Ukunqamuka kokuya esikhathini, inqubo engokwemvelo yezinto eziphilayo, kusho ukuphela kweminyaka yokuzala yowesifazane.Ngokuvamile kwenzeka phakathi kweminyaka yobudala engama-45 nengu-55, nakuba isikhathi esiqondile sihluka kubantu ngabanye.Ukunqamuka kokuya esikhathini kubonakala ngokunqamuka kokuya esikhathini kanye nokwehla kwamahomoni okuzala, ikakhulukazi i-estrogen ne-progesterone.Lolu shintsho, oluphawulwa izinguquko ezihlukahlukene ezingokomzimba nezingokomzwelo, lungaba nomthelela omkhulu empilweni nasenhlalakahleni yowesifazane.Ukuqonda izigaba, izimpawu, ukuxilongwa, nokuphathwa kokunqamuka kokuya esikhathini kubalulekile ukuze uzulazule kulesi sigaba sempilo ngokuzethemba nangokunethezeka.
I. Ukuguquka Kwesikhathi Sokunqamuka kokuya esikhathini:
A. I-Perimenopause: Isigaba Esedlule
Incazelo Nobude Besikhathi: Ukunqamuka kokuya esikhathini kubhekisela enkathini yesikhashana eholela ekunqamukeni kokuya esikhathini, lapho kwenzeka khona ukushintsha kwama-hormone, futhi kungase kube nokungahambi kahle kokuya esikhathini.
Izinguquko Emazingeni E-Hormone Namaphethini Okuya Esikhathini: Amazinga e-Estrogen ne-progesterone ayashintshashintsha, okuholela ekushintsheni komjikelezo wokuya esikhathini, njengokuya esikhathini okungajwayelekile, imijikelezo emifushane noma emide, kanye nokushintsha kokugeleza.
Izimpawu Ezivamile Nezinselele: Abesifazane bangase babe nezimpawu ze-vasomotor (ukushisa okushisayo, ukujuluka ebusuku), ukuphazamiseka kokulala, ukushintsha kwemizwelo, ukomisa kwesitho sangasese sowesifazane, kanye nezinguquko ku-libido.
B. Ukunqamuka kokuya esikhathini: Ukuphela Kwesikhathi
Incazelo kanye Nesikhathi: Ukunqamuka kokuya esikhathini kuchazwa ngokomtholampilo njengokungabi khona kwezikhathi zokuya esikhathini izinyanga eziyi-12 ezilandelanayo.Isilinganiso seminyaka yobudala yokunqamuka kokuya esikhathini semvelo cishe siyiminyaka engama-51.
Izinguquko Zomzimba kanye Nokushintsha KweHormonal: Ukukhiqizwa kwe-Estrogen ne-progesterone kwehla, okuholela ekushintsheni kwemisebenzi nezinhlelo ezihlukahlukene zomzimba, okuhlanganisa ukuzala, imithambo yenhliziyo, amathambo, nezinhlelo zezinzwa.
Umthelela Empilweni Yokuzala Nokuzala: Ukunqamuka kokuya esikhathini kuphawula ukuphela kwekhono lokuzala lowesifazane, ngokuncipha kokusebenza kwesibeletho kanye nokuphela kokuzala.
C. Postmenopause: Life After Menopause
Incazelo Nobude Besikhathi: I-Postmenopause ibhekisela esigabeni esilandela ukuya esikhathini, esidlulela kuyo yonke ingxenye esele yokuphila kowesifazane.
Izinguquko Eziqhubekayo ZamaHormonal Nokucatshangelwa Kwezempilo: Nakuba amazinga e-estrogen ehlala ephansi, ukushintshashintsha kwama-hormone kungase kuqhubeke, kuthinte ukuminyana kwamathambo, impilo yenhliziyo nemithambo yegazi, kanye nokuphila kahle.
