Imikhakha yisishiyagalombili yokungapheli komjikelezo wokuya esikhathini?

Ukukhulelwa okungajwayelekile kusho noma iyiphi inguquko ekujwayelekile kwesikhathi sakho sokukhulelwa. Lokhu kufaka phakathi isikhathi esingajwayelekile, ukugeleza okukhulu, noma ukungabi khona kwezinyanga. Abantu abaningi bayabhekana nalokhu, futhi ucwaningo lubonisa ukuthi inani elikhulu labesifazane libhekene nephuzu elithile lezingqinamba zokukhulelwa phakathi neminyaka yabo yokuzala. Ukuqonda ukukhulelwa okungajwayelekile kubalulekile ngezizathu eziningana.

Okokuqala, kungaba uphawu lwezinkinga zempilo. Izikhathi eziqondile ngokuvamile zibonisa impilo enhle yokuzala, kuyilapho izinguquko zingase zibhekisele ezinkingeni ezinjengokungalingani kwamahomoni noma izimo ezinzima kakhulu. Okwesibili, ukwazi ngezinhlobo ezahlukene zokukhulelwa okungajwayelekile—njengokungabi khona kwezinyanga (amenorrhea), izinyanga ezingekho njalo (oligomenorrhea), izinyanga ezibuhlungu (dysmenorrhea), izinyanga ezinkulu (menorrhagia), ukuphuza okungalindelekile (metrorrhagia), izinyanga ezivame kakhulu (polymenorrhea), ukuphuza ngemuva kokuphela kwesikhathi sokukhulelwa, kanye ne-premenstrual syndrome (PMS)—kusiza abantu ukuthi baqonde kangcono izimpawu zabo.

1. Amenorrhea

I-Amenorrhea ukungabi khona kokukhulelwa, futhi ingahlelwa ngezinhlobo ezimbili:

1. I-Amenorrhea yokuqala: Lokhu kubhekisela esimweni lapho intombazane ingakaze ibe nesikhathi sayo sokuqala ngaphambi kweminyaka engu-16. Kungase kube ngenxa yokungalingani kwamahomoni, izici ze-genetic, noma ukungapheleli kokwakheka kwesistimu yokuzala.

2. I-Amenorrhea yesibili: Lena yifomu elivamile futhi kwenzeka lapho owesifazane okade enezikhathi eziqondile emisa ukukhulelwa izinyanga ezintathu noma ngaphezulu ezilandelayo. Kungabangelwa izici ezinjengengcindezi, ukuzivocavoca okukhulu, ukunciphisa noma ukwanda kwesisindo, ukungalingani kwamahomoni (njengokungasebenzi kahle kwe-thyroid noma i-polycystic ovary syndrome), noma izici zesitayela sokuphila.

Lesi simo singabangela izinkinga zokuzala futhi singase sibonise izinkinga zempilo eziyimfihlo. Ukwelashwa kuncike esizathwini esiyimbangela futhi kungafaka phakathi ukwelashwa kwamahomoni, ukushintsha kwesitayela sokuphila, noma ukulungisa izimo zezokwelapha. Kubalulekile kubantu ababhekene ne-amenorrhea ukuthintana nodokotela ukuze bathole ukuxilongwa okulungile nokuphathwa.

2. Oligomenorrhea

I-Oligomenorrhea ibhekisela ekukhulelweni okungavamile noma okungajwayelekile, lapho izikhathi zokukhulelwa zenzeka ngaphezu kwezinsuku ezingu-35 kodwa ngaphansi kwezinyanga eziyisithupha. Abesifazane abane-oligomenorrhea bangase babe nezinyanga ezincane kunesishiyagalolunye ngonyaka, ngezikhathi ezihlukahlukene ubude.

Lesi simo singabangelwa izici ezihlukahlukene, kufaka phakathi ukungalingani kwamahomoni, ukucindezeleka, ukuzivocavoca okukhulu, i-polycystic ovary syndrome (PCOS), ukungasebenzi kahle kwe-thyroid, noma ukushintsha okukhulu kwesisindo. I-Oligomenorrhea ingathinta ukukhulelwa, njengoba izikhathi ezingajwayelekile zingase zihlupheke ekukhulelweni.

