I-Amenorrhea

Wake wazibuza ukuthi kungani abanye besifazane bephuthelwa ukuya esikhathini isikhathi eside? Lesi simo, esaziwa nge-amenorrhea, sithinta abesifazane abaningi emhlabeni wonke futhi singaba nezimbangela nemithelela ehlukahlukene. I-Amenorrhea yisimo sezempilo esibonakala ngokungabi bikho kokuya esikhathini, okungenzeka ngokwemvelo ngesikhathi sokukhulelwa noma ukuncelisa, kodwa futhi kungabonisa izinkinga zempilo eziyisisekelo ezidinga ukunakwa.

Lesi sihloko sihlolisisa ubunkimbinkimbi be-amenorrhea, ihlola izinhlobo zayo, izimbangela nezimpawu zayo. 

Iyini i-Amenorrhea?

I-Amenorrhea yi-zero menstruation (ukuphuthelwa yinkathi noma izikhathi ezinwetshiwe) kwabesifazane abaneminyaka yobudala yokuzala. Kunomthelela ku-1.5-3% wabesifazane phakathi neminyaka yabo yokuzala. 

Lesi simo singabangelwa izici ezihlukahlukene ezinjengokungalingani kwama-hormone, ukucindezeleka ngokweqile, izimo zezokwelapha ezingaphansi, noma ukushintshashintsha kwesisindo okuphawulekayo. 

Yiziphi Izinhlobo ze-Amenorrhea?

Kunezinhlobo ezimbili eziyinhloko ze-amenorrhea: eyinhloko neyesibili.

• I-amenorrhea eyinhloko yenzeka lapho intombazane ingazange iye esikhathini sokuqala lapho ineminyaka engu-15 ubudala. Lesi isimo esiyivelakancane.
• I-amenorrhea yesibili kwenzeka lapho owesifazane owayenesikhathi esivamile eyeka ukuya esikhathini izinyanga ezintathu ezilandelanayo noma ngaphezulu. Kuthinta cishe u-4% wabesifazane ngesikhathi sokuphila kwabo. 

Izinkinga ze-Amenorrhea

I-amenorrhea inezimbangela ezihlukahlukene, kusukela ezenzakalweni zemvelo kuya kwezimo zempilo ezingaphansi. Okulandelayo ezinye zezizathu ezivamile ze-amenorrhea:

• Ukukhulelwa, ukuncelisa ibele, nokunqamuka kokuya esikhathini kuyizimbangela ezivamile ze-amenorrhea yemvelo. 
• Ukungalingani kwe-hormonal, okufana nalokhu okubonwa ku-polycystic ovary syndrome (PCOS) noma ukuphazamiseka kwe-thyroid, kungaholela ekutheni i-amenorrhea. 
• Izici zendlela yokuphila, okuhlanganisa ukuvivinya umzimba ngokweqile, ukuncipha noma ukukhuluphala ngokweqile, nokucindezeleka, kungase futhi kuphazamise imijikelezo yokuya esikhathini. 
• Izimo zezokwelapha ezifana nokuhluleka kwe-ovarian ngaphambi kwesikhathi, izimila ze-pituitary, nezibazi zesibeletho zingabangela i-amenorrhea.
• Imithi ethile, okuhlanganisa ezinye izindlela zokulawula inzalo kanye nama-antidepressants, ingase futhi ibangele ukuphutha esikhathini. 

Izimpawu ze-Amenorrhea

Uphawu oluyinhloko lwe-amenorrhea ukungabikho kokuya esikhathini. Nokho, abesifazane bangase babe nezimpawu ezengeziwe kuye ngembangela ewumsuka. Lokhu kungase kuhlanganise: 

• Ukushisa okushisayo
• Ukoma kwe-Vaginal
• Ukuphathwa yikhanda
• Abanye abantu bangase babone ukukhishwa kwezingono ze-milky noma izinguquko zombono. 
• Ukukhula kwezinwele zobuso ngokweqile kanye nezinduna nakho kuyizimpawu ezingenzeka. 
• Ezimweni ezihlobene nokungalingani kwe-hormonal, abesifazane bangase bazwe ubuhlungu be-pelvic. 

