Yintoni i-PCOS?

Imfundo yezeMpilo

Njengoko uMick Jagger wayesibonisa ukuhamba kwakhe, mna nomhlobo wam sasikhala-sicula kunye nomculo kwaye sithatha umboniso. Kwaye kwenzeka. Isandla sam si brashe isilevu sam, kwaye ndaziva ukuba iinwele zokuqala ezinwele. Ndandineminyaka eli-14 ubudala; Ndingade ndiqale ukucheba imilenze yam ... ndingaba neenwele ezikhulayo ebusweni bam? Ndichithe ikonsathi yonke ngokukrakra ndingena kumhlaseli wekota-intshi ngelixa uMick ekhala ngokungakwazi kwakhe ukoneliseka. Le yayiyinto yam yokuqala endinayo isifo se-ovary polycystic (PCOS), ingxaki eqhelekileyo yehomoni phakathi kwabafazi abakwiminyaka yokuzala.

Yintoni i-PCOS?

I-PCOS yimeko yehomoni ebandakanya i-endocrine kunye neenkqubo zokuzala. It ichaphazela phakathi kwe-5% kunye ne-13% Abafazi abaphakathi kweminyaka eli-15 ukuya kwengama-44 ubudala, kwaye kunokubangela ukwandisa amaqanda okanye ii-cysts ezincinci ze-ovari. Kuphela kusemva kokuchongwa kwam njengomntu ofikisayo nalapho ndafumanisa ukuba bangaphi abanye abantu basetyhini ebomini bam abakwimeko efanayo. Kuxhaphake kakhulu kunokuba abaninzi abafazi beqonda.

Zeziphi iimpawu zokuqala zePCOS?

Iimpawu zePCOS ziyahluka ukusuka komnye umntu ukuya komnye. Umntu one I-PCOS inokubonisa ezinye okanye zonke ezi zinto zilandelayo:

• Amaxesha okuya exesheni ngokungaqhelekanga, kubandakanya ukungayi exesheni, ukuhlala exesheni rhoqo, ukuphuma kwegazi kakhulu, okanye ukopha ngaphandle kwe-ovulation
• Ukutyeba okanye ukutyeba kakhulu
• Kunzima ukunciphisa umzimba
• Iingxaki zokuchuma okanye ukungachumi
• Intlungu yePelvic
• Ukukhula okungaphezulu kweenwele kwiindawo ezinje ngobuso, isifuba, isisu, okanye amathanga-ngamanye amaxesha abizwa ngokuba yi-hirsutism
• Ulusu olunamafutha
• Amabala, ngakumbi ukuba aqatha, ukuqala kwangoko, kunye / okanye akaphenduli kakuhle kunyango lwekhawuntareni
• I-Acanthosis Nigricans (iipatches ezimnyama, ezixineneyo, isikhumba esimnyama),ifunyenwe kwimiqolo yentamo, emakhwapheni, kwi-groin nakwezinye iindawo

Yintoni ebangela iPCOS?

Unobangela wePCOS akaziwa, uyacacisa U-Ann Peters , MD, ugqirha wamazinyo kunye noogqirha kwiZiko leGynecology kwiziko lonyango iMercy eBaltimore, eMaryland. I-PCOS sisifo esintsokothileyo ekukholelwa ukuba siyinxalenye yokuzalwa (ilifa) nakwinxalenye yendalo esingqongileyo. I-PCOS inokusebenza kwiintsapho. Phantse esinye sezigulana ezine ezine-PCOS sinomama owaye wafumanisa ukuba une-PCOS (kwezinye izifundo eli nani liphezulu kakhulu).

Ngelixa izinto zemfuza nezokusingqongileyo zikrokrelwa, UGeoffrey Cly , MD, i-OB / GYN eFort Wayne, eIndiana, ithi akukho zifundo zibonise ngokucacileyo ikhonkco lemfuzo okanye into ethile yokusingqongileyo ebangela iPCOS.

Njengokuba ibisenzelwa mna, i-PCOS ihlala ikhula kwinqanaba lokufikisa, kodwa uGqirha uPeter uthi, ukuxilongwa kunokulibaziseka kangangeminyaka embalwa emva kokuqala kwexesha, njengoko imijikelezo yokuya exesheni engaqhelekanga ingaqhelekanga njengonxibelelwano phakathi kwengqondo, amaqanda, kunye nokuvuthwa kwesibeleko.

