Ukuthatha isinqumo mayelana nokwelashwa kwehomoni

Ukwelashwa kweHormone (HT) kusebenzisa ihomoni eyodwa noma amaningi ukwelapha izimpawu zokunqamuka kokuya esikhathini.

Ngesikhathi sokunqamuka kokuya esikhathini:

• Amaqanda omuntu wesifazane ayayeka ukwenza amaqanda. Ziphinde zikhiqize i-estrogen ne-progesterone encane.
• Izikhathi zokuya esikhathini ziyeka kancane ngokuhamba kwesikhathi.
• Izikhathi zingasondela kakhulu noma zihlukaniswe kabanzi. Le patheni ingahlala iminyaka eyi-1 kuya kwengu-3 uma uqale ukweqa izikhathi.

Ukugeleza kokuya esikhathini kungama ngokungazelelwe ngemuva kokuhlinzwa ukukhipha ama-ovari, i-chemotherapy, noma izindlela ezithile zokwelapha ama-hormone zomdlavuza webele.

Izimpawu zokunqamuka kokuya esikhathini zingahlala iminyaka emihlanu noma ngaphezulu, kufaka phakathi:

• Ukuqhuma okushisayo nokujuluka, ngokuvamile kubi kakhulu onyakeni wokuqala kuya kwemibili ngemuva kwesikhathi sakho sokugcina
• Ukoma kwesitho sangasese sowesifazane
• Ukushintsha kwemizwelo
• Izinkinga zokulala
• Intshisekelo encane kwezocansi

I-HT ingasetshenziselwa ukwelapha izimpawu zokunqamuka kokuya esikhathini. I-HT isebenzisa ama-hormone i-estrogen ne-progestin, uhlobo lwe-progesterone. Kwesinye isikhathi i-testosterone nayo iyangezwa.

Ezinye izimpawu zokunqamuka kokuya esikhathini zingaphathwa ngaphandle kwe-HT. Umthamo ophansi wesitho sangasese sowesifazane kanye nezithambisi zesitho sangasese sowesifazane kungasiza ukoma kwesitho sangasese sowesifazane.

I-HT iza ngesimo sephilisi, isichibi, umjovo, ukhilimu wesitho sangasese sowesifazane noma ithebhulethi, noma iringi.

Ukuthatha ama-hormone kungaba nezingozi ezithile. Lapho ucabangela i-HT, funda ngokuthi ingakusiza kanjani.

Lapho uthatha ama-hormone, ukukhanya okushisayo nokujuluka ebusuku kuvame ukwenzeka kancane futhi kungaphela nokuhamba kwesikhathi. Ukunciphisa kancane i-HT kungenza lezi zimpawu zingakhathazi kangako.

Ukwelashwa kweHormone nakho kungasiza kakhulu ekusizeni:

• Izinkinga zokulala
• Ukoma kwesitho sangasese sowesifazane
• Ukukhathazeka
• Ukuguquguquka nokucasuka

Ngesinye isikhathi, i-HT yayisetshenziselwa ukuvimbela ukuncipha kwamathambo (i-osteoporosis). Lokho akusenjalo. Udokotela wakho angakunikeza eminye imithi yokwelapha i-osteoporosis.

Ucwaningo lukhombisa ukuthi i-HT ayisizi ukwelapha:

• Isifo senhliziyo
• Ukungakwazi ukubamba umchamo
• Isifo i-Alzheimer
• Ukuwohloka komqondo

Qiniseka ukuthi ukhuluma nodokotela wakho ngezingozi ze-HT. Lezi zingcuphe zingahluka ngokuya ngeminyaka yakho, umlando wezokwelapha, nezinye izinto.

IZINGXENYE ZEGAZI

Ukuthatha i-HT kungandisa ubungozi bamahlule egazi. Ingozi yakho yamahlule egazi nayo iphakeme uma ukhuluphele noma ubhema.

Ingozi yakho yamahlule egazi ingahle ibe phansi uma usebenzisa amabala wesikhumba e-estrogen esikhundleni samaphilisi.

Ingozi yakho iphansi uma usebenzisa okhilimu namaphilisi wesitho sangasese sowesifazane kanye nendandatho yesilinganiso esincane se-estrogen.