Izingozi Zezingozi

Kunezici eziningana ezandisa amathuba okuthuthukisa i-amenorrhea, njenge:

• Umlando womndeni we-amenorrhea noma ukunqamuka kokuya esikhathini kwangaphambi kwesikhathi uphakamisa ukuthambekela kofuzo. 
• Ukuphazamiseka kwemikhuba yokudla (i-anorexia nervosa noma i-bulimia) kuphakamisa kakhulu ingozi. 
• Ukuvivinya umzimba ngokweqile nokuqeqeshwa okuqinile kwezemidlalo nakho kungaholela ekubeni i-amenorrhea. 
• Ukukhuluphala ngokweqile kuthonya ibhalansi ye-hormonal futhi kungase kube nomthelela kulesi simo. 
• Izinqubo zokwelapha eziqondile, ezihlanganisa i-D&C noma inqubo ye-loop electro-diathermy excision (LEEP), ikhulisa ubungozi be-amenorrhea yesibili. 
• Ukwengeza, izici zofuzo, njengezinguquko ku-FMR1 gene ehambisana nesifo se-Fragile X, zingadlala indima ekuthuthukiseni i-amenorrhea.

Izinkinga

I-Amenorrhea ithonya izici ezihlukahlukene zempilo, okuholela ezinkingeni ezingase zibe khona. Okulandelayo eminye imiphumela emibi evamile ye-amenorrhea:

• Ukungabi nanzalo kuwukukhathazeka okuyinhloko, njengoba ukungabi khona kokuya esikhathini ngokuvamile kubonisa ukuntuleka kwe-ovulation. 
• Lesi simo siphinde sibe nomthelela empilweni yamathambo, okwandisa ingozi ye-osteoporosis ngenxa yokucwiliswa kwamazinga e-estrogen. 
• Izinkinga zenhliziyo nemithambo yegazi zingase ziphakame, lapho iziguli ezine-amenorrhea zibhekene namathuba aphezulu okuba nezinkinga zenhliziyo.
• Ukucindezeleka okungokwengqondo kuvamile, ikakhulukazi kwabesifazane abasebasha lapho beziqhathanisa nontanga. Kwezinye izimo, i-amenorrhea ibangela ubuhlungu be-pelvic. 
• Ukwengeza, ukungalingani kwe-hormonal okuhlotshaniswa ne-amenorrhea kungase kubangele ukuphazamiseka kwe-metabolic futhi kuthinte inhlalakahle yonke.

Ukuxilongwa kwe-Amenorrhea

Ukuxilongwa kwe-amenorrhea kuhilela izinyathelo ezimbalwa:

• Udokotela wakho uqala ngomlando wezokwelapha ophelele, ohlanganisa imininingwane emayelana nendlela yokuya esikhathini kanye nezici zendlela yokuphila. Kulandela ukuhlolwa komzimba nokuhlolwa kwe-pelvic. 
• Ukuhlolwa kwegazi kuhlola amazinga e-hormone, okuhlanganisa i-hormone evuselela igilo, i-follicle-stimulating hormone, ne-prolactin. 
• Ukuhlolwa kwesithombe njenge-ultrasound noma i-MRI kungase kusetshenziselwe ukuhlola izitho zokuzala noma ukuhlola izimila ze-pituitary. 
• Kwezinye izimo, ukuhlolwa kofuzo noma i-hysteroscopy kungase kudingeke. 
• Ukuhlolwa kokukhulelwa ngokuvamile kuyisinyathelo sokuqala, njengoba ukukhulelwa kuyimbangela evamile ye-amenorrhea yesibili. 

Ukwelashwa kwe-Amenorrhea

Indlela yokwelapha i-amenorrhea incike kumbangela yayo. 

