kaʻāmene no kaka loaʻa ʻole o ka menstruation i kahi wahine hānau keiki. ʻO ka huaʻōlelo "amenorrhea" mai ka Helene mai a no ka hoʻonele, melancholy no nā mahina a ka rhea piholo.

Mai ka 2% a i ka 5% o nā wahine e loli ʻia e ka amenorrhea. ʻO kēia kahi symptom ka mea nui e ʻike i ke kumu. Kūlohelohe ka ʻole o nā wā ke, ʻo kahi laʻana, hāpai ka wahine, hānai a kokoke paha i ka menopause. Akā ma waho o kēia mau kūlana, hiki ke lilo i hōʻailona hōʻailona o ke kaumaha mau loa a i ʻole kahi pilikia olakino e like me ka anorexia a i ʻole kahi maʻi o ka momona thyroid.

Nā ʻano o nā wā i hala

• ʻAmenehea kumu: i ka makahiki 16, ʻaʻole i hoʻomaka ʻia kāu wā. ʻO nā ʻano moekolohe lua (hoʻomohala ʻana i ka umauma, ka lauoho i ka pubis a me nā ʻelima a me ka hāʻawi ʻana i nā mea momona i nā pūhaka, nā ʻūhā a me nā ʻūhā.
• Amenorea lua: i ka manawa i loaʻa ai i kahi wahine kona wā a kū i ka loaʻa ʻana o kāna wā no kekahi kumu a i ʻole ʻē aʻe, no kahi manawa e like me ka liʻiliʻi o 3 mau manawa o nā wā mua a i ʻole 6 mau mahina me ka ʻole o ka menstruation.

I ka manawa e nīnau ai inā ʻaʻohe ou kau?

ʻO nā manawa pinepine, ʻaʻole ʻike i ke kumu o ka amenorrhea e hopohopo nei. Pono kēia poʻe ʻike i ke kauka :

- nā wahine me ka amorrhea mua a kula ʻelua paha;

- i ka hanana o ka amenorrhea post-contraceptive, pono ka loiloi lapaʻau inā hoʻomau ka amenorrhea ma mua o 6 mau mahina i nā wahine i kau i ka pill contraceptive, i komo i ka Mirena® hormonal IUD, a ʻoi paha ma mua o 12 mau mahina ma hope o ka ka pahu hope loa o Dépo-Provera®.

Kānāwai o amenorrhea

I ka hapanui o nā hihia, kaʻike i kaʻike kino, no kahi an ʻōhumu hoʻomaʻamaʻa a i kekahi manawa ua lawa ka ultrasound o nā mea moekolohe e alakaʻi i ke kuhi.

ʻO kahi x-ray o ka pulimaʻu (e nānā i ka ulu ʻana o ka pubertal), hoʻāʻo ʻia ka hormone a i ʻole ka hoʻāʻo ʻana i ka moekolohe chromosomal i nā hanana kakaʻī o ka amorrhea mua.

Nā kumu o ka hala ʻana o nā wā

Nui nā kumu o ka amenorrhea. Eia nā mea pinepine pinepine i ka iho ʻana i lalo.

• Ka hāpai keiki. ʻO ke kumu maʻamau o ka amenorrhea lua, ʻo ia ka mea i manaʻo mua ʻia i ka wahine hana kolohe. ʻO ka mea kupaianaha, hana pinepine ia e hōʻole ʻia kēia kumu me ka ʻole o ka nānā mua ʻana, ʻaʻole ia me ka ʻole o ka makaʻu. Hōʻike ʻia kekahi mau hōʻailona e mālama i ka amenorrhea i ka hāpai ʻana. A me nā hoʻāʻo e loaʻa ana i ka ʻoihana, maʻalahi ka ʻike.
• Hoopanee iki i ka wā ʻōpio. ʻO ia ke kumu pinepine o ka amenorrhea mua. ʻO ka makahiki ʻōpio ma waena o 11 a 13 mau makahiki, akā hiki ke loli i ka nui o ka lāhui, kahi o ka ʻāina, ka papaʻai, a me ke kūlana olakino.

