Ke kahe ʻana o ka uterine maʻamau

ʻO ke kahe ʻana o ka uterine maʻamau (AUB) e kahe ana ke kō mai ka uterus ʻoi aku ka lōʻihi ma mua o ka hana maʻamau a i ʻole kū i kahi manawa kūpono ʻole. ʻOi aku paha ka ʻoi aku o ka māmā a ʻoi aku paha o ka kahe ma mua o ka maʻamau a hana pinepine ʻia a lohi paha.

Hiki i ka AUB ke hana:

• I ke kiko ʻana a i ʻole ke kahe ʻana ma waena o kāu mau kau
• Ma hope o ka moekolohe
• No nā lā lōʻihi aku ma mua o ka maʻamau
• ʻOi aku ka maikaʻi ma mua o ka maʻamau
• Ma hope o ka menopause

ʻAʻole ia i ka wā o ka hāpai ʻana. ʻO ke kahe ʻana i ka wā hāpai he mau kumu like ʻole. Inā loaʻa kou kahe i kou hāpai ʻana, e kelepona pono i kāu kauka.

ʻOkoʻa ka wā o kēlā me kēia wahine (menstrual cycle).

• Ma ka awelika, kū ka wā o ka wahine i kēlā me kēia 28 lā.
• ʻO ka hapa nui o nā wahine he mau pōʻaiapuni ma waena o 24 a 34 mau lā ke kaʻawale. ʻO ka maʻamau ma hope o 4 a 7 mau lā.
• Hiki i nā kaikamahine ʻōpio ke loaʻa i kā lākou wā ma kahi mai 21 a 45 mau lā a ʻoi paha ka kaʻawale.
• Hiki paha i nā wahine i ka 40 mau makahiki ke hoʻomaka e hoʻemi pinepine i kā lākou wā a i ʻole ka wā i waena o kā lākou mau wā e emi ai.

No ka hapanui o nā wahine, hoʻololi nā pae hormone wahine i kēlā me kēia mahina. Hoʻokuʻu ʻia nā hormones estrogen a me progesterone ma ke ʻano he mahele o ke kaʻina hana o ka ovulation. Ke ovulate wahine, hoʻokuʻu i kahi hua manu.

Hiki i ka AUB ke hana i ka wā ʻaʻole hoʻokuʻu nā ovaries i kahi hua manu. Hoʻohuli i nā pae hormonone i kou manawa ma hope a ma mua paha. Ua kaumaha paha kāu wā i kekahi manawa ma mua o ka maʻamau.

ʻOi aku ka maʻamau o ka AUB i nā ʻōpio a i ʻole nā ​​wahine premenopausal. Hiki paha i nā wahine i ʻoi ke kaupaona ke loaʻa ka AUB.

I nā wahine he nui, hoʻokumu ʻia ʻo AUB e kahi palekana hormonone. Hiki iā ia ke hana ma muli o nā kumu:

• Ka mānoanoa o ka paia uterine a i ʻole ka pale
• Nā fibroids ʻōterine
• Polyps Uterine
• Nā maʻi ʻōkeke o nā ovaries, uterus, cervix, a i ʻole puʻupaʻa
• Nā maʻi hōʻeha a me nā pilikia me ke kō ʻana o ke koko
• ʻO Polycystic ovary syndrome
• ʻO ka hōʻemi kaumaha nui
• Ka hānau hānau Hormonal, e like me nā kaohi kaohi hānau a i ʻole nā ​​mea intrauterine (IUD)
• Loaʻa ka pohō a nalowale paha (ʻoi aku ma mua o 10 paona a i ʻole 4.5 kilokilo)
• ʻO ka maʻi o ka uterus a i ʻole ka cervix

He kūpono ʻole ʻo AUB. Kaumaha loa paha ke kahe ʻana a māmā paha, a hiki pinepine a i ʻole ka loaʻa ʻole.

Pākuʻi ʻia paha nā ʻōuli o AUB:

• ʻO ke kahe ʻana a i ʻole ke kiko ʻana mai ka lua ma waena o nā wā
• Nā manawa i kū ma lalo o 28 mau lā ke kaʻawale (ʻoi aku ka nui) a ʻoi aku paha ma mua o 35 mau lā ke kaʻawale
• Hoʻololi ka manawa ma waena o nā manawa i kēlā me kēia mahina
• ʻO ke kahe kahe nui (e like me ka hala ʻana i nā clots nui, pono e hoʻololi i ka pale i ka pō, ke komo i loko o kahi pale hoʻomaʻemaʻe a tampon paha i kēlā me kēia hola no 2 a 3 mau hola i ka lālani)
• ʻO ke kahe ʻana e mau ana no nā lā hou aʻe ma mua o ka maʻamau a i ʻole ma mua o 7 mau lā

ʻO nā ʻōuli ʻē aʻe i hoʻokumu ʻia e nā loli i nā pae hormone e komo pū paha:

• ʻO ka ulu nui ʻana o ka lauoho o ke kino i kahi ʻano kāne (hirsutism)
• ʻO nā kukuna wela
• Swings hāhuli
• ʻO ka mālie a me ka maloʻo o ka ʻōpala

Luhi paha a luhi paha ka wahine inā lilo ʻo ia i ke koko i ka manawa. He hōʻailona kēia o ka anemia.