Ukuphathwa kuncike esizathwini esiyimbangela futhi kungafaka phakathi ukuguqulwa kwesitayela sokuphila, ukwelashwa kwamahomoni, noma ukuphathwa kwezimo ezinjenge-PCOS. Kubalulekile ukufuna iseluleko sezokwelapha ukuze uthole ukuxilongwa okulungile nokuphathwa.

3. Dysmenorrhea

I-Dysmenorrhea ibhekisela ekukhulelweni okuhlungu, ngokuvamile kubonakala ngama-cramps esiswini esisezantsi noma e-pelvis phakathi nesikhathi sokukhulelwa. Kunezinhlobo ezimbili:

1. I-Dysmenorrhea yokuqala: Lolu hlobo luvela ngaphandle kwesimo sezempilo esiyimbangela futhi yilona uhlobo oluvamile lobuhlungu besikhathi sokukhulelwa. Ngokuvamile luqala ngaphakathi kwamahora ambalwa ngemuva kokuba kuqale isikhathi futhi lungase luqhubeke kusuka ezinsukwini eziyi-1 kuya kwezi-3. Ubuhlungu bubangelwa ukukhishwa kwe-prostaglandins, okuvusa ukucindezeleka kwesisu.

2. I-Dysmenorrhea yesibili: Lolu hlobo lubangelwa isimo sezempilo esiyimbangela, njenge-endometriosis, ama-fibroids, noma isifo se-pelvic inflammatory. Ubuhlungu ngokuvamile luqala ngaphambi kwesikhathi futhi lungase lube nzima futhi luqhubeke isikhathi eside.

Izinketho zokwelapha i-dysmenorrhea zifaka phakathi ukunciphisa ubuhlungu obungathengwa ngaphandle komtholampilo, ukuphathwa kokuzala kwamahomoni, noma, uma kunjalo i-dysmenorrhea yesibili, ukulungisa isimo esiyimbangela. Uma ubuhlungu bukhulu noma buhlala isikhathi eside, kunconywa ukuthintana nodokotela.

4. Menorrhagia

I-Menorrhagia yigama elisetshenziswa ekukhulelweni okukhulu noma okuhlala isikhathi eside, okuhlala isikhathi esingaphezu kwezinsuku ezingu-7 noma kuhilela ukulahlekelwa igazi okukhulu (ngaphezulu kwama-milliliters angu-80 ngesikhathi). Lesi simo singaphazamisa imisebenzi yansuku zonke futhi singabangela izimpawu ezinjengokukhathala, i-anemia, nobuhlungu besiswini esisezantsi.

Izimbangela ezivamile ze-menorrhagia zifaka phakathi ukungalingani kwamahomoni, ama-fibroids, ama-polyps, i-endometriosis, noma izimo zezokwelapha ezinjengokungasebenzi kahle kwe-thyroid noma izinkinga zokugqwala kwegazi. Kwezinye izimo, isizathu singase singachazwanga.

Izinketho zokwelapha zihluka kuye ngesizathu esiyimbangela futhi zingafaka phakathi imithi (njengokwelashwa kwamahomoni noma i-tranexamic acid), izinqubo ezingaphambili (njengokususwa kwe-endometrial), noma ukuhlinzwa (njengokususwa kwesisu) ezimweni ezinkulu. Kubalulekile ukuthintana nodokotela ukuze uthole ukuxilongwa okulungile nokuphathwa.

5. Metrorrhagia

I-Metrorrhagia ibhekisela ekopha phakathi kwezikhathi zokukhulelwa, ngokuvamile kwenzeka ngezikhathi ezingajwayelekile. Nanka amanye amaphuzu ayisihluthulelo:

• Izimpawu: Ukuphuza okukhanyayo noma okulinganiselwe phakathi kwezikhathi.