• Nge-amenorrhea eyinhloko, odokotela bangase batuse ukulinda okuqaphile uma ukuhlolwa komsebenzi we-ovary kubonisa amazinga aphansi e-hormone, njengoba ukuya esikhathini kungase kubambezeleke. 
• Ezimweni ze-amenorrhea yesibili, ukwelashwa kungabandakanya imithi ye-hormonal efana namaphilisi okulawula ukuzalwa noma ukwelashwa kokubuyisela i-estrogen. 
• Ukwelashwa kwe-Clomiphene citrate ngokuvamile kusiza ukuvusa i-ovulation.
• Akuvamile, ukuhlinzwa kungase kudingeke, njengokukhipha izicubu ezibomvu esibelethweni noma ukubhekana nezimila ze-pituitary. 

Uyombona Nini Udokotela?

Xhumana nodokotela uma uye weqiwa izikhathi ezintathu zilandelana noma ungakayi esikhathini sakho sokuqala lapho uneminyaka engu-15. Lezi zimo zingase zibonise i-amenorrhea, okungaba uphawu lwezinkinga zempilo eziwumsuka. Funa iseluleko kudokotela wakho uma uhlangabezana nezimpawu ezifana nokushintsha kwesisindo okungachazeki, ukwanda kwezinwele zobuso, noma izinguquko ezwini lakho. Ukwengeza, uma uya ocansini futhi usola ukuthi ukhulelwe, kubalulekile ukubonana nodokotela. 

Ukuvimbela i-Amenorrhea

Nakuba kuyinselele ukuvimbela zonke izinhlobo ze-amenorrhea, ukukhetha okuthile kwendlela yokuphila kunganciphisa ingozi ye-amenorrhea yesibili. 

• Ukugcina isisindo esinempilo, ukudla okulinganiselayo nokuzivocavoca njalo kuthonya ibhalansi yamahomoni kanye nokuya esikhathini. 
• Ukulawula ukucindezeleka ngempumelelo nakho kudlala indima eyisisekelo. 
• Kubalulekile ukuqaphela umjikelezo wakho wokuya esikhathini futhi uqaphele noma yiziphi izinguquko. 
• Ukuhlolwa njalo nodokotela kuvumela ukutholwa kusenesikhathi kwezinkinga ezingase zibe khona. 
• Kubadlali, ukuthola ibhalansi phakathi kokuqeqeshwa nokuphumula kubalulekile ukuvimbela i-amenorrhea ebangelwa ukuzivocavoca. 
• Ukufakwa kwezinye izinketho zokwelapha zemvelo ze-amenorrhea, njengetiye le-herbal, imikhiqizo ethile yokudla (i-ginger, izaqathe, i-papaya), i-yoga, ukudla okulinganiselayo, ukulawula ukucindezeleka, kanye nokutshopa, kungasiza ukugqugquzela ukugeleza kwegazi nokulawula amahomoni okuzala.

Isiphetho

Ukuqonda i-amenorrhea kunomthelela ekuphathweni kwezempilo yabesifazane kanye nempilo yonke. Lesi simo, esibonakala ngokungabikho kokuya esikhathini, singabangelwa yizimbangela ezihlukahlukene kusukela ezenzakalweni zemvelo njengokukhulelwa kuya ezinkingeni zempilo. Kuthinta abesifazane babo bonke ubudala, ngezinhlobo ezahlukene nezici zobungozi ezinomthelela ekuthuthukisweni kwayo. Ukuqaphela izimpawu ze-amenorrhea kanye nezinkinga ezingase zibe khona kuthonya ukutholwa kusenesikhathi nokungenelela okufika ngesikhathi.

Imibuzo Evame Ukubuzwa

1. Abahlinzeki bezempilo bayihlola kanjani i-amenorrhea?

Odokotela basebenzisa umlando wezokwelapha, izivivinyo, kanye nokuhlolwa ukuze bathole imbangela futhi bahlole izinketho zokulawula i-amenorrhea kanye namandla okulondoloza inzalo (uma kudingekile).

