I-Amenorrhea

I-Amenorrhea isho ukuthi izikhathi zabo ziyayeka, futhi kungenzeka ngezizathu eziningi. Cishe owesifazane oyedwa kwabangu-4 uba ne-amenorrhea esikhathini esithile ekuphileni kwabo, ngisho noma engakhulelwe, ibele noma ukuya esikhathini. 

Odokotela baqaphela izinhlobo ezimbili eziyinhloko ze-amenorrhea. Umuntu uba ne-amenorrhea eyinhloko uma isikhathi sakhe sokuqala singakaqali eneminyaka eyi-15. Uhlobo lwesibili lwenzeka lapho ukuya esikhathini kothile kuma izinyanga ezintathu noma ngaphezulu ngemva kokuba eke waba nemijikelezo evamile. ukukhulelwa yisona sizathu esivame kakhulu sokuthi izikhathi ziyeke, kodwa ezinye izinto ezifana nokucindezeleka, ukugula okungapheli, nezinkinga zamahomoni zingenza izikhathi ziyeke, futhi.

Ukwazi ukuthi yini ebangela ukuphuthelwa yizinyanga kusiza abantu banqume ukuthi badinga ukubonana nodokotela. Odokotela basikisela ukuthi intsha kufanele ihlolwe uma ingakayi enkathini yokuqala ngeminyaka engu-15. Abantu kufanele futhi bakhulume nodokotela wabo uma izikhathi zabo ziyeka isikhathi esingaphezu kwezinyanga ezintathu ngaphandle kwesizathu esicacile.

Iyini i-Amenorrhea?

Igama elithi amenorrhea livela emagameni esiGreki asho ukuthi "akukho ukugeleza kwanyanga zonke". Ichaza ukungabibikho kwezikhathi zokuya esikhathini kwabesifazane abakwazi ukuzala abantwana. Umjikelezo ovamile wokuya esikhathini udinga izingxenye ezine zomzimba ezihlukene ukuze zisebenze kahle: i-hypothalamus, i-anterior pituitary gland, ama-ovaries, kanye nepheshana lokuphuma kwezitho zangasese.

Izinhlobo ze-Amenorrhea

Odokotela bahlukanisa i-amenorrhea ngezigaba ezimbili eziyinhloko:

• I-amenorrhea eyinhloko: Lokhu kwenzeka lapho intombazane ingangeni esikhathini sokuqala ngeminyaka eyi-15 noma phakathi neminyaka emi-3 ngemva kokukhula kwamabele ayo. Kuthinta cishe u-1-2% wabesifazane.
• I-amenorrhea yesibili: Umjikelezo wokuya esikhathini uyama izinyanga ezi-3 eziqondile kwabesifazane ababenesikhathi esivamile ngaphambi noma izinyanga ezingu-6+ kulabo ababenesikhathi okungenani esisodwa. Lokhu kuthinta cishe u-3-5% wabesifazane.

Izimpawu ze-Amenorrhea

Abesifazane bangase babe nalezi zimpawu ngaphandle kokuya esikhathini:

• Ukushisa nokoma kwesitho sangasese sowesifazane
• Ukuphuma kobisi ezingonweni (galactorrhea)
• Ubuhlungu bekhanda nokushintsha kokubona
• Ukukhula kwezinwele okwengeziwe
• induna

Izinkinga ze-Amenorrhea

Ziningana izinto ezingamisa ukuya esikhathini:

• I-amenorrhea yemvelo ibangela: Ukukhulelwa (kwenzeka kaningi), ukuncelisa, ukunqamuka kokuya esikhathini
• Ukungalingani kweHormonal: PCOS, Izinkinga ze-thyroid, izimila pituitary
• Izici zendlela yokuphila: Ukuvivinya umzimba kakhulu, izinguquko ezinkulu zesisindo, ukucindezeleka okukhulu
• Izinkinga zesakhiwo: Izibazi zesibeletho, ukungabikho kwezitho zokuzala, ukuvaleka kwesitho sangasese sowesifazane
• Imithi: Ukulawula ukuzalwa, ama-antidepressants, imiphumela emibi yokwelashwa ngamakhemikhali

Izingozi Zezingozi

Abantu babhekana nezingozi eziphakeme uma benomlando womndeni we-amenorrhea, izimo zofuzo, izinkinga zesisindo esidlulele, ukuphazamiseka kwemikhuba yokudla, noma ukuvivinya umzimba ngokweqile.

