi okuba nawo ukushisa okushisayo okulinganiselwe noma okusindayo uma kuqhathaniswa nabesifazane abajwayele ukuvivinya umzimba^{3, I-4,47}.

Kunconywa ukuthi usebenze ngokulingene okungenani 30 imizuzu ngosuku futhi uhlanganise ukuzivocavoca okuguquguqukayo ohlelweni lwakho: ukwelula, i-tai chi noma i-yoga, isibonelo. Ukuze uthole iseluleko esifanele, thintana nesazi se-kinesiologist (uchwepheshe wokuzivocavoca umzimba).

Amasu okuphumula

Ukuphefumula okujulile, ukubhucunga umzimba, i-yoga, ukubona ngeso lengqondo, ukuzindla, njll. kungasiza ngezinkinga zokulala, uma zikhona. Ukuphumula kungasiza ekudambiseni ezinye izimpawu zokunqamuka kokuya esikhathini (bheka isigaba sezindlela Ezengeziwe).

Imithi

Ukulwa nezinkinga ezahlukahlukene ezihlobene nokunqamuka kokuya esikhathini, odokotela basebenzisa izinhlobo ezi-3 zezindlela zemithi:

• ukwelashwa kwe-hormonal jikelele;
• ukwelashwa kwe-hormonal yendawo;
• ukwelashwa okungezona ama-hormonal.

Ukwelashwa okuvamile kwamahomoni

THEi-hormone therapy inikeza ama-hormone ukuthi ama-ovari ayeke ukukhishwa. Ivumela iningi labesifazane ukuthi libone okwabo izimpawu (ukushisa okushisayo, ukuphazamiseka kokulala, ukushintshashintsha kwemizwelo) ngesikhathi sokwelashwa ngama-hormone.

Kubalulekile ukwazi ukuthi iningi labesifazane abaqala ukwelashwa ngama-hormone okuvamile bazophinde bathole izimpawu zabo lapho beyeka ukwelashwa ngoba umzimba uzophinde udlule ekushintsheni kwehomoni. Abanye besifazane bangase, ngokwesibonelo, bathathe isinqumo thatha i-hormone therapy iminyaka embalwa bese unquma ukuyeka ukuyithatha lapho usuthatha umhlalaphansi, wazi ukuthi kuzoba lula ukuphatha izimpawu zabo ngalesi sikhathi sokuphila.

I-systemic hormone therapy ngokuvamile isebenzisa inhlanganisela ye-estrogens nama-progestin. I i-estrogen kuphela zigcinelwe abesifazane abaye bakhishwa isibeletho (hysterectomy) kusukela, ezithathwe isikhathi eside, bandisa ingozi yomdlavuza wesibeletho. Ukwengeza i-progestin kunciphisa le ngozi.

Kulezi zinsuku, i-i-hormone therapy igcinelwe abesifazane abazimpawu zabo zokunqamuka kokuya esikhathini ezivezwayo futhi izinga labo lokuphila lisengozini ngokwanele ukuze likuthethelele. I I-Society of Obstetricians kanye neGynecologists yaseCanada incoma ukuthi odokotela banikeze umthamo ophansi kakhulu osebenzayo ngesikhathi esifushane kakhulu. Ubukhulu besikhathi esiphakanyisiwe ngu- iminyaka 5.

Ukwelashwa kweHormone kungasiza ekubambezeleni ukulahleka isisindo samathambo futhi ngaleyo ndlela kunciphise ingozi yokuphuka. Nokho, akufanele imiselwe le njongo kuphela.

I-hormone replacement therapy ngezinye izikhathi ine okuqhamuka uma udla imishanguzo ayiyingozi, kodwa ayijabulisi. Hlola nodokotela wakho.

Abanye besifazane bathatha ama-hormone kanjalo qhubeka, okungukuthi, bathatha ama-estrogens nama-progestin nsuku zonke. Ukuya esikhathini bese kuyayeka. Imvamisa, aziqhubeki lapho ukwelashwa ngama-hormone kuyeka, uma sekuthathe isikhathi eside ngokwanele. Abanye besifazane bayalashwa okujikelezayo, futhi uthathe ama-progestin izinsuku ezingu-14 kuphela ngenyanga kanye ne-estrogen nsuku zonke. Ukwelashwa kweHormonal okuthathwa ngomjikelezo kudala "izikhathi zamanga" noma ukuphuma ukuhoxiswa (okungahlobene ne-ovulation, njengasendabeni yephilisi lokulawula ukuzalwa).

I-Classic hormone therapy

ECanada, i-conjugated equine estrogens (Premarin®) kade yaba khona okushiwo kakhulu. Lawa ma-estrogens akhishwa emchameni wama-mares akhulelwe futhi afakwa ngomlomo. Nokho, lokhu akusenjalo. 1^er February 2010, i-Premarin® yahoxiswa ohlwini lwezidakamizwa ezimbozwe uhlelo lomshwalense womphakathi wase-Quebec, ngenxa yokwenyuka okukhulu kwenani elithengiswayo.². (I-Premplus®, inhlanganisela ye-conjugated equine estrogen kanye ne-synthetic progesterone, nayo ihoxisiwe.)