• Izimbangela ezivamile:

  • Ukungalingani kwamahomoni (ibh. i-PCOS, ukusetshenziswa kokulawula ukubeletha)

  • Ama-fibroids esisu noma ama-polyps

  • I-Endometrial hyperplasia noma ukutheleleka

  • Ukucindezeleka noma ukushintsha kwesitayela sokuphila

• Izimbangela ezinzima ezingase zenzeke:

  • Umshuqa we-endometrial noma we-cervical

  • Ukungaqondakali kwesisu noma izinkinga zokwakheka

• Izinketho zokwelapha:

  • Ukuphathwa kwamahomoni (amaphilisi okulawula ukubeletha, ama-IUD)

  • Imithi yokulawula ukuphuza

  • Izinketho zokuhlinzwa zezinkinga zokwakheka (ibh. ukususwa kwama-polyps, ukususwa kwe-endometrial)

Uma ubhekene nokuphuza okungachazwanga, ukuthintana nodokotela kubalulekile ukuze uthole ukuxilongwa okulungile nokuphathwa.

6. Polymenorrhea

I-Polymenorrhea ibhekisela ezikhathini zokukhulelwa ezivame kakhulu, lapho izikhathi zenzeka ngezikhathi ezincane kunama-21. Lesi simo sibangela ukuphuza okuvamile futhi singabangela ukungakhululeki nokuphazamiseka empilweni yansuku zonke. Abesifazane ababhekene ne-polymenorrhea bangase babe nezikhathi ezimfushane, ukuphuza okukhulu, noma kokubili, okungabangela ukucindezeleka okukhulu komzimba nangokomzwelo.

Izimbangela ezivamile ze-polymenorrhea zifaka phakathi ukungalingani kwamahomoni, njengokuhlupheka amazinga e-estrogen ne-progesterone, i-polycystic ovary syndrome (PCOS), ukungasebenzi kahle kwe-thyroid, kanye namazinga aphezulu engcindezi. Izinkinga zesisu ezinjengama-fibroids noma i-endometrial hyperplasia zingase futhi zinikeze izikhathi ezivame kakhulu. Ukwelashwa ngokuvamile kugxile ekulungiseni isizathu esiyimbangela, futhi izinketho zingafaka phakathi ukwelashwa kwamahomoni njengamaphilisi okulawula ukubeletha noma ama-IUD, imithi njenge-progestin, futhi ngezinye izikhathi ukungenelela okuhlinzwayo kwezinkinga zokwakheka.

7. Ukuphuza ngemuva kokuphela kwesikhathi sokukhulelwa

Ukuphuza ngemuva kokuphela kwesikhathi sokukhulelwa kubhekisela kunoma yiluphi ukuphuza kwe-vaginal okuvela ngemuva kokuba owesifazane esephelile isikhathi sakhe sokukhulelwa, okuchazwa njengezinyanga ezingu-12 ezilandelayo ngaphandle kwesikhathi sokukhulelwa. Ukuphuza ngemuva kokuphela kwesikhathi sokukhulelwa akucabangi ukuthi kuyinto evamile futhi kufanele kuhlale kuhlolwe udodotela.

Izimbangela ezivamile:

• Ukungalingani kwamahomoni: Amazinga e-estrogen aphansi angabangela ukuncipha kwe-vaginal lining, okubangela ukopha okuncane noma ukuphuza.

• I-Endometrial atrophy: Ukunciphisa kwe-uterine lining, okungabangela ukuphuza okuncane noma ukopha okuncane.

• I-Endometrial hyperplasia: Ukukhuluphala kwe-uterine lining, ngokuvamile ngenxa yokungalingani kwamahomoni.

• Ama-fibroids esisu noma ama-polyps: ukukhula okungekho msundu esiswini okungabangela ukuphuza.

• Umshuqa we-cervical noma we-endometrial: Ukuphuza ngemuva kokuphela kwesikhathi sokukhulelwa kungaba uphawu lomsundu wesisu noma we-cervical, nakuba kungelona njalo i-cancer.

Izinketho zokwelapha:

• Ukuphathwa kwamahomoni: ukwelashwa kwe-estrogen ukusiza ukulawula i-uterine lining.

• I-D&C (I-Dilation ne-Curettage): Inqubo yokuhlinzwa yokususwa kwezicubu ezingajwayelekile esiswini.

• I-Hysteroscopy: Inqubo yokuhlola ngaphakathi kwesisu nokukhipha ama-polyps noma ama-fibroids.

• Imithi: Ukwelashwa kwe-progestin ukwelapha i-endometrial hyperplasia.

