Menopause

ʻO Menopause ka manawa i ke ola o ka wahine ke pau kāna mau kau (menstruation). ʻO ka pinepine, he kūlohelohe, hoʻololi i ke kino maʻamau e hana pinepine ʻia ma waena o 45 a 55 mau makahiki. Ma hope o ka menopause, ʻaʻole hiki i ka wahine ke hāpai hou.

I ka wā menopause, hoʻōki nā ovaries a ka wahine i ka hoʻokuʻu ʻana i nā hua. Hana ke kino i ka liʻiliʻi o nā hormones wahine a me ka progesterone. ʻO nā pae haʻahaʻa o kēia mau hormoni ke kumu o nā ʻōuli menopause.

Hoʻemi pinepine ʻia nā wā a kū i hope. I kekahi manawa hiki koke kēia. Akā ka hapa nui o ka manawa, kū mālie nā wā i ka holo ʻana o ka manawa.

Pau ka Menopause ke loaʻa ʻole iā ʻoe kahi manawa no 1 makahiki. Kapa ʻia kēia postmenopause. Hana ʻia ka menopause ʻoki lāʻau ke hana nā lāʻau ʻoki kino i kahi kulu o ka estrogen. Hiki i kēia ke hana inā lawe ʻia kāu mau ovaries ʻelua.

Hiki i kekahi manawa ke hana i ka menopause e nā lāʻau i hoʻohana ʻia no ka chemotherapy a i ʻole ka hormone therapy (HT) no ka maʻi ʻaʻai umauma.

Kūleʻa nā ʻōuli mai ka wahine a ka wahine. Kū paha lākou i 5 a ʻoi paha mau makahiki. ʻOi aku paha ka maikaʻi o nā ʻōuli ma kekahi mau wahine ma mua o nā mea ʻē aʻe. Hiki ke ʻoi aku ka ikaika o nā ʻōuli o ka menopause ʻoki kino a hoʻomaka hou me ka hiki ʻole.

ʻO ka mea mua āu e ʻike ai ka hoʻomaka ʻana o nā wā e loli. Hiki pinepine paha lākou a i ʻole pinepine pinepine paha. Loaʻa paha i kekahi mau wahine i ko lākou wā i kēlā me kēia 3 mau pule ma mua o ka hoʻomaka ʻana e haʻalele i nā wā. Loaʻa paha iā ʻoe nā manawa kūpono ʻole no 1 a 3 mau makahiki ma mua o ka pau ʻana.

ʻO nā ʻōuli maʻamau o ka menopause pū me:

• ʻO nā wā haehae e hana pinepine ʻia a kū hoʻi ma hope
• Kuʻi ka naʻau a heihei paha
• ʻO nā uila wela, ʻoi aku ka maikaʻi ma mua o ka 1 a 2 mau makahiki
• Hoʻoulu ka pō
• ʻ fllapa ʻili
• Pilikia hiamoe (hiamoe)

Hiki i nā ʻōuli ʻē aʻe o ka menopause ke:

• Hoemi i ka hoihoi i ka moekolohe a i ʻole nā ​​loli i ka pane kolohe
• Poina (i kekahi mau wahine)
• Poʻo poʻo poʻo
• Huli ke ʻano, me ka huhū, ke kaumaha, a me ka hopohopo
• Kūkulu mimi
• ʻO ka maloʻo maloʻo a me ka moekolohe ʻeha
• Nā maʻi ahulau
• ʻEhaʻeha a me nā ʻeha
• Kuʻi naʻau kaulike (palpitations)

Hiki ke hoʻohana ʻia nā hoʻokolohua koko a me ka mimi e nānā i nā loli o ka pae o ka hormone. Hiki i nā hopena hōʻike ke kōkua i kāu kauka olakino e hoʻoholo inā kokoke ʻoe i ka menopause a i ʻole inā ua hala mua ʻoe i ka menopause. Pono paha kāu mea hāʻawi e hana hou i ka hoʻāʻo ʻana i kāu pae hormonone i nā manawa he nui e hōʻoia i kou kūlana menopausal inā ʻaʻole ʻoe i hoʻopau loa i ka menstruating.