Iipilisi zolawulo lokuzalwa zinokufihla iimpawu kwaye zibangele iziphumo zovavanyo ezingachanekanga, ezibangela ukulibaziseka phakathi kokuqala kwePCOS kunye nokuxilongwa. I-PCOS isenokungafunyanwa de izigulana ziyeke iindlela zolawulo lokuzalwa okanye ziqaphele amaxesha angaqhelekanga njengoko bezama ukukhulelwa, ucacisa uGqirha uPeter, esongeza ukuba kwezinye iimeko i-PCOS ibonakala kamva ebomini-ngakumbi kwabasetyhini abathe bafumana ubunzima ngokulandelelana ngexesha lokufikisa kwabo nasekuqaleni Ngama-20.

Ikliniki yaseMayo ikhankanya amanqanaba aphezulu e-insulin-ihomoni elinganisa amanqanaba eswekile yegazi, ukuveliswa kwe-androgen egqithileyo, kunye nokudumba okumgangatho ophantsi njengezinto ezinobungozi ezinokudlala indima kwi-PCOS, kodwa ukuza kuthi ga ngoku oyena nobangela awaziwa.

Ngaba i-PCOS imbi?

Ngelixa ezinye zeempawu zePCOS, ezinje ngeenwele ezingaphezulu okanye amabala yimicimbi yezithambiso, iPCOS inxulunyaniswa nezinye iingxaki zempilo.

Abasetyhini abane-PCOS basemngciphekweni okhulayo wenani leengxaki zonyango, utshilo uGqirha Peters. [Ezi zinto zibandakanya] isifo se-metabolic syndrome (ingqokelela yokuxilongwa kubandakanya uxinzelelo lwegazi oluphezulu, ukungaqheleki kwe-lipid, kunye nokukhuluphala)[umgca wesibeleko]umhlaza.

Ezinye iingxaki zinokubandakanya i-apnea yokulala, i-steatohepatitis engeyiyo yotywala (ukudumba kwesibindi okubangelwa kukuqokelelana kwamafutha esibindini), isifo seswekile sokukhulelwa, kunye nokuphuma kwesisu okanye ukuzalwa ngaphambi kwexesha.

Oku akuthethi ukuba bonke abantu basetyhini abane-PCOS baya kuphuhlisa le meko, kodwa ukonyuka komngcipheko wezempilo kuthetha ukuba ukunyanga i-PCOS kubalulekile. Ugqirha Peters uxela ukuba i-PCOS sisifo esihlala ixesha elide.

I-PCOS inokuchaphazela impilo yengqondo. Uxinzelelo kunye nokuphazamiseka ngokweemvakalelo [yimibandela ebalulekileyo] ekufuneka ingashiywanga inganyangwa ngengcebiso, unyango lweqela, kunye / okanye amayeza xa kufanelekile, utshilo uGqirha Cly.

Isifundo ijongiswe nguNjingalwazi we-University of Nursing University uNancy Reame, i-MSN, i-Ph.D., kwaye yapapashwa kwi Ijenali yeeNkonzo zezeMpilo kunye noPhando ifumanise ukuba isitenxo sokuya exesheni lolona phawu luhambelana kakhulu neengxaki zengqondo.

Ichongwa njani iPCOS?

Isinyathelo sokuqala kukubona umboneleli wakho wezempilo. Ugqirha wakho jikelele yindawo elungileyo onokuqala kuyo. Kuxhomekeka kwiimpawu zakho kunye nonyango olufunekayo, ugqirha wakho unokukuthumela ukuba ubone ugqirha wezempilo yabasetyhini okanye ezinye iingcali ezinje nge-gynecologist, i-endocrinologist, kunye / okanye ugqirha wesikhumba.

Ugqirha wakho unokubuza malunga neempawu zakho kunye nokuba bakhona ixesha elingakanani, kunye nokuba ngawaphi amayeza owathathayo. Banokukuthumela kuvavanyo lwegazi, ngakumbi ukujonga amanqanaba aphezulu e-androgen,okt testosterone(ihomoni yamadoda).

I-ultrasound yokujonga i-ovarian cysts inokucetyiswa nayo. Abasetyhini abangenayo i-PCOS banokuba ne-cysts, kodwa abangaphantsi kwe-12 abahlangabezani neendlela zokuqonda isifo, ubhala UGqirha Jessica Chan, unjingalwazi oncedisayo we-Obstetrics kunye ne-Gynecology e-Cedars-Sinai kunye ne-endocrinologist yokuzala ene-PCOS ekhethekileyo.

