Contents
Nā lāʻau lapaʻau no ka menopause
Ke ala o ke ola
Un ke ola maikaʻi kōkua i ka hōʻemi ʻana i ka ikaika o nā hōʻailona menopausal, hoʻomaikaʻi i ke olakino cardiovascular a me ka iwi, a hāʻawi i kekahi hoomaluia kū'ē i kekahi mau pilikia olakino.
ai
ʻO nā lāʻau lapaʻau no ka menopause: hoʻomaopopo i nā mea āpau i 2 min
E hoemi i ka wela wela
- Ma mua o ka loaʻa ʻana o 3 mau meaʻai nui, e hoʻemi i nā ʻāpana a hoʻolālā i nā meaʻai maikaʻi ma waena o nā meaʻai;
- E inu nui i ka wai;
- E hōʻalo a hōʻemi nui paha i kāu ʻai ʻana i nā mea hoʻoulu: nā mea inu wela, kofe, waiʻona, nā kīʻaha laʻa;
- E ho'ēmi i kouʻaiʻana i nā sugars concentrated;
- E ʻai mau i nā meaʻai momona i nā phytoestrogens.
No nā ʻōlelo aʻo kūpono ʻē aʻe, e ʻimi i ka meaʻai i hana ʻia e Tailor: Menopause a me perimenopause. |
ʻO ka hoʻoikaika kino
ʻOi aku ka maikaʻi o kēlā me kēia ʻano hana kino ma mua o ka hana kino ʻole. No nā wāhine a pau, a me ka poʻe e komo ana i kēia wā hoʻololi, kahoʻoikaika kino i kēlā me kēia lā hāʻawi i kekahi mau pono nui:
- mālama a loaʻa i kahi kaumaha olakino;
- mālama pono i ka ʻōnaehana cardiovascular;
- hoʻemi i ka nalowale o ka iwi iwi a me ka pilikia o ka hāʻule;
- ho'ēmi i ka pilikia o ka maʻi 'aʻai umauma;
- hoʻoulu i ka makemake moekolohe.
Eia kekahi, hōʻike nā haʻawina e loaʻa i nā wahine noho ka wela wela haʻahaʻa a kaumaha paha i hoʻohālikelike ʻia me nā wahine e hoʻoikaika mau3, 4,47.
Manaʻo ʻia e hana maʻalahi ma ka liʻiliʻi 30 mau lā i kahi lā a hoʻohui i nā hoʻomaʻamaʻa maʻalahi i kāu hana maʻamau: hoʻopololei, tai chi a i ʻole yoga, no ka laʻana. No ka ʻōlelo aʻo kūpono, e nīnau i kahi kinesiologist (ke loea i ka hana kino).
Nāʻano hoʻolālā hou
Hiki i ka hanu hohonu, ka lomilomi, ka yoga, ka nānā ʻana, ka noʻonoʻo ʻana, a me nā mea ʻē aʻe ke kōkua i nā pilikia hiamoe, inā aia. Hiki ke hoʻomaha i ka hoʻomaha ʻana i nā hōʻailona ʻē aʻe o ka menopause (e ʻike i ka ʻāpana ʻO nā ala hou aku).
ka lapaʻauʻia
No ka hakakā ʻana i nā pilikia like ʻole e pili ana i ka menopause, hoʻohana nā kauka i 3 mau ʻano o ka pharmacological approaches:
- lapaʻau hormonal maʻamau;
- lapaʻau hormonal kūloko;
- lapaʻau non-hormonal.
Lapaʻau hormonal maʻamau
THEʻO ka hormone therapy hāʻawi i nā hormones e pau ai ka huna ʻana o nā ovaries. ʻAe ia i ka hapa nui o nā wahine e ʻike i kā lākou nā hōʻailona (nā wela wela, nā pilikia hiamoe, nā loli o ke ʻano) no ka lōʻihi o ka lāʻau lapaʻau hormone.
He mea nui e ʻike i ka hapa nui o nā wahine e hoʻomaka ana i ka lāʻau lapaʻau maʻamau e loaʻa hou nā hōʻailona ke hoʻōki lākou i ka mālama ʻana no ka mea e hele hou ke kino i kahi hoʻololi hormonal. Hiki i kekahi mau wahine, no ka laʻana, lawe i ka olelo hooholo e lawe i ka hormone therapy no kekahi mau makahiki a laila e hoʻoholo e hoʻōki i ka lawe ʻana i ka wā hoʻomaha, me ka ʻike e maʻalahi ka mālama ʻana i kā lākou mau hōʻailona i kēia manawa o ke ola.
