Ukuqothuka Kwesikhumba Se-Vajina

Ukoma komalule (i-atrophic vaginitis) kuyinto yokuncipha, ukumomotheka nokutheleleka kwezindonga zomlomo wesikhumba okungase kwenzeke uma umzimba wakho ungenawo i-estrogen. Ukoma komalule kwenzeka kakhulu ngemuva kokuphela kwesikhathi.Kubantu abaningi besifazane, ukoma komalule akuwenzi nje kuphela ubuhlobo bube buhlungu kodwa futhi kuholela ezimpahleni ezibuhlungu zokukhishwa kwamanzi. Ngenxa yokuthi lesi simo sibangela kokubili izimpahlanzomlomo wesikhumba nezokukhishwa kwamanzi, odokotela basebenzisa igama elithi "isimo socansi sokuphela kwesikhathi (GSM)" ukuchaza ukoma komalule kanye nezimpahlanzalo ezihambisana nalo. Kukhona ukwelashwa okulula, okuphumelelayo kwesimo socansi sokuphela kwesikhathi (GSM). Amazinga e-estrogen aphansi abangela ukushintsha emzimbeni wakho, kodwa akusho ukuthi kufanele uhlale uhlupheka ngokungakhululeki kwe-GSM.

Izimpawu nezincazelo ze-Genitourinary syndrome of menopause (GSM) zingafaka:

• Ukombile kwesikhumba se-vagina
• Ukushisa kwesikhumba se-vagina
• Ukuphuma kwesikhumba se-vagina
• Ukukhahlela kwesikhumba se-genital
• Ukushisa lapho uthimba
• Ukucindezeleka lapho uthimba
• Ukuthimba njalo
• Ukutheleleka okuphindaphindayo kwe-urinary tract
• Ukungakwazi ukuqapha isithimba
• Ukopha okuncane ngemva kokuthomba
• Ukuphazamiseka lapho uthomba
• Ukunciphisa ukufuywa kwesikhumba se-vagina ngesikhathi sokuthomba
• Ukufinyeka nokufinyeka kwesikhumba se-vagina

Abesifazane abaningi abesebekugcineni kwesikhathi sabo sokubeletha baba ne-GSM. Kodwa abambalwa abafuna ukwelashwa. Abesifazane bangase bajabule ukuxoxa ngezimpawu zabo nodokotela wabo futhi bangase bazinikela ekuphileni nalezi zimpawu.

Yenza i-aphoyintimenti nodokotela wakho uma une-spotting noma ukopha okungachazwanga kwe-vagina, ukopha okungavamile, ukushisa, noma ubuhlungu.

Futhi yenza i-aphoyintimenti ukubona udokotela wakho uma uhlushwa ukuxabana okuhlungu okungaxazululwa ngokusebenzisa i-moisturizer ye-vagina (i-K-Y Liquibeads, i-Replens, i-Sliquid, nabanye) noma i-lubricant yamanzi (i-Astroglide, i-K-Y Jelly, i-Sliquid, nabanye).

I-Genitourinary syndrome yemenopouse ibangelwa ukwehla kokukhiqizwa kwe-estrogen. I-estrogen encane yenza izicubu zakho ze-vaginal zibe zininzi, zomile, zingalambi futhi zibuthakathaka.

Ukuwa kwezinga le-estrogen kungaqala:

• Ngemva kwemenopouse
• Eminyakeni eya phambili kwemenopouse (i-perimenopouse)
• Ngemva kokususwa kwe-ovari zombili ngokusebenza (imenopouse yokusebenza)
• Ngesikhathi sokuncelisa
• Uma uthatha imithi engathinta amazinga e-estrogen, njengezinye izitho zokulawula ukubeletha
• Ngemva kokwelashwa ngomgogodla we-pelvic ngenxa yomdlavuza
• Ngemva kokwelashwa nge-chemotherapy ngenxa yomdlavuza
• Njengomphumela wecala lokwelashwa kwe-hormonal yomdlavuza wamabele

Izimpawu ze-GSM zingase ziqale ukukukhathaza eminyakeni eya phambili kwemenopouse, noma zingase zingabi yinkinga kuze kube eminyakeni embalwa ngemva kwemenopouse. Nakuba lesi simo sivamile, akuzona bonke abesifazane abasemenopouse ababhekana ne-GSM. Ukuya ocansini njalo, nokuthi ube nomlingani noma cha, kungakusiza ukugcina izicubu zakho ze-vaginal ziphilile.

Izici ezithile zingase zifake isandla ekuqaleni kwe-GSM, ezifana nalezi:

• Ukubhema. Ukubhema isigarethi kuchaphazela ukujikeleza kwegazi, futhi kunganciphisa ukugeleza kwegazi no-oksijini esibelethweni nakwezinye izindawo eziseduze. Ukubhema kunciphisa futhi imiphumela yama-estrogens avamile emzimbeni wakho.
• Ukungeni ukubeletha ngesibeletho. Abacwaningi baye baphawula ukuthi abesifazane abakaze babelethe ngesibeletho banesilinganiso esiphezulu sokuthola izimpawu ze-GSM kunabesifazane abake baba nezingane ngesibeletho.
• Ukungeni umsebenzi wezocansi. Umsebenzi wezocansi, nokuthi ukhona yini umlingani noma cha, wenza igazi ligeleze futhi wenze izicubu zesibethelo zibe nokuqina.