Kusukela ngaleso sikhathi, odokotela banganikeza noma yimaphi ama-estrogen alandelayo. Lawa amaphilisi okumele aphuzwe ngomlomo.

- I-Estrace®: i-oestradiol-17ß;

- Amehlo®: i-estropipate (uhlobo lwe-estrone);

- I-CES®: i-synthetic conjugated estrogens.

Ama-Estrogens ngokuvamile anqunywa ngokuhambisana nawo ama-progestin okwenziwa : i-medroxy-progesterone acetate (MPA) njenge Hlola® noma progesterone micronized kusukela ezitshalweni ezifana I-Prometrium®. I-progesterone ye-Micronized iwuhlobo lwehomoni “ye-bioidentical” (bheka ngezansi).

I-bioidentical hormone therapy

The amahomoni ezinto eziphilayo babe nesakhiwo samangqamuzana esifana namahomoni akhiqizwa ama-ovari: i-estradiol-17ß (i-estrogen eyinhloko ekhiqizwa umzimba wesifazane) kanye ne-progesterone. Zenziwe elabhoratri kusuka ezitshalweni ezinjengobhontshisi noma izigaxa zasendle.

I-Bioidentical estradiol-17ß ilawulwa ngu isikhumba, okukuhlukanisa nokwelashwa okuvamile kwamahomoni. Itholakala ngesimo se izitembu (Estraderm®, Oesclim®, Estradot®, Sandoz-Estradiol Derm® noma iClimara®) noma evela i-gel (Estrogel®).

Ngaphezu kweumagazine-17ß, odokotela abasebenzisa i-bioidentical therapy bavame ukunquma progesterone micronized. Inqubo ye-micronization iguqula i-progesterone ibe izinhlayiya ezincane ezimuncwa kahle ngumzimba. Lokhu kunikezwa ngu ngomlomo (I-Prometrium®).

Amahomoni afana ne-Bio-afana anqunywe iminyaka eminingana eCanada naseFrance (igama elithi bio-identical nokho lakamuva). Ngesikhathi sokubhala, le mithi yayimbozwe kuphela wuhlelo lomshwalense womphakathi waseQuebec ezimeni ezithile ezithile. Nokho, iningi lezinhlelo zomshwalense ezizimele ziyazibuyisela.

esasizizwa. Kungenzeka futhi ukuthenga phezu-the-counter amalungiselelo ahlakaniphile e-bioidentical estrogens, ngendlela yekhilimu equkethe inhlanganisela ye-3 yemvelo ye-estrogenic molecules yabesifazane, i-estradiol, i-estriol ne-estrone. Kodwa-ke, ayikho idatha yesayensi esungule ukusebenza kwayo futhi odokotela abaningi bayeluleka ngokumelene nayo. Ungathola futhi emakhemisi amalungiselelo kamantshi progesterone ngesimo ukhilimu. Laba badangele ngokusemthethweni. Ngokusho kukaD^re U-Sylvie Dodin, ukumuncwa kwe-progesterone esikhumbeni akusebenzi kahle, kuyahluka kakhulu ukusuka kowesifazane oyedwa kuya komunye futhi akuhlinzeki ngokugxila okwanele ukuvikela isibeletho. Khumbula ukuthi ukuthatha i-estrogen kuphela kwandisa ingozi yomdlavuza wesibeletho, nokuthi ukufakwa kwe-progesterone kusiza ukunciphisa le ngozi.

Ukwelashwa kwe-hormonal yendawo

Ukusetshenziswa kwe-estrogen ngemithamo emincane, sangasese, ihlose ukukhulula izimpawu ezihlobene ukumelela kwesisu nasekunciphiseni kolwelwesi lwamafinyila. Kodwa-ke, ayinamphumela wokwelapha ekushiseni okushisayo, ukuphazamiseka kokulala, nokuphazamiseka kwemizwelo. Ukwelashwa kwamahomoni endawo akubangeli imiphumela emibi kanye nezingozi ezihlobene nokwelashwa kwama-hormone okuvamile.

Ama-Estrogens angalethwa esithweni sangasese kusetshenziswa a ukhilimu,An ring or amaphilisi. Ukusebenza kwazo kuyefana. Ukhilimu we-vaginal kanye namaphilisi kufakwa esithweni sangasese kusetshenziswa okokufaka isicelo. Indandatho yesitho sangasese sangasese efakwe i-estrogen yenziwe ngepulasitiki eguquguqukayo. Ingena ijule esithweni sangasese sowesifazane futhi kufanele ishintshwe njalo ezinyangeni ezi-3. Iningi labesifazane likubekezelela kahle, kodwa abanye bakuthola kungakhululeki noma kwesinye isikhathi kunomkhuba wokunyakaza nokuphuma esithweni sangasese.

Ekuqaleni kokwelashwa, lapho ulwelwesi lwesitho sangasese sowesifazane luncane kakhulu, i-estrogen efakwa endaweni yangasese ingase isakazekele emzimbeni. Nokho, ayikho imiphumela emibi yesikhathi eside yezempilo eye yabikwa kumithamo enconyiwe.