UMdlavuza Webele

• Ochwepheshe abaningi bakholelwa ukuthi ukuthatha i-HT kuze kube yiminyaka engu-5 ayikhuphuli ingozi yokuba nomdlavuza webele.
• Ukuthatha i-estrogen ne-progestin ndawonye isikhathi eside kuneminyaka emi-3 kuye kwengu-5 kungakhuphula ingozi yokuba nomdlavuza webele, kuya ngohlobo lwe-progestin oyibekiwe.
• Ukuthatha i-HT kungenza isithombe se-mammogram samabele akho sibonakale siguqubele. Lokhu kungenza kube nzima ukuthola umdlavuza webele kusenesikhathi.
• Ukuthatha i-estrogen kuphela kuhlotshaniswa nokwehliswa kwengozi yomdlavuza webele. Kodwa-ke, uma uthatha i-estrogen ne-progestin ndawonye, ​​ingozi yokuba nomdlavuza webele ingaba phezulu, kuye ngohlobo lweprogesterone oyithathayo.

IKHANSELA LOKUQEDELA (ISIBELELE)

• Ukuthatha i-estrogen kukodwa kwandisa ingozi yokuba nomdlavuza we-endometrium.
• Ukuthatha i-progestin nge-estrogen kuvikela kulo mdlavuza. Uma unesibeletho, kufanele uthathe i-HT ngakho kokubili i-estrogen ne-progestin.
• Awukwazi ukuthola umdlavuza we-endometrial uma ungenaso isibeletho. Kuphephile futhi kunconyelwe ukusebenzisa i-estrogen yodwa kuleli cala.

ISIFO SENHLIZIYO

I-HT iphephe kakhulu lapho ithathwa ngaphambi kweminyaka yobudala engama-60 noma kungakapheli iminyaka eyishumi ngemuva kokuqala ukuya esikhathini. Uma uthatha isinqumo sokuthatha i-estrogen, ucwaningo lukhombisa ukuthi kuphephe kakhulu ukuqala i-estrogen ngemuva nje kokutholakala ukuthi unqamuka esikhathini. Ukuqala kwe-estrogen eminyakeni engaphezu kwengu-10 ngemuva kokuqala kokunqamuka kokuya esikhathini kwandisa ubungozi besifo senhliziyo.

• I-HT ingakhuphula ubungozi bokuhlaselwa yisifo senhliziyo kwabesifazane asebekhulile.
• I-HT ingakhuphula ubungozi kwabesifazane abaqale ukusebenzisa i-estrogen ngaphezu kweminyaka eyi-10 ngemuva kwesikhathi sabo sokugcina.

ISITOKELA

Abesifazane abathatha i-estrogen kuphela futhi abathatha i-estrogen nge-progestin basengozini enkulu yokushaywa unhlangothi. Ukusebenzisa isichibi se-estrogen esikhundleni sephilisi lomlomo kunciphisa le ngozi. Kodwa-ke, ubungozi busengakhuphuka uma kuqhathaniswa nokungathathi nhlobo amahomoni.Umthamo ophansi we-HT nawo unciphisa ubungozi bokushaywa unhlangothi.

AMAGALALI

Ukuthatha i-HT kungakhuphula ubungozi bokuthola ama-gallstones.

UBUNGOZI BOKUFA (UKUFA)

Ukufa jikelele kuncishisiwe kwabesifazane abaqala i-HT kuma-50s abo. Ukuvikelwa kuhlala cishe iminyaka eyi-10.

Wonke umuntu wesifazane wehlukile. Abanye besifazane abakhathazwa yizimpawu zokunqamuka kokuya esikhathini. Kwabanye, izimpawu zinzima futhi zithinta izimpilo zabo kakhulu.

Uma izimpawu zokunqamuka kokuya esikhathini zikukhathaza, khuluma nodokotela wakho ngezinzuzo nezingozi ze-HT. Wena nodokotela wakho ninganquma ukuthi ngabe i-HT ikulungele yini. Udokotela wakho kufanele awazi umlando wakho wezokwelapha ngaphambi kokunquma i-HT.