Ukuphuza ngemuva kokuphela kwesikhathi sokukhulelwa kufanele kuhlale kuhlolwe udodotela ukuze kuvinjelwe izimo ezinzima, kufaka phakathi i-cancer. Ukutholakala kwangaphambi kwesikhathi nokuphathwa kubalulekile ekuphathweni okuphumelelayo.

8. I-Premenstrual Syndrome (PMS)

I-Premenstrual syndrome (PMS) yinqubo yezimpawu zomzimba, zomzwelo, nezenhlalakahle ezivela emasontweni amabili ngaphambi kwesikhathi sokukhulelwa sowesifazane. Lezi zimpawu zingase zihluke kakhulu ezingeni lobukhulu futhi zifaka phakathi ukukhuluphala, ubuhlungu besifuba, ukukhathala, izikhathi zokukhathala, ukushintsha kwesimo sengqondo, ukucasuka, kanye nokushintsha ekudleni noma ezimisweni zokulala. Kwabesifazane abaningi, i-PMS ingaphazamisa imisebenzi yansuku zonke, ithinta kokubili impilo yabo yomuntu siqu nezezimali.

Isizathu esiqondile se-PMS asiqondakali ngokuphelele, kodwa kukholelwa ukuthi sihlotshaniswa nokungalingani kwamahomoni, ikakhulukazi ukushintsha amazinga e-estrogen ne-progesterone phakathi nesikhathi sokukhulelwa. Ezinye izici ezinikezayo zingase zifake ukucindezeleka, ukudla okubi, ukungabi khona kokuzivocavoca, kanye nomlando womndeni we-PMS noma izifo ezihlobene nezimpawu zengqondo. Nakuba abesifazane abaningi bebhekene nezimpawu ezilula, i-PMS enzima ingathinta kakhulu ikhwalithi yempilo yabo.

Ukuphathwa ngokuvamile kufaka phakathi ukushintsha kwesitayela sokuphila, ukuphathwa kwengcindezi, imithi njengokunciphisa ubuhlungu, ukuphathwa kokuzala kwamahomoni, noma ama-antidepressants ezimpawu zomzwelo, kanye nezinye izithasiselo zokudla ezinjenge-calcium noma i-magnesium ukusiza ukunciphisa izimpawu.

Imininingwane ebalulekile

• Ukukhulelwa okungajwayelekile kungase kubonise izinkinga zempilo: Izinguquko ezinjengokungabi khona kwezinyanga, ukugeleza okukhulu, noma izikhathi ezingajwayelekile zingase zibonise ukungalingani kwamahomoni noma ezinye izimo zezokwelapha ezinjenge-PCOS, ukungasebenzi kahle kwe-thyroid, noma ngisho nomdlavuza.

• Ukubonisana nodokotela ngesikhathi esifanele kubalulekile: Ukuqaphela izimpawu zokukhulelwa okungajwayelekile ngokushesha kungabangela ukuphathwa kangcono, ukuxilongwa kwangaphambi kwesikhathi, nezinketho zokwelapha eziphumelelayo.

• Ukuphathwa kuyahluka kuye ngesizathu: Kuye ngesimo esiyimbangela, ukwelashwa kuya kusuka ekushintsheni kwesitayela sokuphila nokuphathwa kwamahomoni kuya ekuhlinzweni.

Imibuzo evame ukubuzwa

1. Iyini i-PMS?
   I-PMS (I-Premenstrual Syndrome) ibhekisela ekubumbeni kwezimpawu zomzimba, zomzwelo, nezenhlalakahle ezivela ngaphambi kwesikhathi sokukhulelwa sowesifazane.

2. Yini ebangela i-PMS?
   I-PMS kukholelwa ukuthi ibangelwa ukungalingani kwamahomoni, ukucindezeleka, ukudla okubi, ukungabi khona kokuzivocavoca, nomlando womndeni wezimpawu ezifanayo.

3. I-PMS ingaphathwa kanjani?
   I-PMS ingaphathwa ngokushintsha kwesitayela sokuphila, ukuphathwa kwengcindezi, ukunciphisa ubuhlungu obungathengwa ngaphandle komtholampilo, ukwelashwa kwamahomoni, kanye nezinye izithasiselo zokudla ezinjenge-calcium ne-magnesium. Ukuqaphela kwangaphambi kwesikhathi nokubonisana nodokotela kubangela ukuxilongwa nokuphathwa okuhle.