Izingozi Zezempilo Zesikhathi Eside Nokuvimbela Izifo: Abesifazane be-Postmenopausal basengozini enkulu ye-osteoporosis, isifo senhliziyo, kanye nomdlavuza othile.Ukuguqulwa kwendlela yokuphila kanye nezinyathelo zokuvimbela kubalulekile ekugcineni impilo nokunciphisa ingozi yezifo.
II.Izimpawu zokunqamuka kokuya esikhathini:
A. Izimpawu zeVasomotor
Ukushisa Okushisayo Nokujuluka Kwasebusuku: Ukuzwa ukushisa okungazelelwe, okushubile, okuvame ukuhambisana nokushaywa umoya, ukujuluka, nokushaya kwenhliziyo.
Ukuvama Nokuqina: Izimpawu ze-Vasomotor ziyahlukahluka kakhulu phakathi kwabesifazane, abanye baba nokukhanya okuthambile ngezikhathi ezithile kanti abanye baba neziqephu ezinzima.
Umthelela Ezenzweni Zansuku Zonke Nekhwalithi Yokulala: Ukukhanya okushisayo nokujuluka ebusuku kungaphazamisa amaphethini okulala, okuholela ekukhathaleni, ukucasuka, kanye nokungasebenzi kahle kwasemini.
B. Izimpawu Ze-genitourinary
Ukoma Nokungaphatheki kahle kwe-Vaginal: Ukuncipha kwamazinga e-estrogen kungaholela ekomeni kwesitho sangasese sowesifazane, ukulunywa, ukuvutha, nokungakhululeki ngesikhathi socansi.
Izinguquko Zokuchama Nokungafinyeleli: Izinguquko emgudwini womchamo, njengokunyuka kwemvamisa, ukuphuthuma, nokungakwazi ukuzithiba, kungase kwenzeke ngenxa yokuntuleka kwe-estrogen.
Umsebenzi Wezocansi Nokukhathazeka Ngokusondelana: Izimpawu ze-genitourinary zingathinta kabi isifiso socansi, inkanuko, nokwaneliseka, kuthinte ukusondelana nobudlelwano.
C. Izimpawu Zengqondo
Ukushintshashintsha Kwemizwa Nokungaqini Kwemizwelo: Ukushintshashintsha kwama-hormone ngesikhathi sokuya esikhathini kungase kube nomthelela ekushintsheni kwemizwa, ukucasuka, ukukhathazeka nokucindezeleka.
Ukukhathazeka Nokucindezeleka: Abesifazane bangase babe nemizwa eyengeziwe yokukhathazeka, yokudabuka, noma yokuphelelwa ithemba ngesikhathi sokunqamuka kokuya esikhathini, okudinga ukusekelwa ngokomzwelo nokwelulekwa.
Izinguquko Zengqondo Nokukhathazeka Ngenkumbulo: Abanye besifazane bangase babone izinguquko ekusebenzeni kwengqondo, njengokukhohlwa, ubunzima bokugxila, kanye nenkungu yengqondo, okungaba nomthelela ekusebenzeni kwansuku zonke kanye nezinga lempilo.
III.Ukuxilongwa kweMenopause:
A. Ukuhlolwa Komtholampilo Nomlando Wezokwelapha: Abahlinzeki bezempilo bahlola izimpawu zowesifazane, umlando wezokwelapha, namaphethini okuya esikhathini ukuze banqume isigaba sokunqamuka kokuya esikhathini.
B. Ukuhlolwa Kwezimpawu Nomlando Wokuya esikhathini: Ukuba khona kanye nokuqina kwezimpawu zokunqamuka kokuya esikhathini, kanye noshintsho lwamaphethini okuya esikhathini, kunikeza izinkomba ezibalulekile zokuxilonga.
C. Ukuhlolwa Kwaselabhorethri: Ukuhlolwa kwegazi ukuze kukalwe amazinga e-hormone, njenge-follicle-stimulating hormone (FSH) ne-estradiol, kungasiza ukuqinisekisa isimo sokunqamuka kokuya esikhathini.