Izinkinga ze-Amenorrhea

Abesifazane abangalaphi i-amenorrhea bangase babhekane:

• Izinkinga zokukhulelwa
• Amathambo abuthakathaka avela ku-estrogen ephansi
• Isifo senhliziyo
• I-Endometrial hyperplasia
• Izinkinga zempilo yengqondo njengokukhathazeka nokudangala

Ukuxilongwa kwe-Amenorrhea

Odokotela baqala ngokuqoqa umlando wezokwelapha ophelele. Babuza mayelana nendlela yokuya esikhathini, izenzo zocansi, ukushintsha kwesisindo, imikhuba yokuzivocavoca, imithi, namazinga okucindezeleka. Kulandela ukuhlolwa komzimba okuhlanganisa ukuhlola izitho zokuzala.

Ukuhlola kuyizisekelo zokuxilongwa:

• Ukuhlolwa kokukhulelwa kuza kuqala kwabesifazane abenza ucansi
• Umsebenzi wegazi uhlola amazinga e-hormone (FSH, LH, prolactin, i-thyroid-stimulating hormone)
• Odokotela bahlola amazinga amahomoni wesilisa uma iziguli zibona izinwele zobuso noma izinguquko zezwi

Izindlela ezimbalwa zokuthatha izithombe zisiza odokotela babone okwenzekayo:

• I-Ultrasound iveza izinkinga zesitho sokuzala
• Ama-MRI scan athola izimila ze-pituitary
• Ama-CT scan akhombisa izinkinga zesibeletho noma zesibeletho

Ngezinye izikhathi odokotela benza ukuhlolwa kwe-hormone inselele. Lokhu kuhlanganisa ukuphuza imithi izinsuku ezingu-7-10 ukuze kuvuse ukopha kokuya esikhathini futhi kubonisa ukuthi amazinga e-estrogen asebenza kahle yini.

Ukwelashwa kwe-Amenorrhea

Izinketho zokwelapha ziyashintsha ngokusekelwe kulokho okubangela inkinga:

• Izinguquko ezilula zendlela yokuphila zivame ukubuyisela izikhathi emuva:
  • Ukufinyelela isisindo esinempilo ngokudla okungcono
  • Ukunciphisa ukujima okuqinile
  • Ukulawula ukucindezeleka okungcono
  • Ukuthola i-calcium eyanele (1,000-1,300 mg nsuku zonke) kanye novithamini D (600 IU nsuku zonke)
• Ukwelashwa kwemithi kufana nezimo ezithile:
  • Ukushintshwa kwama-hormone kusiza ukungasebenzi kahle kwe-ovarian
  • Amaphilisi okulawula ukuzalwa alawula imijikelezo
  • Imithi ihlose i-PCOS noma izinkinga ze-thyroid
  • Ama-agonists e-Dopamine aphatha amazinga aphezulu e-prolactin
• Ukuhlinzwa kuba inketho yezinkinga zesakhiwo ezifana nezibazi zesibeletho, izimila ze-pituitary, noma izindlela ezivimbekile.

Uzoyibona Nini Udokotela

Intsha kufanele ihlolwe uma:

• Angikaze ngibe nesikhathi ngo-15
• Ungabonisi ukukhula kwebele ngo-13

Abantu abadala kufanele babonane nodokotela wabo uma:

• Ungaphuthelwa izikhathi izinyanga ezintathu ziqondile
• Thola ubuhlungu bekhanda, izinguquko zombono, noma ubisi lwebele olungalindelekile
• Qaphela ukukhula kwezinwele zobuso okungajwayelekile

Ukuxilongwa okusheshayo kanye nokwelashwa okufanele kusiza ukugwema izinkinga zesikhathi eside, ikakhulukazi ukulahlekelwa kwamathambo. Izindaba ezinhle? Ukwelashwa kusebenza kahle kwabesifazane abaningi, nakuba kungase kuthathe izinyanga ezimbalwa ukuthi izikhathi zibuye njalo.

