Ukopha okungalunganga kwesibeleko

Ukopha okungaqhelekanga kwesibeleko (AUB) kuphuma kwisibeleko okude kunesiqhelo okanye okwenzeka ngexesha elingaqhelekanga. Ukopha kunokuba nzima okanye kube lula kunesiqhelo kwaye kwenzeka rhoqo okanye ngokungacwangciswanga.

I-AUB inokwenzeka:

• Njengokubona okanye ukopha phakathi kwexesha lakho
• Emva kwesondo
• Iintsuku ezinde kuneqhelekileyo
• Inzima kunesiqhelo
• Emva kokuyeka ukuya exesheni

Ayenzeki ngexesha lokukhulelwa. Ukopha ngexesha lokukhulelwa kunezizathu ezahlukeneyo. Ukuba ukopha xa ukhulelwe, qiniseka ukubiza umboneleli wakho wezempilo.

Ixesha ngalinye lowasetyhini (umjikelo wokuya exesheni) lahlukile.

• Ngokomndilili, ixesha lowasetyhini livela rhoqo kwiintsuku ezingama-28.
• Uninzi lwabasetyhini lunemijikelezo phakathi kweentsuku ezingama-24 nama-34 ngokwahlukeneyo. Ihlala iintsuku ezi-4 ukuya kwezi-7.
• Amantombazana amancinci anokufumana ixesha lawo ukusuka kwi-21 ukuya kwi-45 yeentsuku okanye nangaphezulu ngokwahlukana.
• Abasetyhini abakuma-40s abo banokuqala ukuba nexesha labo ngokufuthi okanye ixesha lokuphumla phakathi kwexesha labo lehle.

Kwabafazi abaninzi, amanqanaba ehomoni yabasetyhini ayatshintsha inyanga nenyanga. Iihomoni ze-estrogen kunye neprogesterone zikhutshwa njengenxalenye yenkqubo ye-ovulation. Xa umntu obhinqileyo evuthisa iqanda liyaphuma.

I-AUB inokwenzeka xa ii-ovari zingalikhuphi iqanda. Utshintsho kumanqanaba ehomoni lubangela ukuba ixesha lakho libe kamva okanye ngaphambili. Ixesha lakho ngamanye amaxesha linokuba nzima kunesiqhelo.

I-AUB ixhaphake kakhulu kulutsha okanye kwabasetyhini abangaphambi kokuya exesheni. Abasetyhini abatyebe kakhulu banokubakho kwi-AUB.

Kwabasetyhini abaninzi, i-AUB ibangelwa kukungalingani kwehomoni. Inokwenzeka kwakhona ngenxa yezi zizathu zilandelayo:

• Ukuqina kodonga lwesibeleko okanye ulwelwesi
• Zesibeleko fibroids
• Polyp zesisu
• Umhlaza wamaqanda, isibeleko, umlomo wesibeleko, okanye ubufazi
• Ukuphazamiseka kwegazi okanye iingxaki zokunqanda igazi
• Isifo sePolycystic ovary
• Ukwehla kobunzima obukhulu
• Ulawulo lokuzalwa lweHormonal, njengeepilisi zolawulo lokuzalwa okanye izixhobo ze-intrauterine (IUD)
• Ukutyeba kakhulu okanye ukunciphisa ilahleko (ngaphezulu kweepawundi ezili-10 okanye iikhilogram eziyi-4.5)
• Usulelo lwesibeleko okanye umlomo wesibeleko

I-AUB ayinakulinganiswa. Ukopha kunokuba nzima kakhulu okanye ukukhanya, kwaye kunokwenzeka rhoqo okanye ngokungacwangciswanga.

Iimpawu ze-AUB zinokubandakanya:

• Ukopha okanye ukubonwa kwilungu lobufazi phakathi kwamaxesha
• Amaxesha okwenzeka ngaphantsi kweentsuku ezingama-28 (ngaphandle kwesiqhelo) okanye ngaphezulu kweentsuku ezingama-35 ngokwahlukana
• Ixesha phakathi kwamaxesha litshintsha inyanga nenyanga
• Ukuphuma kwegazi okunzima (njengokugqithisa amahlwili amakhulu, kufuna ukutshintsha ukhuselo ebusuku, ukuntywila ngephedi yococeko okanye itampon ngeyure nganye iiyure ezimbini ukuya kwezintathu zilandelelana)
• Ukopha okuhlala ngaphezulu kweentsuku kunesiqhelo okanye ngaphezulu kweentsuku ezisi-7

Ezinye iimpawu ezibangelwa lutshintsho kumanqanaba ehomoni anokubandakanya:

• Ukukhula okugqithileyo kweenwele zomzimba kwipateni yamadoda (hirsutism)
• Kushushu
• Ukuhamba kweemvakalelo
• Ukuthantamisa kunye nokoma kwilungu lobufazi

Umfazi unokuziva ediniwe okanye ediniwe ukuba ulahlekelwa ligazi elininzi ngokuhamba kwexesha. Olu luphawu lwe-anemia.