Akufanele uthathe i-HT uma:

• Ube nesifo sohlangothi noma isifo senhliziyo
• Yiba nomlando wamahlule egazini emithanjeni yakho noma emaphashini
• Uke waba nomdlavuza webele noma we-endometrial
• Unesifo sesibindi

Izinguquko ezithile zendlela yokuphila zingakusiza uzivumelanise nezinguquko zokunqamuka kokuya esikhathini ngaphandle kokuthatha ama-hormone. Zingasiza futhi ukuvikela amathambo akho, zithuthukise impilo yenhliziyo yakho, futhi zikusize uhlale uphilile.

Kodwa-ke, kwabesifazane abaningi, ukuthatha i-HT kuyindlela ephephile yokwelapha izimpawu zokunqamuka kokuya esikhathini.

Njengamanje, ochwepheshe akucaci ukuthi kufanele uthathe i-HT isikhathi esingakanani. Amanye amaqembu ochwepheshe asikisela ukuthi ungathatha i-HT yezimpawu zokunqamuka kokuya esikhathini isikhathi eside uma singekho isizathu sezokwelapha sokuyeka umuthi. Kwabesifazane abaningi, amanani aphansi we-HT angenela ukulawula izimpawu eziyinkinga. Ukweqiwa okuphansi kwe-HT kuvame ukuba nemiphumela engemihle embalwa.

Lezi yizo zonke izingqinamba okufanele uxoxe ngazo nomhlinzeki wakho wezokunakekelwa kwempilo.

Uma wopha esithweni sangasese sowesifazane noma ezinye izimpawu ezingavamile ngesikhathi se-HT, shayela udokotela wakho.

Qiniseka ukuthi uqhubeka nokubona udokotela wakho ukuze akuhlole njalo.

I-HRT - ithatha isinqumo; Ukwelashwa kwe-Estrogen esikhundleni - ukunquma; ERT- ukunquma; Ukwelashwa esikhundleni seHormone - ukunquma; Ukunqamuka kokuya esikhathini - ukunquma; I-HT - ithatha isinqumo; Ukwelashwa kwe-hormone ye-Menopausal - ukunquma; I-MHT - ithatha isinqumo

Umbono weKomidi le-ACOG No. 565: Ukwelashwa kweHormone nesifo senhliziyo. Isikhubekiso seGynecol. 2013; 121 (6): 1407-1410. I-PMID: 23812486 pubmed.ncbi.nlm.nih.gov/23812486/.

UCosman F, de Beur SJ, LeBoff MS, et al. Umhlahlandlela womtholampilo wokuvimbela nokwelashwa kwe-osteoporosis. I-Osteoporosis Int. 2014; 25 (10): 2359-2381. I-PMID: 25182228 pubmed.ncbi.nlm.nih.gov/25182228/.

de Villiers TJ, Hall JE, Pinkerton JV, et al. Isitatimende Esibukeziwe Somhlaba Wonke Sokuvumelana Ngokwelapha i-menopausal hormone therapy. Isimo sezulu. 2016; 19 (4): 313-315. I-PMID: 27322027 pubmed.ncbi.nlm.nih.gov/27322027/.

Lobo RA. Ukunqamuka kokuya esikhathini nokunakekelwa kowesifazane ovuthiwe: i-endocrinology, imiphumela yokushoda kwe-estrogen, imiphumela yokwelashwa kwamahomoni, nezinye izindlela zokwelashwa. Ku: Lobo RA, Gershenson DM, Lentz GM, Valea FA, eds. I-Gynecology ephelele. Umhla wesi-7. IPhiladelphia, PA: Elsevier; I-2017: isahluko 14.

IMagowan BA, Owen P, Thomson A. Ukwelashwa kokunqamuka kokuya esikhathini kanye ne-hormone. Ku: Magowan BA, Owen P, Thomson A, eds. I-Clinical Obstetrics ne-Gynecology. Umhla wesi-4. Elsevier; 2019: isahluko 9.

UStuenkel CA, uDavis SR, uGompel A, et al. Ukwelashwa kwezimpawu zokunqamuka kokuya esikhathini: Umhlahlandlela we-Endocrine Society Clinical Practice Guideline. UJ Clin Endocrinol Metab. 2015; 100 (11): 3975-4011. I-PMID: 26444994 pubmed.ncbi.nlm.nih.gov/26444994/.

• Ukwelashwa Okubuyisela IHormone
• Ukunqamuka kokuya esikhathini