   

  I nā ʻāina kūkulu, he mea maʻamau ka wā ʻōpio i nā wahine ʻōpio lahilahi a haʻuki paha. Me he mea lā ʻaʻohe lawa o ka momona o ke kino o kēia mau wahine ʻōpio e ʻae ai i ka hana ʻana o nā estrogen estrogen. ʻAe ʻo Estrogens i ka uhi o ka uterus e mānoanoa, a ma hope o ka menstruation inā ʻaʻole i hoʻohua ʻia ka hua manu e kahi sperm. I kekahi ʻano, pale kūlohelohe nā kino o kēia mau wahine ʻōpio iā lākou iho a hōʻailona me ka lawa ʻole o ko lākou ʻano kino e kākoʻo ai i ka hāpai keiki.

   

  Inā loaʻa ko lākou ʻano moekolohe ʻelua (ke nānā aku i nā umauma, ka lauoho pubic a me nā lima lima), ʻaʻohe mea e hopohopo ai ma mua o ka makahiki 16 a 17 paha. Inā ʻaʻole i loaʻa nā ʻōuli o ka moekolohe ma ka makahiki 14, kahi pilikia chromosomal (kahi X sex chromosome ma kahi o 2, kahi ʻano i kapa ʻia ʻo Turner Syndrome), kahi pilikia me ka hoʻomohala ʻana o ka ʻōnaehana hānau a i ʻole ka pilikia hormonal.

• Hānai umauma. ʻO ka manawa pinepine, ʻaʻohe manawa o nā wahine hānai. Eia nō naʻe, pono e hoʻomaopopo he hiki nō iā lākou ke hoʻopili i kēia wā, a no laila he hāpai hou. Hoʻomaha ʻo Breastfeeding i ka ovulation a pale aku i ka hāpai ʻana (99%) inā wale nō:

  - lawe ka pēpē i ka umauma wale nō;

  - emi ka pēpē ma lalo o 6 mau makahiki.