Hoʻohana maʻamau ka ʻōnaehana hormone systemic i ka hui pū ʻana o nā estrogens a me nā progestins. ʻO ka estrogen wale mālama ʻia no nā wahine i wehe ʻia ka ʻōpū (hysterectomy) no ka mea, lawe ʻia i kahi manawa lōʻihi, hoʻonui lākou i ka pilikia o ka maʻi kanesa ʻōpū. ʻO ka hoʻohui ʻana i kahi progestin e hōʻemi i kēia pilikia.
I kēia mau lā, kaʻO ka hormone therapy Ua mālama ʻia no nā wahine i hōʻike ʻia nā hōʻailona o ka menopause a ʻo ka maikaʻi o ke ola i hoʻohālikelike ʻia e hōʻoia ai. ʻO ka Ka Hui o nā Obstetricians a me Gynecologists o Kanada paipai i nā kauka e kuhikuhi i ka haʻahaʻa haʻahaʻa loa no ka manawa pōkole loa. ʻO ka lōʻihi i ʻōlelo ʻia 5 makahiki.
Hiki i ka hormone therapy ke kōkua i ka lohi i ka nalowale o iwi lehulehu a pēlā e hoʻemi ai i ka pilikia o ka haʻihaʻi. Akā naʻe, ʻaʻole pono e kuhikuhi ʻia no kēia kumu hoʻokahi.
Ua loaʻa i ka lāʻau hoʻololi homoni i kekahi manawa aoao waiwai ʻaʻole pilikia, akā ʻoluʻolu. E nānā me kāu kauka.
Lawe kekahi mau wahine i nā hormones pēlā e hoomau aku, ʻo ia hoʻi, lawe lākou i nā estrogens a me nā progestins i kēlā me kēia lā. Paʻa ka haʻi ʻana. ʻO ka maʻamau, ʻaʻole lākou e hoʻomaka hou i ka wā e pau ai ka hormone therapy, inā lōʻihi ka lōʻihi. Hoʻopaʻa ʻia nā wahine ʻē aʻe iā Cyclic, a lawe i nā progestins wale nō 14 lā o ka mahina a me ka estrogen i kēlā me kēia lā. Hormonal therapy i lawe cyclically e hoʻopuka i nā "manawa hoʻopunipuni" a i ʻole kaheʻana withdrawal (ʻaʻole pili i ka ovulation, e like me ka hihia o ka pilina mana hānau).
ʻO ka lāʻau lapaʻau maʻamau
Ma Kanada, conjugated equine estrogens (Premarin®) ua lōʻihi ka mea i kauoha ʻia. Lawe ʻia kēia mau estrogens mai ka mimi o nā bipi wahine hāpai a lawelawe ʻia ma ka waha. Eia naʻe, ʻaʻole kēia ka hihia. 1er ʻO Pepeluali 2010, ua hoʻihoʻi ʻia ʻo Premarin® mai ka papa inoa o nā lāʻau i uhi ʻia e ka hoʻolālā ʻinikua lāʻau lapaʻau o Quebec, ma muli o ka piʻi nui loa o kāna kumukūʻai kūʻai.2. (Premplus®, kahi hui o ka conjugated equine estrogen a me synthetic progesterone, ua hoʻihoʻi ʻia.)
Mai ia manawa, hiki i nā kauka ke kuhikuhi i kekahi o kēia mau estrogens. He mau papa kēia e lawe ʻia ma ka waha.
- estrace®: estradiol-17ß;
- maka®: estropipate (kahi ʻano o ka estrone);
- CES®: nā estrogens conjugated synthetic.
Hoʻokomo pinepine ʻia nā Estrogens i hui pū me synthetic progestins : medroxy-progesterone acetate (MPA) e like me Check® a i ʻole micronized progesterone mai nā mea kanu like Prometrium®. ʻO ka micronized progesterone kahi ʻano o ka hormone "bioidentical" (e nānā i lalo).