E kāpae kāu mea hāʻawi i nā kumu kūpono ʻē aʻe o ke kahe koko ʻole. E loaʻa paha iā ʻoe kahi hōʻike pelvic a me ka hoʻāʻo Pap / HPV. Nā hoʻokolohua ʻē aʻe i hana ʻia e hoʻopili ʻia:

• Helu piha koko (CBC)
• Kaha pili koko
• Nā ho'āʻo hana ate (LFT)
• Ka hoʻokēʻai i ke kō glucose
• Nā ho'āʻo Hormone, no ka FSH, LH, male kāne (androgen) pae, prolactin, a me progesterone
• Hōʻike hāpai
• Nā hoʻāʻo ʻana o ka hana thyroid

Koi paha kāu mea hāʻawi i kēia mau mea:

• ʻO ka moʻomeheu e nānā no ka maʻi
• ʻO Biopsy e nānā i ka precancer, maʻi ʻaʻai, a i ʻole e kōkua i ka hoʻoholo ʻana i ka mālama ʻana i ka hormone
• Hysteroscopy, hana ʻia i ke keʻena o kāu mea hāʻawi e nānā i loko o ka kōpū ma o ka ʻōpū
• Ultrasound e nānā i nā pilikia i loko o ka uterus a i ʻole pelvis

Hoʻokomo ʻia ka mālama ʻana i hoʻokahi a ʻoi paha o kēia mau mea:

• Nā lāʻau hoʻokaumaha hānau haʻahaʻa
• Hoʻoikaika Hormone
• ʻO ka lāʻau estrogen estrogen kiʻekiʻe no nā wahine me ke kahe koko kaumaha loa
• Mea hana Intrauterine (IUD) e hoʻokuʻu i ka progestin hormone
• Lawe ʻia nā lāʻau anti-inflammatory Nonsteroidal (NSAIDs) ma mua pono o ka manawa
• ʻOki kino, inā ke kumu o ke kahe ʻana he polyp a fibroid paha

Hoʻokomo paha kāu mea hāʻawi iā ʻoe i nā mea hoʻohui hao inā loaʻa ʻoe i ka maʻi anemia.

Inā makemake ʻoe e hāpai, hāʻawi ʻia ʻoe i ka lāʻau e hoʻoulu ai i ka hoʻoipoipo.

ʻO nā wahine me nā ʻōuli koʻikoʻi e hoʻomaikaʻi ʻole a i loaʻa paha i ka maʻi ʻaʻai a precancerous paha e koi i nā kaʻina hana ʻē aʻe e like me:

• ʻO ke kaʻina hana e luku a wehe paha i ka uhi o ka kōpū
• Hysterectomy e hoʻoneʻe i ka kōpū

Hoʻomaha pinepine ka Hormone therapy i nā ʻōuli. ʻAʻole pono ka lāʻau lapaʻau inā ʻaʻole ʻoe e hoʻomōhala i ka anemia ma muli o ke kahe o ke koko. Hoʻomaʻamaʻa koke kahi lāʻau e kia ana i ke kumu o ke kahe ʻana o ke kahe. ʻO ia ke kumu he mea nui e hoʻomaopopo i ke kumu.

Nā pilikia e hiki mai ana:

• Infertility (hiki ʻole ke hāpai)
• Anemia koʻikoʻi ma muli o ka nui o ke kahe o ke koko ma luna o ka manawa
• Hoʻonui i ka makaʻu no ka maʻi ʻaʻai endometrial

Kāhea i kāu mea hāʻawi inā loaʻa iā ʻoe ke kahe o ke kahe maʻamau.

Kahe koko Anovulatory; Ke kahe ʻana o ka uterine kūpono ʻole - hormonal; Polymenorrhea - kahe o ke kō uterine

• Anatomy uterine maʻamau (ʻoki ʻoki)

Ke Kulanui ʻAmelika o nā Obstetricians a me ka pūnaewele Gynecologists. Manaʻo ke komite ACOG no. 557: ka mālama ʻana i ke kahe ʻana o ka uterine abnormal i ka wahine hānau ʻole. Reaffirmed 2017. www.acog.org/Clinical-Guidance-and-Publications/Komite-Opinions/Commite-on-Gynecologic-Practice/Management-of-Acute-Abnormal-Uterine-Bleeding-in-Nonpregnant-Reproductive-Aged-Women . Loaʻa iā ʻOkakopa 27, 2018.

Bahamondes L, Ali M. Nā holomua hou o ka mālama ʻana a me ka hoʻomaopopo ʻana i nā maʻi menstrual. F1000Prime Rep. 2015; 7:33. PMID: 25926984 www.ncbi.nlm.nih.gov/pubmed/25926984.

ʻO Ryntz T, ʻo Lobo RA. ʻO ke kahe ʻana o ka uterine kūlohelohe: etiology a me ka mālama ʻana i ke kahe nui a koʻikoʻi. I: Lobo RA, Gershenson DM, Lentz GM, Valea FA, eds. Gynecology Comprehensive. ʻEpekema 7 Piladelapia, PA: Elsevier; 2017: chap 26.

Schrager S. Ke kahe ʻana o ka uterine maʻamau. I: Kellerman RD, Bope ET, eds. ʻO Conn's Current Therapy 2018. Piladelapia, PA: Elsevier; 2018: 1073-1074.