2. Yini okufanele uyenze uma izikhathi zingafiki?

Ukulibaziseka kokuya esikhathini kudinga ukubonisana nochwepheshe bezokunakekelwa kwempilo. Bangakusiza ukuthi uhlole imbangela futhi uthole ukwelashwa, okuholela kumjikelezo onempilo nolawulwayo.

3. Ingabe kufanele ngilandele isikhathi sami sokuya esikhathini?

Ukulandelela umjikelezo wakho wokuya esikhathini kunomthelela ekuxilongeni i-amenorrhea. Sebenzisa uhlelo lokusebenza noma ijenali ukurekhoda ubude besikhathi, idethi yokugcina yokuya esikhathini, imithi, izinguquko zokudla nokuzivocavoca, nezinselele zemizwa. Lolu lwazi lusiza odokotela bathole imbangela eyisisekelo ye-amenorrhea.

4. I-amenorrhea ihlala isikhathi esingakanani?

Isikhathi se-amenorrhea siyahlukahluka kuye ngokuthi imbangela yayo. Ngokwelashwa okufanele, izikhathi ngokuvamile ziqala kabusha phakathi nezinyanga ezimbalwa. Nokho, umugqa wesikhathi oqondile uyahluka kumuntu ngamunye. 

5. Kuthiwani uma izikhathi zephuzile ngezinsuku eziyi-10?

Isikhathi sekwephuzile, ngezinsuku eziyi-10, singabangelwa ukucindezeleka, izinguquko zesisindo, noma izinkinga ze-hormonal. Uma lokhu kungavamile, cabangela ukuhlolwa kokukhulelwa futhi uthintane nodokotela wakho.

6. Iyini imbangela ehamba phambili ye-amenorrhea?

I-Amenorrhea inezimbangela ezihlukahlukene, kokubili kwemvelo kanye nezokwelapha. Ukukhulelwa kuyisizathu esivame kakhulu ngemuva kwe-amenorrhea yesibili. Ezinye izizathu zemvelo zihlanganisa ukuncelisa kanye nokunqamuka kokuya esikhathini. Izimo zezokwelapha, ukungalingani kwama-hormone, nezici zendlela yokuphila nakho kungaholela ekuguleni kwe-amenorrhea.

7. Ngibuyela kanjani esikhathini sami ngemva kwe-amenorrhea?

Ukwelashwa kugxile ekubhekaneni nembangela ewumsuka yokubuyisela ukuya esikhathini. Lokhu kungase kuhlanganise ukulondoloza isisindo esinempilo, ukulawula ukucindezeleka, ukulungisa amazinga okuzivocavoca, noma ukuphuza imithi ye-hormonal enqunyiwe. Ezimweni ezingavamile, kungase kudingeke ukuhlinzwa.

8. Ingabe i-amenorrhea ingelapheka?

Ezimweni eziningi, izikhathi ziyabuya lapho imbangela eyisisekelo seselashiwe. Nokho, kungase kuthathe isikhathi ukuthi imijikelezo iphinde ibe njalo. Ezinye izimo zezempilo zingase zibangele i-amenorrhea unomphela.

9. Ingabe i-amenorrhea iyingozi?

Nakuba kungekona ukuphila engozini, i-amenorrhea ingaholela ezinkingeni uma ingelashwa. Lokhu kungase kuhlanganise i-osteoporosis, isifo senhliziyo, izinkinga zokuzala, nobuhlungu be-pelvic. 

UDkt. Kranthi Shilpa

I-MBBS, i-MS (ObGyn), i-Fellowship in Infertility
CARE Hospitals Outpatient Centre, Banjara Hills, Hyderabad

Ukuze Ubhukhe Isikhathi, shayela:

+ 91 40-68106529

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