ʻO nā pilikia e pili ana i ka lāʻau hormone maʻamau La Haʻawina Hoʻomaka Ola Ola Wahine (WHI), he noiʻi nui i mālama ʻia ma ʻAmelika mai 1991 a i 2006 ma waena o 160 mau wahine postmenopausal, he hopena nui i ka mālama ʻana i nā hōʻailona o ka menopause.49. Lawe ʻia nā mea komo Premarin® et du Check®, ʻo Premarin® wale nō (no nā wahine i loaʻa ʻole ka ʻōpū), a i ʻole kahi placebo. Ua paʻi ʻia nā hopena mua ma 2002. Ua pili kēia ʻai ʻana i ka hormone me ka piʻi ʻana o ka pilikia no ka wā lōʻihi o nā pilikia olakino e hiki mai ana.
Ua hoʻonui ʻia kēia mau pilikia me ka lōʻihi o ka hoʻohana ʻana a me nā mea pilikia pilikino (makahiki, nā kumu genetic a me nā mea ʻē aʻe). hoʻopuka. ʻOiai ʻaʻole i hoʻokomo ka haʻawina WHI i ka hormone therapy me Estrace®, Ogen®, a me CES®, hiki ke manaʻo ʻia ʻo kēia mau ʻano hormones e hoʻokau i nā wahine i nā pilikia cardiovascular e like me Premarin® no ka mea ua lawe ʻia lākou ma ke ala waha. |
ʻO ka lāʻau hormone bioidentical
ka nā hormones bioidentical loaʻa i ka molecular structure like me nā hormones huna ʻia e nā ovaries: estradiol-17ß (ka estrogen nui i hana ʻia e ke kino wahine) a me ka progesterone. Hoʻohui ʻia lākou i loko o ka hale hana mai nā mea kanu e like me ka soybeans a i ʻole nā uala hihiu.
Hāʻawi ʻia ka bioidentical estradiol-17ß e dermal, ka mea e hoʻokaʻawale ai ia mai ka lāʻau hormone maʻamau. Loaʻa ia ma ke ʻano o A hehi ihola au (Estraderm®, Oesclim®, Estradot®, Sandoz-Estradiol Derm® a i ʻole Climara®) a mai kūkā (Estrogel®).
I hou i kaoestradiol-17ß, kaukaʻi maʻamau nā kauka e hoʻohana i ka lāʻau bioidentical micronized progesterone. Hoʻololi ka ʻenehana micronization i ka progesterone i mau ʻāpana liʻiliʻi i hoʻopili maikaʻi ʻia e ke kino. Hāʻawi ʻia kēia e moʻolelo (Prometrium®).
Ua kuhikuhi ʻia nā hormones bio-identical no nā makahiki he nui ma Kanada a me Palani (ʻo ka inoa bio-identical he mea hou naʻe). I ka manawa kākau, ua uhi wale ʻia kēia mau lāʻau lapaʻau e ka hoʻolālā ʻinikua lāʻau lapaʻau o Quebec ma kekahi mau hihia kikoʻī. Eia naʻe, ʻo ka hapa nui o nā hoʻolālā pilikino pilikino e uku hou iā lākou.
hoʻopuka. Hiki nō hoʻi ke kūʻai aku ma luna o ka hale kūʻai hoʻomākaukau akamai o nā estrogens bioidentical, ma keʻano o ka cream i loaʻa i kahi hui o ka 3 mau mole estrogenic maoli o nā wāhine, estradiol, estriol a me estrone. Eia naʻe, ʻaʻohe ʻikepili ʻepekema i hoʻokumu i ko lākou pono a ʻōlelo ka hapa nui o nā kauka e kūʻē iā lākou. Hiki iā ʻoe ke loaʻa i nā pharmacies magistral hoʻomākaukau o pākuʻi ma ke ano o ka holika. Hoʻopau ʻia kēia mau mea. Wahi a ka Dre ʻO Sylvie Dodin, ʻaʻole kūpono ka lawe ʻana o ka progesterone ma o ka ʻili, he ʻano like ʻole mai kekahi wahine a i kekahi wahine a ʻaʻole hāʻawi i ka manaʻo kūpono e pale ai i ka ʻōpū. E hoʻomanaʻo ʻo ka lawe ʻana i ka estrogen wale nō e hoʻonui ai i ka maʻi kanesa o ka ʻōpū, a ʻo ka hoʻohui ʻana o ka progesterone e hoʻemi i kēia pilikia.