I-Genitourinary syndrome yemenopouse ikwandisa ingozi yakho yokuthola:

• Ukutheleleka kwesikhumba. Ukushintsha kokulingana kwa-asidi kwesikhumba sakho kwenza ukutheleleka kwesikhumba kube lula kakhulu.
• Izinkinga zokukhishwa kwamanzi. Ukushintsha kokukhishwa kwamanzi okuhambisana ne-GSM kungase kube nomthelela ezinkingeni zokukhishwa kwamanzi. Ungase ube nokuqhubeka noma ukucindezeleka kokukhishwa kwamanzi noma ukushisa lapho ukhishwa amanzi. Abanye abesifazane bahlangabezana nokutholakala okukhulu kwezifo zokukhishwa kwamanzi noma ukuvuza kwamandla (ukungakwazi ukulawula).

Ukuhlangana ngokobulili njalo, kungakhathaliseki ukuthi kunomlingani noma cha, kungasiza ekunqobeni i-genitourinary syndrome ye-menopause. Ukuhlangana ngokobulili kukhuphula ukugeleza kwegazi e-vagina yakho, okusiza ekugcineni izicubu ze-vagina ziphilile.

Ukuhlolwa kwe-genitourinary syndrome of menopause (GSM) kungabandakanya:

Ekuhlolweni kwesisu, umhlinzeki wakho wezempilo ufake imilenze emibili egqoke isigqoko ngaphakathi kwesikhumba sakho. Ucindezela phansi esiswini sakho ngesikhathi esifanayo, umhlinzeki wakho angahlola isisu sakho, ama-ovari namanye amalungu.

• Ukuhlolwa kwesisu, lapho udokotela wakho azizwa khona amalungu akho esisu futhi ahlole ngeso lengqondo amalungu akho angaphandle okuzala, isikhumba nesibopho.
• Iviki lokuhlola, elihilela ukuqoqa nokuhlola umchamo wakho, uma unezimpawu zokungasebenzi kahle kwesisu.
• Ukuhlolwa kokulingana kwe-asidi, okuhilela ukuthatha isampula yezinto ezikhona esikhumbeni noma ukubeka uphahla lomkhombandlela ephepheni esikhumbeni sakho ukuze uhlole ukulingana kwe-asidi yaso.

Ukuqapha i-genitourinary syndrome yemenopouse, udokotela wakho angase aqale ngokuncoma ukwelashwa okuthengiswayo ngaphandle kwesikripthi, okuhlanganisa:

Uma lezo zinto zingayincipisi izimpawu zakho, udokotela wakho angase ancome:

I-estrogen ye-vaginal inenzuzo yokuba isebenza kahle ngamanani aphansi futhi ikhawulelise ukukhishwa kwakho ku-estrogen ngoba kuncane okufinyelela egazini lakho. Ingase futhi inikeze ukukhululeka okuqondile kwezimpawu kunaleyo ye-estrogen yomlomo.

Ukuphathwa kwe-estrogen ye-vaginal kuza ngezindlela eziningi. Ngenxa yokuthi zonke zibonakala zisebenza ngokulinganayo, wena nodokotela wakho ninganquma ukuthi iyiphi engcono kuwe.

Le pilule, ethathwa nsuku zonke, ingasiza ekuqapheni izimpawu zobuhlungu bobulili kwabesifazane abane-genitourinary syndrome yemenopouse (GSM) ephakathi nendawo. Ayivunyelwe kwabesifazane abake baba nomdlavuza webele noma abanesongo elikhulu lokuthuthukisa umdlavuza webele.

Lezi zinto zifaka i-hormone i-DHEA ngokuqondile e-vagina ukuze kuqashwe ubuhlungu bobulili. I-DHEA iyi-hormone esiza umzimba ukuba ukhiqize ezinye i-hormones, kuhlanganise ne-estrogen. I-Prasterone isebenza ubusuku bonke ngenxa yokunciphisa okuphakathi nendawo kwe-vaginal.

Uma ukumomotheka kwe-vaginal kuhlotshaniswa nezinye izimpawu ze-menopause, njengokushisa okuphakathi nendawo noma okukhulu, udokotela wakho angase ancome amaphilisi e-estrogen, ama-patches noma ijeli, noma i-ring ye-estrogen enesilinganiso esiphezulu. I-estrogen ethathwa ngomlomo ingena ohlelweni lwakho lonke. Cela udokotela wakho ukuba achaze izingozi ngokumelene nezinzuzo ze-estrogen yomlomo, nokuthi ngabe udinga ukusebenzisa enye i-hormone ebizwa nge-progestin kanye ne-estrogen.

Ungase usebenzise ama-dilators e-vaginal njengendlela yokwelapha engapheli i-hormone. Ama-dilators e-vaginal angase futhi asebenziselwe ukwengeza ekwelapheni kwe-estrogen. Lezi zinto zikhuthaza futhi zolula imisipha ye-vaginal ukuze kuqashwe ukunciphisa kwe-vagina.