ʻO nā hoʻāʻo e hana ʻia ana paha:

• ʻO Estradiol
• ʻO ka hormone hoʻonāukiuki Follicle (FSH)
• Luteinizing hormone (LH)

E hana ana kāu mea hāʻawi i kahi hōʻike pelvic. Hiki i ka estrogen ke emi ke hana i nā loli i ka uhi o ka moku.

Hoʻonui ka pohō o ka iwi i loko o nā makahiki mua ma hope o kāu kau hope loa. E kauoha paha kāu mea hāʻawi i kahi hoʻāʻo o ka iwi e nānā no ka nalo ʻana o ka iwi e pili ana i ka osteoporosis. Paipai ʻia kēia hoʻāʻo density iwi no nā wahine āpau ma mua o 65 mau makahiki. E paipai ʻia paha kēia hōʻike inā aia ʻoe ma kahi kiʻekiʻe o ka makaʻi no ka osteoporosis ma muli o kāu moʻolelo ʻohana a i ʻole nā ​​lāʻau e lawe ai.

Hiki i ka mālama ʻana ke hoʻopili i nā loli nohona a HT paha. Pili ka mālama ʻana i nā kumu he nui e like me:

• Pehea ka maikaʻi ʻole o kāu mau ʻōuli
• ʻO kou olakino holoʻokoʻa
• ʻO kāu mau makemake

HORMONE THERAPY

Hiki i ke HT ke kōkua inā loaʻa iā ʻoe nā uila wela, nā sweats i ka pō, nā pilikia o ka naʻau, a me ka maloʻo liʻiliʻi. Mālama ʻo HT me ka estrogen a, i kekahi manawa, progesterone.

E kamaʻilio i kāu mea hāʻawi e pili ana i nā pono a me nā pilikia o HT. Pono e ʻike ka mea nāna e hāʻawi i kāu mōʻaukala holoʻokoʻa a me ka mōʻaukala holoʻokoʻa ma mua o ke kuhikuhi ʻana iā HT.

Ua nīnau kekahi mau noiʻi nui e pili ana i nā pono olakino a me nā pilikia o ka HT, ʻo ia pū me ka makaʻu o ka hoʻomohala ʻana i ka maʻi ʻaʻai umauma, nā puʻuwai puʻuwai, nā hahau, a me nā kahe koko. Eia nō naʻe, e hoʻohana ana i ka HT no 10 mau makahiki ma hope o ka hoʻomohala ʻana i ka menopause e pili me ka haʻahaʻa haʻahaʻa o ka make.

Kākoʻo nā kulekele o kēia manawa i ka hoʻohana o HT no ka mālama ʻana i nā uila wela. Nā ʻōlelo kūikawā:

• Hoʻomaka paha ʻo HT i nā wahine i komo i ka menopause.
• ʻAʻole pono e hoʻohana ʻia ʻo HT i nā wahine i hoʻomaka i ka menopause i nā makahiki i hala aku nei, koe wale no nā lāʻau estrogen estrogen.
• ʻAʻole pono e hoʻohana ʻia ka lāʻau no ka mea ʻoi aku ka pono. Pono paha kekahi mau wahine e hoʻohana i ka estrogen hoʻolōʻihi ma muli o nā uila wela i pilikia. Palekana kēia i nā wahine olakino.
• Pono nā wahine e lawe ana iā HT i kahi kūlana haʻahaʻa no ka hahau, maʻi puʻuwai, ke koko, a i ʻole ka maʻi ʻaʻai umauma.