ʻOi aku ka palekana, bioidentical hormone therapy? ʻAʻohe haʻawina hiki ke hōʻoia i kēia. Wahi a ka Dre ʻO Sylvie Dodin, ʻaʻole loa e loaʻa iā mākou kahi pane i kēia nīnau, no ka mea, ʻoi aku ke kumukūʻai o kahi noiʻi hoʻohālikelike (e like me ka Women's Health Initiative Study). No laila, pono nā wahine e koho i kahi kohoʻikeʻole. ʻO kēlā ʻōlelo, ʻo ka hāʻawi ʻia ʻana o ka estrogen ma o ka ʻili e hōʻemi i ka pilikia mea'ōnaehana mānowai koko e hele pū me ka hoʻohana ʻana i ka lāʻau lapaʻau oral hormone maʻamau. ʻO ka ʻoiaʻiʻo, ma ka hele ʻana i ka ʻōnaehana digestive, a ʻoi aku ka nui o ke ake, hana nā estrogens i nā metabolites, ʻaʻole i loaʻa me nā hormones bioidentical i lawe ʻia e ka dermal. ʻO ia ke kumu i makemake ai kekahi mau kauka i nā wahine i ka pilikia o ka puʻuwai, no ka laʻana. E nana ia manao o 3 kauka ka poe hoihoi i keia ninau: Dre ʻO Sylvie Demers, Dre ʻO Sylvie Dodin lāua ʻo Dre ʻO Michèle Moreau, i kā mākou dossier Menopause: nā hormones bioidentical, ʻike ʻoe? |
Lapaʻau hormonal kūloko
ʻO ka hoʻohana ʻana o ka estrogen i nā liʻiliʻi liʻiliʻi, ʻōiwi, manaʻo e hoʻomaha i nā hōʻailona pili i Maloʻo maloʻo a i ka lahilahi o ka mucous membranes. Eia nō naʻe, ʻaʻohe hopena therapeutic i ka wela wela, nā maʻi hiamoe, a me nā maʻi ʻeha. ʻAʻole hiki i ka lāʻau hormone kūloko ke kumu i nā hopena ʻaoʻao a me nā pilikia e pili ana i ka lāʻau lapaʻau maʻamau.
Hiki ke hāʻawi ʻia nā estrogens i loko o ka ʻōpū me ka hoʻohana ʻana i ka a holika, Ma ke komo lima or papa. Ua like ko lakou pono. Hoʻokomo ʻia ka ʻaila a me nā papa i loko o ka vagina me ka hoʻohana ʻana i kahi applicator. Hana ʻia ke apo vaginal estrogen impregnated me ka plastic flexible. Ua kūpono i loko o ka ʻōpū a pono e hoʻololi i kēlā me kēia 3 mahina. ʻAʻole maikaʻi ka hapa nui o nā wahine, akā ʻike kekahi he mea hōʻoluʻolu a i ʻole i kekahi manawa ke neʻe a puka i waho o ka ʻōpū.
I ka hoʻomaka ʻana o ka lāʻau lapaʻau, inā ʻeleʻele loa ka mucosa vaginal, hiki i ka estrogen ke hoʻohana ʻia i loko o ka ʻōpū ke laha i loko o ke kino. Eia naʻe, ʻaʻole i hōʻike ʻia nā hopena olakino no ka wā lōʻihi ma nā kau i ʻōlelo ʻia.
ʻO nā lāʻau lapaʻau non-hormonal
Hiki i nā lāʻau lapaʻau non-hormonal ke hoʻemi i kekahi mau hōʻailona o ka menopause.
Kūʻē i nā uila wela
Nā lāʻau hōʻeha. Hōʻike nā haʻawina e hiki i kekahi mau antidepressants ke hoʻemi i ka wela wela (akā ʻoi aku ka hopena ma mua o ka hoʻomaʻamaʻa hormone) inā ʻaʻole i lalo ke kaumaha. He koho maikaʻi paha kēia koho no ka wahine i loaʻa nā hōʻailona depressive a me nā wela wela, akā ʻaʻole makemake e lawe i nā hormones.
Nā lāʻau antihypertensive. ʻO Clonidine, kahi lāʻau i hoʻohana ʻia e hoʻohaʻahaʻa i ke koko, ua hōʻike ʻia he ʻoi aku ka maikaʻi ma mua o ka placebo i ka hoʻomaha ʻana i ka wela wela. Akā naʻe, ʻaʻole i hoʻohana nui ʻia kēia lāʻau no ka mea he nui nā hopena ʻaoʻao, e like me ka waha maloʻo, ka hiamoe a me ka constipation.