Imibuzo Evame Ukubuzwa

1. Ingabe i-amenorrhea isengakhulelwa?

Abesifazane bangakhulelwa ngisho ngaphandle kokuya esikhathini njalo. Ezinye izimo ezibangela i-amenorrhea zinganciphisa ukuzala, kodwa ukukhulelwa kuhlala kungenzeka. Nakhu okufanele ukwazi:

• Abesifazane abane-amenorrhea ngezinye izikhathi bakhipha i-ovulation, ikakhulukazi labo abanezimo ezifana nokuntuleka kwe-ovarian ngaphambi kwesikhathi
• Imithi yokwelapha ehlose ukungayi esikhathini ingakhuphula amathuba okukhulelwa
• Omama abancelisa ibele ngokuvamile bakholelwa ukuthi akukho ukuya esikhathini okusho ukuthi ngeke bakhulelwe, kodwa le ndlela ayithembekile.

Ukukhulelwa kwemvelo kuba nzima kodwa kungenzeki lapho i-amenorrhea ibangelwa ukuntuleka kwe-ovulation. Abesifazane abakhathazeke ngezabo ukuzala kufanele abonane nodokotela ngokushesha, njengoba ukutholwa kusenesikhathi kusiza ukubuyisela imijikelezo evamile yokuya esikhathini.

Abesifazane abane-amenorrhea badinga ukuvimbela inzalo uma befuna ukugwema ukukhulelwa njengoba ukukhulelwa kusengenzeka.

2. Uyini umehluko phakathi kwe-amenorrhea eyinhloko neyesibili?

Umehluko omkhulu usesikhathini kanye nomlando wokuya esikhathini:

• I-amenorrhea eyinhloko ibhekisela ku:
  • Akukho ukuya esikhathini ngeminyaka eyi-15
  • Izimo zofuzo, izinkinga zokukhula, noma ukubambezeleka kokuthomba kuvame ukubangela lesi simo
• I-amenorrhea yesibili ihlanganisa:
  • Izinyanga ezintathu ezilandelanayo ngaphandle kokuya esikhathini kwabesifazane ababenemijikelezo evamile
  • Izinyanga eziyisithupha ngaphandle kokuya esikhathini kwabesifazane ababenesikhathi okungenani esisodwa sangaphambilini
  • Izinga lokukhulelwa phakathi kwezinye izimbangela ezifana ne-PCOS, i-hypothalamic amenorrhea, noma ukungasebenzi kahle kwe-ovarian

3. Indlela yokuvimbela i-amenorrhea?

Ezinye izimbangela zihlala zingenakugwenywa, kodwa lawa maqhinga asiza ukwehlisa ubungozi bakho:

• Ukuphatha isisindo: Isisindo esinempilo sisiza ukugcina ibhalansi ye-hormone. Ukuba mncane kakhulu noma ukukhuluphala ngokweqile kungaphazamisa le bhalansi.
• Ukunciphisa ingcindezi: Thola izinto ezikubangela ukucindezeleka futhi usebenze ukuze uzinciphise. Umndeni, abangani, abeluleki noma odokotela bangasiza.
• Ibhalansi yokuzivocavoca: Gcina umsebenzi womzimba usezingeni elifanele. Ukuqeqesha kakhulu kungamisa imijikelezo yokuya esikhathini.
• Landelela umjikelezo wakho: Rekhoda ukuthi izikhathi ziqala nini nokuthi zihlala isikhathi esingakanani, futhi uqaphele noma yiziphi izinkinga.
• Indlela yokuphila enempilo: Yidla a Ukudla okunazo zonke, ulale kahle, futhi unciphise utshwala nokubhema.

UDkt. Neena Agrawal

MBBS, MS, FICOG, Diploma in Gynaecology, Endoscopy
Izibhedlela ze-CARE CHL, e-Indore

Ukuze Ubhukhe Isikhathi, shayela:

+91 406 810 6585