• Ka hoʻomaka ʻana o ka menopause. ʻO Menopause ka hoʻomaha kūlohelohe o nā pōʻai menstrual i kū i nā wahine ma waena o nā makahiki 45 a me 55. Hoʻoemi haʻahaʻa ka hana ʻana o ka estrogen, e hoʻonāukiuki ana i nā wā a laila hele loa. Hiki iā 'oe ke ovulate sporadically no 2 mau makahiki ma hope o kou kūʻana i ka loaʻaʻana o kāu manawa.
• Lawe i ka pale hormonal. ʻO nā "wā" e kū nei ma waena o ʻelua mau paina o nā pila ʻaʻole pili nā manawa i kahi pōʻaiapuni ovatory, akā ʻo "withdrawal" kahe ke hoʻopau ʻia nā papa. ʻO kekahi o kēia mau huaale e hoʻoliʻiliʻi i ke kahe ʻana o ke kahe, i kekahi manawa ma hope o kekahi mau mahina a i ʻole mau makahiki o ka lawe ʻana ʻaʻole paha e hana hou ʻia. ʻO Mirena® hormonal intrauterine device (IUD), hoʻokomo ʻia ʻo Depo-Provera®, paukū contraceptive mau, Norplant a me Implanon implants hiki i ka amenorrhea. ʻAʻole koʻikoʻi a hōʻike i ka pono contraceptive: pinepine ka mea hoʻohana i kahi "ʻano hormonal o ka hāpai" a ʻaʻole ovulate. No laila ʻaʻohe ona pōʻaiapuni a i ʻole nā ​​lula.
• Ke kū nei i ka lawe ʻana i kahi hana pale (nā pills kaohi hānau, Depo-Provera®, Mirena® hormonal IUD) ma hope o kekahi mau mahina a mau makahiki paha o ka hoʻohana. He mau mahina paha ka lōʻihi ma mua o ka hoʻihoʻi ʻia o ke kaʻina maʻamau o ka ovulation a me ka menstruation. Kapa ʻia ʻo ia ʻo amenorrhea post-contraceptive. I ka ʻoiaʻiʻo, hana nā ʻano hana hana pale hormonal i ke ʻano hormonal o ka hāpai ʻana, a no laila hiki ke hoʻopaneʻe i nā manawa. No laila, lawe paha kēia i kekahi manawa e hoʻi ma hope o ka hoʻōki ʻana i ke ʻano, e like me ma hope o ka hāpai ʻana. ʻO kēia ka hihia i nā wahine i lōʻihi loa (ʻoi aku ma mua o 35 mau lā) a me ka pōʻaiapuni kuhi ʻole ma mua o ka lawe ʻana i ke ʻano hana pale. ʻAʻohe pilikia pilikia ka amenorrhea post-contraceptive a ʻaʻole ia e hoʻopili i ka momona ma hope. ʻO nā wahine ʻike lākou he pilikia momona kā lākou ma hope o ka hānau ʻana i loaʻa iā lākou ma mua, akā ma muli o kā lākou hana ʻoki ʻana, ʻaʻole lākou i "hoʻāʻo" i ko lākou momona.
• Ka hana o ke aʻo a i ʻole kahi haʻuki koi e like me ka marathon, bodybuilding, gymnastics a i ʻole ballet ʻoihana. Manaʻo ʻia ka “wahine haʻuki wahine amene” e pili ana i ka lawa ʻole o nā kino momona a me ke koʻikoʻi i hoʻokau ʻia ai ke kino. Loaʻa ka nele o ka estrogen i kēia mau wahine. Hiki iā ia no ke kino ke hoʻopau ʻole i ka ikehu me ka ʻole ma muli o ka hana pinepine ʻana i ka papa calorie haʻahaʻa. ʻO ka amenorrhea he 4-20 mau manawa i ʻike pinepine ʻia i nā poʻe haʻuki ma mua o ka heluna lehulehu¹.
• Hoʻopilikia a haʻalulu psychological paha. ʻO nā mea i kapa ʻia he psychogenic amenorrhea nā hopena mai ka noʻonoʻo psychological (make i loko o ka ʻohana, hemo, haʻalele i ka hana) a i ʻole kekahi ʻano koʻikoʻi koʻikoʻi (huakaʻi, nā hoʻololi nui i ka nohona, a pēlā aku.). Hiki i kēia mau kūlana ke hoʻopilikia i ka hana o ka hypothalamus no ka manawa pōkole a hoʻokū i ka menstruation e like me ka lōʻihi o ke kumu o ke koʻikoʻi.
• ʻO ke kaupaona wikiwiki a me ka lawena ʻai pathological. Hiki i ke kaumaha o ke kino ke alakaʻi i kahi hāʻule o ka hana estrogen a me ka hoʻomaha ʻana o ka menstruation. I ka hapanui o nā wahine e ʻeha i ka anorexia a i ʻole bulimia, kū nā wā.
• Huna nui o ka prolactin mai ka pituitary gland. ʻO Prolactin kahi hormone e hāpai i ka ulu a me ka lactation o ka mammary gland. Hiki ke kumu ʻia ka hūnā nui ʻia o ka prolactin mai ka pituitary gland e kahi maʻi liʻiliʻi (ka mea maʻa mau) a i ʻole kekahi mau lāʻau lapaʻau (ʻoiaʻiʻo nā antidepressants). I ka hihia hope, maʻalahi kāna lāʻau: hōʻike hou nā lula i kekahi mau pule ma hope o ka hoʻōki ʻana i ka lāʻau.
• Ka momona a i ʻole ke kaupaona.
• Lawe i kekahi mau lāʻau e like me corticosteroids waha, antidepressants, antipsychotics, a me chemotherapy. Hiki i ke kuhi lāʻau ke kumu i ka amenorrhea.
• ʻArskū Uterine. Ma hope o ke kahakaha ʻana e mālama ai i nā fibroids uterine, ka hopena endometrial, a i ʻole i kekahi manawa kahi ʻāpana cesarean, aia paha kahi hōʻemi nui o ka menstruation, a i ʻole amenorrhea kuewa a mau loa paha.