I mea e hōʻemi ai i nā pilikia o ka estrogen therapy, hiki i kāu mea hāʻawi ke ʻōlelo:

• ʻO kahi mahele lāʻau ʻoi loa o ka estrogen a i ʻole kahi hoʻomākaukau estrogen ʻē aʻe (e laʻa me kahi kalima ʻili a i ʻole ka ʻili ma mua o ka pill).
• ʻOi aku ka palekana o ka hoʻohana ʻana i nā pākuʻi ma mua o ka estrogen o ka waha, no ka mea ke pale aku nei i ka nui o ka makaʻu o ke koko i ʻike ʻia me ka hoʻohana ʻana o ka estrogen waha.
• ʻO nā hoʻāʻo kino pinepine a maʻamau hoʻi, me nā hōʻike umauma a me nā mammogram

ʻO nā wahine i loaʻa i kahi kōpū (ʻo ia hoʻi, ʻaʻole i hana ʻoki ʻia e wehe iā ia no kekahi kumu) pono lākou e lawe i ka estrogen i hui pū ʻia me ka progesterone e pale ai i ka maʻi ʻaʻai o ka uhi o ka uterus (cancer endometrial).

KALAHELE E HORMONE THERAPY

Aia kekahi mau lāʻau ʻē aʻe i hiki ke kōkua me ka loli o ka naʻau, nā uila wela, a me nā ʻōuli ʻē aʻe. Pākuʻi ʻia kēia mau mea:

• Nā Antidepressants, me paroxetine (Paxil), venlafaxine (Effexor), bupropion (Wellbutrin), a me fluoxetine (Prozac)
• ʻO kahi lāʻau lapaʻau koko i kapa ʻia ʻo clonidine
• ʻO Gabapentin, kahi lāʻau hopu i kōkua pū ʻia e hōʻemi i nā uila wela

KA HOʻOLOHE ANA I KA MAKAHI A ME KA OLA ANA

Nā hana e hiki ai iā ʻoe ke lawe e hōʻemi i nā ʻōuli menopause i:

Hoʻololi nā meaʻai

• Hōʻalo i ka caffeine, wai ʻona, a me nā meaʻai nīoi.
• ʻAi i nā meaʻai soy. Loaʻa ka estrogen i ka soya.
• E kiʻi i ka nui o ka puna a me ka wikamina D i ka meaʻai a i ʻole nā ​​mea hoʻopili.

Nā hana hoʻoikaika kino a me ka hoʻomaha:

• E hoʻonui i ka hoʻoikaika kino.
• Hana Kegel hoʻoikaika i kēlā me kēia lā. Hoʻoikaika lākou i nā mākala o kou ʻūlū a me kou pelvis.
• E hoʻomaʻamaʻa i ka hanu hohonu ʻana i ka manawa e hoʻomaka ai kahi flash wela. E hoʻāʻo i ka hanu ʻana he 6 i hoʻokahi minuke.
• E hoʻāʻo i ka yoga, tai chi, a i ʻole ka noʻonoʻo ʻana.

Nā ʻōlelo aʻoaʻo ʻē aʻe:

• Hōʻaʻahu māmā a i nā papa.
• E hoʻomau i ka moekolohe.
• E hoʻohana i nā lubricants i hoʻokumu ʻia i ka wai a i ʻole kahi moisturizer vaginal i ka wā o ka moekolohe.
• E ʻike i ka loea acupuncture.

Loaʻa i kekahi mau wahine ke kahe o ka maʻi ma hope o ka menopause. ʻAʻole pinepine kēia mea e hopohopo ai. Eia nō naʻe, pono ʻoe e haʻi i kāu mea hāʻawi inā kū kēia, keu hoʻi inā ʻoi aku ia ma mua o hoʻokahi makahiki ma hope o ka menopause. He hōʻailona mua paha ia o nā pilikia e like me ke kanesa. E hana ana kāu mea hāʻawi i kahi biopsy o ka uhi ʻana o ka uterine a i ʻole kahi ultrasound vaginal.