Kūʻē i ka maloʻo o ka waha
Ua hōʻike ʻia ʻo Replens® Moisturizing Gel he mea hoʻomaʻemaʻe vaginal maikaʻi i ka hoʻomaha ʻana i ka ʻeha a me ka huhū a me ka ʻeha i ka wā o ka moekolohe. Hoʻohana ʻia i kēlā me kēia 2 a 3 mau lā.
Kūʻē i nā ʻano ʻano
ʻAʻole pono ka hoʻohana ʻana i nā antidepressants, anxiolytics a me nā lāʻau hiamoe i ka arsenal o ka mālama menopause maʻamau. Pono kā lākou ʻōlelo kuhikuhi e hoʻokō i nā pae hoʻohālike like a me ke koʻikoʻi like me nā manawa ʻē aʻe o ke ola.
Kū'ē i ka osteoporosis
Hoʻohana ʻia kekahi mau lāʻau lapaʻau non-hormonal e hoʻonui i ka iwi iwi a hoʻemi i ka pilikia o ka haki. E ʻike i ka ʻāpana lapaʻau lapaʻau o ka pepa ʻoiaʻiʻo Osteoporosis.
Kū'ē i nā pilikia moe
ʻO kekahi mau manaʻo e hoʻomaʻamaʻa i ka hiamoe: hoʻomaʻamaʻa mau, hoʻohana i nā ʻano mea like ʻole e hoʻomaha ai (hohonu hohonu, lomilomi, etc.), pale i ka caffeine a me ka waiʻona a inu i ka chamomile Kelemania a i ʻole ka lāʻau valerian ma mua o ka moe.6. E nānā pū i ka hiamoe maikaʻi - He alakaʻi hoʻomaʻamaʻa.
ʻAʻohe ola
Hōʻike nā haʻawina i nā wahine me ola moe kolohe ʻoi aku ka liʻiliʻi o nā hōʻailona i ka menopause ma mua o ka poʻe me ka liʻiliʻi a i ʻole ka moe kolohe7. Akā ʻaʻole ʻike ʻia inā he kumu a me ka hopena pili a i ʻole he coincidence maʻalahi ma waena o nā mea ʻelua.
Eia nō naʻe, ʻike maopopo ʻia ka menopause i hoʻopaʻa ʻia e nā hōʻailona he nui e hoʻopau i ke ola wahine. Eia nō naʻe, hiki i kekahi ke mālama i kahi ola wahine ikaika a ʻoluʻolu ma o ka hoʻohana ʻana i ka lāʻau hormone vaginal, moisturizer vaginal a i ʻole lubricant.
E hoʻomanaʻo, hiki i ka hoʻoikaika kino ke hoʻāla i ka makemake i nā wahine. No ka mālama ʻana i ka libido ʻeleu, he mea nui hoʻi e mālama i ka kamaʻilio maikaʻi me ka wahine a me ka mālama ʻana i ke koʻikoʻi ma ka laulā (hana, etc.).
Testosterone. ʻO ke kuhikuhi ʻana i ka testosterone i nā wahine postmenopausal he mea maʻamau i ʻAmelika ʻAmelika. Eia nō naʻe, ʻoi aku ka nui o nā kauka e hana nei e hoʻihoʻi a hoʻonui i ka libido, ʻoi aku hoʻi i nā wahine i loaʻa i nā ovaries ʻelua i ka ʻoki ʻia. ʻAʻole maopopo ka hopena o ka hoʻohana ʻana i ka testosterone i nā wahine. No laila pono mākou e noʻonoʻo i kēia lapaʻau ma ke ʻano he hoʻokolohua.
E nānā i kā mākou palapala ʻoiaʻiʻo Female Sexual Dysfunction.
kumukanawai a
ʻO ka ʻōlelo aʻoaʻo wale nō e pili ana i ka hoʻohana ʻana i ka calcium a me nā mea hoʻohui huaʻai D e hakakā aiosteoporosis, ma kekahi mau hihia. No nā kikoʻī hou aku, e ʻike i ka pepa ma ka osteoporosis a me nā mea i hoʻolaʻa ʻia i kēia mau huahana 2.
Nā ʻōlelo aʻoaʻo no ka pale ʻana i ka wela welaE hoʻokaʻawale i ka manawa e noʻonoʻo ai i ke kumu o kāu mau wela wela a laila e pale aku iā lākou. O kahi laʻana :
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