D. Izifundo Zokucabanga: I-pelvic ultrasound kanye ne-bone density scan (DEXA scan) ingenziwa ukuze kuhlolwe impilo yesitho sokuzala kanye nokuminyana kwamathambo, ngokulandelana.
IV.Izinketho Zokulawula Izimpawu Zokunqamuka kokuya esikhathini:
A. Ukuguqulwa Kwendlela Yokuphila
Ukudla Nokudla Okunomsoco: Ukudla ukudla okulinganiselayo okucebile izithelo, imifino, okusanhlamvu okuphelele, namaprotheni angenalutho kungasekela impilo yonke futhi kunciphise izimpawu zokunqamuka kokuya esikhathini.
Ukuzivivinya Okuvamile Nokuzivocavoca: Ukuzivocavoca umzimba njalo, njengokuhamba ngokushesha, ukubhukuda, noma i-yoga, kungathuthukisa ukuma kwenhliziyo, ikhwalithi yokulala, nokuqina komzimba.
Izindlela Zokulawula Ukucindezeleka: Ukuzijwayeza amasu okuphumula, ukucabangela, ukuvivinya umzimba kokuphefumula okujulile, namasu okunciphisa ukucindezeleka kungasiza ekudambiseni ukukhathazeka futhi kukhuthaze ukuphila kahle ngokomzwelo.
B. I-Hormone Replacement Therapy (HRT)
I-Estrogen Therapy: Ukushintshwa kwe-estrogen ehlelekile noma yendawo kungadambisa izimpawu ze-vasomotor, izimpawu ze-genitourinary, kanye ne-vaginal atrophy.
I-Estrogen-Progestin Combination Therapy: Ukwelapha okuhlanganisiwe kwe-estrogen-progestin kunconywa kwabesifazane abanesibeletho esiqinile ukuze kuncishiswe ingozi ye-endometrial hyperplasia kanye nomdlavuza.
Izinzuzo, Izingozi, Nokucatshangelwa: I-HRT ingase inikeze ukukhululeka okungokomzwelo kodwa ihlotshaniswa nezingozi ezingase zibe khona, kuhlanganise nezenzakalo zenhliziyo nemithambo yegazi, umdlavuza webele, nezenzakalo ze-thromboembolic.Izinqumo zokwelashwa komuntu ngamunye kufanele zicabangele iminyaka yowesifazane, izimpawu, umlando wezokwelapha, nezici zobungozi.
C. Imithi Engezona I-Hormonal
I-Serotonin Reuptake Inhibitors (SSRIs) ekhethiwe: Imithi yokucindezeleka, njenge-paroxetine ne-venlafaxine, ingasiza ekwehliseni izimpawu ze-vasomotor nokuphazamiseka kwemizwelo.
I-Gabapentin ne-Pregabalin: Imithi ye-Anticonvulsant, njenge-gabapentin ne-pregabalin, ibonise ukusebenza kahle ekunciphiseni ukukhanya okushisa nokuthuthukisa izinga lokulala.
Ama-Antidepressants kanye nama-Anticonvulsants: Imithi ethile, njenge-duloxetine ne-gabapentin, ingase ibekwe ngaphandle kwelebula ukuphatha izimpawu zokunqamuka kokuya esikhathini, kuhlanganise nezimpawu ze-vasomotor nokuphazamiseka kwemizwelo.
D. Izindlela Zokwelapha Ezihambisanayo Nezinye
Izithako Zemithi: Izitshalo ze-Phytoestrogenic, ezifana ne-black cohosh, i-soy isoflavones, ne-clover ebomvu, zivame ukusetshenziselwa ukunciphisa izimpawu zokunqamuka kokuya esikhathini, nakuba ubufakazi bokusebenza buxubene.