Uma ubuhlungu bobulili kuyinkinga, ama-dilators e-vaginal angaqapha ukungakhululeki kwe-vaginal ngokulula i-vagina. Atholakala ngaphandle kwesikripthi, kodwa uma izimpawu zakho zinzima, udokotela wakho angase ancome ukwelashwa komzimba we-pelvic floor nama-dilators e-vaginal. Umhlinzeki wakho wezempilo noma umhlengikazi we-pelvic angakufundisa ukuthi ungawasebenzisa kanjani ama-dilators e-vaginal.

I-topical lidocaine, etholakala njengesipontshi noma ijeli yesikripthi, ingasetshenziswa ekuqapheni ukungakhululeki okuhlotshaniswa nomsebenzi wobulili. Uyifake imizuzu emihlanu kuya kwelishumi ngaphambi kokuba uqale umsebenzi wobulili.

Uma unembali yomdlavuza webele, tshela udokotela wakho bese ucabangele lezi zinto:

• Ama-vaginal moisturizers. Zama i-vaginal moisturizer (K-Y Liquibeads, Replens, Sliquid, nabanye) ukubuyisela ukumomotheka kwe-vaginal yakho. Ungase udinga ukufaka i-moisturizer izinsuku ezimbalwa. Imiphikiswano ye-moisturizer ngokuvamile ihlala isikhathi eside kunaleyo ye-lubricant.

• Ama-lubricants asekelwe emanzini. Lezi lubricants (Astroglide, K-Y Jelly, Sliquid, nabanye) zifakwa ngaphambi nje komsebenzi wobulili futhi zinganciphisa ukungakhululeki ngesikhathi sobulili. Khetha imikhiqizo engayinawo i-glycerin noma izinto ezishisayo ngoba abesifazane abazizwa lezi zinto bangase bazizwe beqiniswe. Gwema i-petroleum jelly noma ezinye izinto eziqhutshwe yi-petroleum ngokugcoba uma usebenzisa ama-condoms, ngoba i-petroleum ingawaphula ama-condoms e-latex uma ihlangana nawo.

• I-vaginal estrogen cream (Estrace, Premarin). Ufaka le cream ngokuqondile e-vagina yakho nge-applicator, ngokuvamile ngobusuku. Ngokuvamile abesifazane bayisebenzisa nsuku zonke amasonto ayi-1 kuya kwamathathu bese kuthi kanye noma kathathu ngesonto ngemuva kwalokho, kodwa udokotela wakho uzokutshela ukuthi usebenzise kangakanani i-cream nokuthi uyifake kaningi kangakanani.

• Ama-vaginal estrogen suppositories (Imvexxy). Lezi suppositories ze-estrogen ezinamanani aphansi zifakwa cishe amasentimitha ama-5 e-vaginal canal nsuku zonke amasonto ambalwa. Khona-ke, lezi suppositories kudingeka zifakwe kabili ngesonto kuphela.

• I-vaginal estrogen ring (Estring, Femring). Wena noma udokotela wakho ufakela i-ring ebushelelezi, eguquguqukayo engxenyeni engaphezulu ye-vagina. I-ring ikhipha inani elilinganiselwe le-estrogen ngenkathi ibekwe futhi kudingeka ithathelwe indawo cishe izinyanga ezintathu. Abesifazane abaningi bayathanda ukulula lokhu okunikayo. I-ring ehlukile, enesilinganiso esiphezulu, ithathelwa ingqikithi kunokwelashwa okusekelwe endaweni.

• I-vaginal estrogen tablet (Vagifem). Usebenzisa i-applicator yokulahla ukuze ufake i-vaginal estrogen tablet e-vagina yakho. Udokotela wakho uzokutshela ukuthi uyifake kaningi kangakanani i-tablet. Ungase, isibonelo, uyisebenzise nsuku zonke emasontweni amabili okuqala bese kuthi kabili ngesonto ngemuva kwalokho.

• Ukuphathwa okungapheli i-hormone. Zama ama-moisturizers nama-lubricants njengokukhetha kokuqala.

• Ama-vaginal dilators. Ama-vaginal dilators yindlela engapheli i-hormone engakhuthaza futhi ilule imisipha ye-vaginal. Lokhu kusiza ekuqapheni ukunciphisa kwe-vagina.

• I-vaginal estrogen. Ngokubonisana nodokotela wakho we-cancer (oncologist), udokotela wakho angase ancome i-vaginal estrogen ephansi uma ukwelashwa okungapheli i-hormone kungasizi izimpawu zakho. Noma kunjalo, kukhona ukukhathazeka ukuthi i-vaginal estrogen ingase ikhulise ingozi yokubuya komdlavuza, ikakhulukazi uma umdlavuza wakho webele wawunezinhlobo ze-hormone.

• Ukuphathwa kwe-estrogen ye-systemic. Ukwelashwa kwe-estrogen ye-systemic ngokuvamile akukukhuthazwa, ikakhulukazi uma umdlavuza wakho webele wawunezinhlobo ze-hormone.