Ukwelashwa okungezona ama-hormonal

Izidakamizwa ezingezona ama-hormone zingasiza ekwehliseni ezinye izimpawu zokunqamuka kokuya esikhathini.

Ngokumelene nokushisa okushisayo

Ama-antidepressants. Ucwaningo luphakamisa ukuthi ezinye izidakamizwa zokucindezeleka zinganciphisa ukushisa (kodwa umphumela ungaphansi kwalowo wokwelashwa ngamahomoni) noma ngabe kukhona noma cha. Le nketho ingaba inketho ekhangayo kowesifazane onezimpawu zokucindezeleka nokukhanya okushisayo, kepha ongafisi ukuthatha ama-hormone.

Ama-antihypertensives. I-Clonidine, umuthi osetshenziselwa ukwehlisa umfutho wegazi, waboniswa usebenza kancane kune-placebo ekudambiseni ukushisa. Kodwa-ke, lo muthi awusetshenziswa kakhulu ngoba udala imiphumela emibi eminingana, njengomlomo owomile, ukozela nokuqunjelwa.

Ngokumelene nokoma kwesitho sangasese sowesifazane

I-Replens® Moisturizing Gel ikhonjiswe ukuthi iyasebenza esithweni sangasese sowesifazane ekudambiseni ukulunywa nokucasuka kanye nobuhlungu ngesikhathi socansi. Isetshenziswa njalo ezinsukwini ezi-2 kuye kwezi-3.

Ngokumelene nokushintshashintsha kwemizwelo

Ukusetshenziswa kwama-antidepressants, ama-anxiolytics namaphilisi okulala akufanele kube yingxenye yezikhali zokunakekelwa okuyisisekelo kokuya esikhathini. Imithi kadokotela kufanele ihlangabezane nemibandela efanayo kanye nokuqina okufanayo nanoma yisiphi esinye isikhathi sokuphila.

Ngokumelene ne-osteoporosis

Izidakamizwa eziningana ezingezona ama-hormone zisetshenziselwa ukukhulisa ukuminyana kwamathambo nokunciphisa ingozi yokuphuka. Bheka isigaba sezokwelapha sephepha leqiniso le-Osteoporosis.

Ngokumelene nezinkinga zokulala

Eminye imibono yokwenza kube lula ukulala: vivinya umzimba njalo, sebenzisa izindlela ezihlukahlukene zokuphumula (ukuphefumula okujulile, ukubhucunga, njll.), gwema i-caffeine notshwala futhi uphuze i-chamomile yesiJalimane noma itiye le-valerian herbal ngaphambi kokulala.⁶. Bheka futhi isihloko esithi Ukulala Okungcono - Umhlahlandlela Owusizo.

Impilo yocansi

Ucwaningo luvame ukukhombisa ukuthi abesifazane nge impilo yocansi esebenzayo babe nezimpawu ezimbalwa ngesikhathi sokunqamuka kokuya esikhathini kunalabo abanocansi oluncane noma abangenalo nhlobo⁷. Kodwa akwaziwa ukuthi kukhona yini imbangela kanye nomphumela wokuxhumanisa noma uma kuwukuhlangana nje phakathi kwalokhu okubili.

Noma kunjalo, kusobala ukuthi ukuya esikhathini okubangelwa izimpawu eziningi kuphazamisa impilo yocansi. Kodwa-ke, umuntu angakwazi ukulondoloza impilo yocansi esebenzayo futhi eyanelisayo ngokusebenzisa i-hormone therapy yesitho sangasese sowesifazane, i-moisturizer yangasese noma i-lubricant.

Khumbula ukuthi ukuvivinya umzimba nakho kungavusa isifiso kwabesifazane. Ukugcina libido esebenzayo, kubalulekile futhi ukugcina ukukhulumisana okuhle nomlingani kanye nokuphatha ukucindezeleka ngokujwayelekile (umsebenzi, njll.).

Testosterone. Ukunquma i-testosterone kwabesifazane base-postmenopausal kuseyinto engavamile eNyakatho Melika. Kodwa-ke, bayanda odokotela abakwenzayo ukuze babuyisele futhi bakhulise i-libido, ikakhulukazi kwabesifazane abaye bahlinzwa womabili ama-ovari. Imiphumela emibi engase ibe khona yokusetshenziswa kwe-testosterone kwabesifazane ayikaqondwa kahle. Ngakho-ke kufanele sibheke lokhu kwelashwa njengokuhlola.

Bheka ishidi leqiniso lethu lokungasebenzi ngokocansi kwabesifazane.

Izithako

Okuwukuphela kwesincomo esisemthethweni siphathelene nokusetshenziswa kwezithako ze-calcium ne-vitamin D ukulwakwamathambo, kwezinye izimo. Ukuze uthole imininingwane eyengeziwe, bheka ishidi elikhuluma nge-osteoporosis kanye naleyo egxile kule mikhiqizo emi-2.