Umboneleli wakho uya kukhupha ezinye izizathu ezinokubangela ukuphuma kwegazi ngokungaqhelekanga. Uya kuba novavanyo lwe-pelvic kunye novavanyo lwePap / HPV. Olunye uvavanyo olunokwenziwa lunokubandakanya:

• Gcwalisa ubalo lwegazi (CBC)
• Iprofayile yokunqanda igazi
• Uvavanyo lomsebenzi wesibindi (LFT)
• Ukuzila ukutya kweglucose
• Uvavanyo lweHormone, lwe-FSH, LH, inqanaba lesilisa (i-androgen), iprolactin, kunye neprogesterone
• Uvavanyo lokukhulelwa
• Uvavanyo lomsebenzi we-thyroid

Umboneleli wakho unokucebisa oku kulandelayo:

• Inkcubeko ukujonga usulelo
• I-Biopsy ukukhangela i-precancer, umhlaza, okanye ukunceda ukuthatha isigqibo kunyango lwehomoni
• I-Hysteroscopy, eyenziwa kwiofisi yomboneleli wakho ukujonga kwisibeleko ngokusebenzisa ubufazi
• I-Ultrasound ukujonga iingxaki kwisibeleko okanye isinqe

Unyango lunokubandakanya enye okanye ezingaphezulu kwezi zilandelayo:

• Iipilisi zolawulo lokuzalwa olunedosi ephantsi
• Unyango lweHormone
• Unyango oluphezulu lwe-estrogen kunyango lwabasetyhini abopha kakhulu
• Isixhobo se-Intrauterine (IUD) esikhupha iprogestin yehomoni
• Izidakamizwa ezichasayo ezichasayo (i-NSAID) ezithathwa ngaphambi nje kokuba kuqala ixesha
• Utyando, ukuba unobangela wokopha yipolyp okanye i-fibroid

Umboneleli wakho unokukubeka kwizongezo zentsimbi ukuba une-anemia.

Ukuba ufuna ukukhulelwa, unokunikwa iyeza ukukhuthaza i-ovulation.

Abasetyhini abaneempawu ezinzima ezingaphuculiyo okanye abanesifo somhlaza okanye sokuqonda kwangaphambili banokufuna ezinye iinkqubo ezinje:

• Inkqubo yoqhaqho ukutshabalalisa okanye ukususa umgca wesibeleko
• IHysterectomy ukususa isibeleko

Unyango lweHormone luhlala luthomalalisa iimpawu. Unyango lusenokungafuneki ukuba awuphuhlisi i-anemia ngenxa yokulahleka kwegazi. Unyango olujolise kwisizathu sokopha luhlala lusebenza ngokukhawuleza. Kungenxa yoko le nto kubalulekile ukuqonda unobangela.

Iingxaki ezinokwenzeka:

• Ukungachumi (ukungakwazi ukukhulelwa)
• I-anemia enkulu ngenxa yokulahleka kwegazi okuninzi ekuhambeni kwexesha
• Umngcipheko owandisiweyo womhlaza we-endometrium

Fowunela umboneleli wakho ukuba wopha ngokungaqhelekanga kwilungu lobufazi.

Ukuphuma kwegazi; Ukuphuma ngokungaqhelekanga kwesibeleko - ihomoni; Polymenorrhea - ukungasebenzi kakuhle kwesibeleko

• I-anatomy yesibeleko yesiqhelo (icandelo elisikiweyo)

Ikholeji yaseMelika yezithintelo kunye newebhusayithi yamaGynecologists. Uluvo lwekomiti ye-ACOG hayi. 557: Ulawulo lokuphuma gwenxa kwesibeleko ngokuqaqamba kwabafazi abaneminyaka engakhulelweyo yokuzala. Uphinde waqinisekisa ngo-2017. . Kufumaneka ngo-Oktobha 27, 2018.

I-Bahamondes L, u-Ali M. Inkqubela phambili ekulawuleni nasekuqondeni iingxaki zokuya exesheni. F1000Prime Rep. Ngo-2015; 7:33. IINKCUKACHA: 25926984 www.ncbi.nlm.nih.gov/pubmed/25926984.

I-Ryntz T, iLobo RA. Ukopha okungaqhelekanga kwesibeleko: i-etiology kunye nolawulo lokopha okungapheliyo kunye nokugula okungapheliyo. Ku: Lobo RA, Gershenson DM, Lentz GM, Valea FA, ii-eds. Gynecology egqibeleleyo. Umhla wesi-7. IPhiladelphia, PA: Elsevier; I-2017: isahluko 26.

ISchrager S. Ukuphuma gwenxa kwesibeleko. Ku: Kellerman RD, Bope ET, ii-eds. Unyango lwangoku lukaConn lwango-2018. IPhiladelphia, PA: Elsevier; Ngo-2018: 1073-1074.