Ukutshopa kanye Nomuthi Wendabuko WaseShayina: Ukutshopa kanye nemithi yendabuko yamaShayina ingase inikeze ukukhululeka kwezimpawu kwabanye besifazane ababhekene nokushisa okushisayo, ukuphazamiseka kokulala, nokushintsha kwemizwa.
Imikhuba Yomzimba Wengqondo: I-Yoga, ukuzindla, i-tai chi, nezindlela zokuphumula zingakhuthaza ukunciphisa ukucindezeleka, ukulinganisela ngokomzwelo, kanye nokuphila kahle ngesikhathi sokuya esikhathini.
V. Okucatshangwayo Kwezempilo Yesikhathi Eside:
A. I-Osteoporosis kanye Nempilo Yamathambo: Abesifazane abangemva kokuya esikhathini basengozini enkulu ye-osteoporosis nokuphuka ngenxa yokuncipha kwamazinga e-estrogen nokulahlekelwa ukuminyana kwamathambo.I-calcium, uvithamini D, ukuvivinya umzimba kwesisindo, nemithi yokuqinisa amathambo kungasiza ekugcineni impilo yamathambo.
B. Ingozi Yezifo Zenhliziyo: Ukuntuleka kwe-Estrogen kuhlotshaniswa nengozi eyengeziwe yesifo senhliziyo nemithambo yegazi, kuhlanganise nesifo senhliziyo, unhlangothi, nokuhluleka kwenhliziyo.Ukuguqulwa kwendlela yokuphila, njengokuyeka ukubhema, ukuvivinya umzimba njalo, nemikhuba yokudla enempilo, kunganciphisa izici eziyingozi zenhliziyo nemithambo yegazi.
C. Ukwehla Kwengqondo Nokuwohloka Komqondo: Okunye ukuhlola kusikisela ukuthi ukwelapha nge-hormone yokunqamuka kokuya esikhathini kungase kuthonye ukusebenza kwengqondo futhi kunciphise ingozi yokuwohloka komqondo kwabesifazane abangemva kokuya esikhathini.Kodwa-ke, ucwaningo olwengeziwe luyadingeka ukuze kucaciswe imiphumela yokwelashwa kwe-estrogen ekugugeni kwengqondo kanye nobungozi bokuwohloka komqondo.
D. Ukuhlolwa Kwezempilo Okuvamile Nokunakekelwa Kokuvimbela: Abesifazane abadlule kokuya esikhathini kufanele bahlolwe njalo impilo, okuhlanganisa i-mammography, ukuhlola ukuminyana kwamathambo, iphrofayili ye-lipid, nokukala umfutho wegazi, ukuze bathole futhi balawule izimo zempilo ezihlobene nobudala ngokuphumelelayo.
Ukunqamuka kokuya esikhathini kuyisigaba sempilo esiletha uguquko esiletha izinselele eziyingqayizivele namathuba empilo kanye nenhlalakahle yabesifazane.Ngokuqonda izigaba, izimpawu, ukuxilongwa, kanye nezinketho zokuphatha ezihlobene nokunqamuka kokuya esikhathini, abesifazane bangakwazi ukuzulazula kulolu shintsho ngokuzethemba, ngokuqina, nangokunika amandla.Abahlinzeki bezempilo badlala indima ebalulekile ekuhlinzekeni ukunakekelwa okuphelele, ukusekela, kanye nemfundo ukusiza abesifazane bathuthukise impilo yabo kanye nezinga lempilo ngesikhathi nangemuva kokunqamuka kokuya esikhathini.Ngokusebenzisa indlela ephelele yokulawulwa kokunqamuka kokuya esikhathini, okuhlanganisa ukuguqulwa kwendlela yokuphila, ukwelashwa kwamahomoni, nokungenelela okusekelwe ebufakazini, abesifazane bangamukela lesi sahluko esisha sempilo ngamandla, umusa, nangokukhuthazela.