ʻO nā kumu aʻe ua emi mai ka liʻiliʻi.

• He anomaly ulu nā kino moekolohe o nā kumu kūlohelohe ʻole. ʻO Androgen insensitivity syndrome ke alo, i kahi kumuhana XY (genetically male), o nā kino wahine e nānā ana ma muli o ka ʻike ʻole ʻia o nā hunaola i nā kāne kāne. ʻO kēia poʻe "intersex" me kahi hiʻohiʻona wahine e kūkākūkā ma ka wā ʻōpio no ka amorrhea mua. ʻO ka hoʻokolohua hoʻokolohua a me nā ultrasound e ʻae i ka hōʻailona: ʻaʻohe o lākou he kōpū, a aia kā lākou mau ʻōpū wahine (testes) i loko o ka ʻōpū.
• Nā maʻi maʻi a i ʻole endocrine. ʻO kahi tumo ovarian, polycystic ovary syndrome, hyperthyroidism, hypothyroidism, a pēlā aku. Nā maʻi maʻi e hele pū me ka pohō kaumaha (tuberculosis, maʻi ʻaʻai, rheumatoid arthritis a me nā maʻi ʻōnaehana ʻōnaehana ʻē aʻe.).
• Nā lāʻau lapaʻau. ʻO kahi laʻana, wehe ʻoki ʻana o ka uterus a i ʻole nā ​​ovaries; ka chemotherapy maʻi ʻaʻai a me ka radiotherapy.
• ʻO kahi anomaly anatomical nā mea moekolohe. Inā ʻaʻole perforated ka hymen (imperforation), hiki i kēia ke hele pū me ka amenorrhea ʻeha i loko o ke kaikamahine ʻōpio: ʻo nā wā mua i paʻa i ka lua o ka pūpū.

Ka papa a me nā pilikia kūpono

ʻO ka lōʻihi o kaʻāmenepili i ke kumu kumu. I ka hapanui o nā hihia, hiki ke hoʻihoʻi ʻia ka amenorrhea a maʻalahi e mālama ʻia (me ka ʻokoʻa, ʻoiaʻiʻo, o ka amenorrhea e pili ana i nā ʻano kūlohelohe, nā malformations non-operable, menopause a i ʻole ka hemo ʻana o ka uterus a me nā ovaries). Eia nō naʻe, ke waiho lōʻihi ʻole ʻia ka amenorrhea, hiki i ke kumu ke kiʻi i nā ʻano hana o ka mea maʻi. kope.

Hoʻohui ʻia, amenorrhea e pili ana me ka nele o ka estrogen (amenorrhea i hoʻokumu ʻia e ke koi ʻana i nā haʻuki a i ʻole kahi maʻi ʻai) ʻoi aku ka makaʻu o ka osteoporosis lōʻihi - no laila o fractures, ka paʻa ʻole o ka vertebrae a me ka lordosis - ʻoiai he mea nui ka estrogen i ka mālama ʻana i ka iwi o ka iwi. Hoʻomaopopo maikaʻi ʻia i kēia manawa ʻo nā ʻaleʻa wahine e ʻehaʻeha i ka amenorrhea i ka liʻiliʻi o ka iwi ma mua o ka maʻamau, ʻo ia ke kumu e maʻalahi ai lākou i nā haki.¹. ʻOiai ʻo ka hoʻoikaika kino e kōkua i ka pale ʻana i ka osteoporosis, ʻo ka nui o ka hoʻoikaika kino ka hopena ʻē aʻe inā ʻaʻole kaulike ʻia e ka lawe ʻana o ka calorie kiʻekiʻe.