Ua hoʻopili ʻia ka pae estrogen i hōʻemi ʻia i kekahi mau hopena lōʻihi, e like me:

• ʻO ka pohō a me ka osteoporosis i kekahi mau wahine
• Hoʻololi i nā pae kolesterol a ʻoi aku ka makaʻu no ka maʻi puʻuwai

Kāhea i kāu mea hāʻawi inā:

• Ke ʻike nei ʻoe i ke koko ma waena o nā kau
• Loaʻa iā ʻoe he 12 mau mahina ma hope me ka manawa ʻole a hoʻomaka hou ke kahe ʻana o ke kahe a me ke kiko (a ʻo ka liʻiliʻi o ke kahe ʻana)

ʻO Menopause kahi mahele maoli o ka ulu ʻana o ka wahine. ʻAʻole pono e kāohi ʻia. Hiki iā ʻoe ke hōʻemi i kou makaʻi no nā pilikia lōʻihi e like me ka osteoporosis a me ka maʻi puʻuwai ma o ka lawe ʻana i kēia mau hana:

• E kāohi i kou kahe koko, cholesterol, a me nā mea ʻino ʻē aʻe no ka maʻi puʻuwai.
• MAI Puhi. Hiki i ka hoʻohana ʻia ʻana o ka Cigarette ke kumu i ka menopause mua.
• E kiʻi i ka hoʻoikaika kino maʻamau. Kōkua ka hoʻoikaika ʻana i ka hoʻoikaika i kou mau iwi a hoʻomaikaʻi i kou kaulike.
• E kamaʻilio me kāu mea hoʻolako e pili ana i nā lāʻau i hiki ke kōkua i ka hōʻemi ʻana i ka iwi e hoʻonāwaliwali inā hōʻike ʻoe i nā hōʻailona mua o ka nalo ʻana o ka iwi a i ʻole ka moʻolelo o ka ʻohana osteoporosis.
• E lawe i ka calcium a me ka huaʻai D.

Perimenopause; Hoopanee

• Menopause
• Mamamogram
• Hoʻoiho kino

Ke KulanuiʻAmelika o nā Obstetricians a me nā Gynecologists. ʻO ka ACOG Bulletin Bulletin Helu 141: ka mālama ʻana i nā ʻōuli menopausal. ʻO Obstet Gynecol. 2014; 123 (1): 202-216. PMID: 24463691 www.ncbi.nlm.nih.gov/pubmed/24463691.

Lobo RA. ʻO ka menopause a me ka mālama ʻana o ka wahine makua: endocrinology, nā hopena o ka nele o ka estrogen, nā hopena o ka hormone therapy, a me nā koho lapaʻau ʻē aʻe. I: Lobo RA, Gershenson DM, Lentz GM, Valea FA, eds. Gynecology Comprehensive. ʻEpekema 7 Piladelapia, PA: Elsevier; 2017: chap 14.

ʻO Lamberts SWJ, van de Beld AW. Endocrinology a me ka ʻelemakule. I: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, eds. ʻO Williams Textbook of Endocrinology. 13th ed. Piladelapia, PA: Elsevier; 2016: chap 27.

ʻO Moyer VA; ʻO ka Hana Hana Hana Hana Preventive US. ʻO ka wikamina D a me ka hoʻohuihui calcium e pale ai i nā haki i nā mākua. ʻO Ann Intern Med. 2013; 158 (9): 691-696. PMID: 23440163 www.ncbi.nlm.nih.gov/pubmed/23440163.

ʻAmelika Hui Pū ʻIa ʻAmelika ʻĀkau. ʻO ka ʻōlelo 2017 kūlana hoʻōla therapy o The North American Menopause Society. Menopause. 2017; 24 (7): 728-753. PMID: 28650892 www.ncbi.nlm.nih.gov/pubmed/28650892.

ʻO Skaznik-Wikiel ME, ʻo Traub ML, ʻo Santoro N. Menopause. I: Jameson JL, De Groot LJ, de Kretser DM, et al, eds. Endocrinology: Makua a Pediatric. ʻEpekema 7 Piladelapia, PA: Elsevier Saunders; 2016: chap 135.