Ugqirha Chan ukwabonisa ukuba abanye abantu basetyhini abane-PCOS abanakho ukuba ne-cysts kwaphela. Ndawela kolu luhlu ngexesha lokuchongwa kwam kwaye kwiminyaka emininzi emva koko. Ugqirha wam wandicacisela ke ngenxa yokuba i-PCOS sisifo, ii-cyst ze-ovari akufuneki zibekhona ukwenza uxilongo lwe-PCOS ukuba zikhona ezinye iimpawu.

UGqr Chan udwelise iikhrayitheriya zokuchongwa kwe-PCOS njengokubonisa ngezi zimbini okanye nangaphezulu kwezi zilandelayo:

• Ixesha elingaqhelekanga, elinzima, okanye elilahlekileyo ngenxa ye-ovulation ephosiweyo (oku kunokuba sisizathu sokuzala)
• Iimpawu zamanqanaba aphezulu-kunesiqhelo ee-androgens, ezinokuthi zibandakanye ukugqithisa kweenwele zomzimba kwiindawo amadoda akhula kuzo iinwele (ubuso, isifuba, umva, njl.njl.), Okanye ukulahleka kweenwele. Amanqanaba eAndrogen anokujongwa kwakhona ngegazi.
• I-12 okanye ii-cysts ezingama-ovari (ezinkulu kunezinto eziqhelekileyo zeqanda) njengoko kubonisiwe nge-ultrasound.

Uluhlu lweemvavanyo zihlala zi-odolwa ukuthintela ubukho bazo naziphi na ezinye iingxaki zehomoni.

Ngaba i-PCOS inokunyanga?

Ngelishwa, akukho lunyango lwe-PCOS, kodwa oko akuthethi ukuba abantu abanesifo kufuneka babandezeleke. Iimpawu ze-PCOS zilawulwa ngempumelelo ngamayeza kunye notshintsho kwindlela yokuphila, uGqr. Nokuba ukungachumi okwenziwa zizigulana ze-PCOS kungoyiswa ngempumelelo ngonyango.

Iphathwa njani iPCOS?

Iimpawu ze-PCOS ziphathwa ngendlela enye okanye indibaniselwano yeendlela ezintathu: utshintsho kwindlela yokuphila, amayeza, kwaye (kunqabile) ngotyando.

Utshintsho kwindlela yokuphila

Utshintsho kwindlela yokuphila kunye nokwehla kobunzima zizinto eziphambili kunyango lwe-PCOS, utshilo uGqirha uPeter.

Ukwehla kobunzima kunye nokutya okusempilweni zezona ndlela zisebenzayo zonyango ezinganyangiyo, utsho njalo uGqirha Cly, esongeza, Ukuphuculwa kwePCOS kuqala ngokulahleka kobunzima [obungaphezulu kwe] 5% yobunzima bomzimba. Ukuphuculwa kweempawu kukhulu nangokwehla kobunzima.

Kwinqaku lakhe leCedars-Sinai, uGqirha Chan ucebisa abaguli abane-PCOS ukuba bahlale bekhuthele, kubandakanya imizuzu engama-30 ukuya kwengama-40 yokuzilolonga iintsuku ezintathu ukuya kwezine ngeveki. Ucebisa nokuba amkele ukutya okune-carbohydrate ephantsi. Abasetyhini abane-PCOS abasoloko beqhuba ii-carbohydrate ngokulula njengabanye abafazi. Ii-carbohydrate ezininzi ezicokisekileyo ezinje ngeswekile zingakhokelela ekumelaneni ne-insulin kunye nokuzuza ubunzima, utshilo.

Amayeza

Amachiza aqhelekileyo iihomoni zolawulo lokuzalwa ngohlobo lweepilisi okanye isiziba okanye umsesane, utshilo uGqirha Cly, kuba ezo zilawula imijikelo yokuya exesheni… kwaye ziyanciphisa nenani le testosterone elijikelezayo oko kuyakunceda nokukhula kweenwele ngokunjalo.

IMetformin , ichiza elisetyenziselwa ukulawula iswekile ephezulu kubantu abanesifo seswekile sesi-2, kunye namanye amayeza eswekile ngamanye amaxesha amiselwe i-PCOS kuba anciphisa ukumelana ne-insulin.Isetyenziswa njengechiza elenziwe ngaphandle kwelebheli njengoko ulawulo lwezoKutya kunye noLawulo lweziyobisi (i-FDA) alulwamkelanga unyango lwe-PCOS ngenxa yokuba umenzi engakhange afune imvume; nangona kunjalo nedatha yophando yeklinikhi, liyeza elisetyenziswa kakhulu.UGqr. Cly akabacebisi kuba izifundo zangexesha elide azibonisanga luncedo. UGqirha Cly ucacisa into eyodwa, nangona kunjalo, xa owasetyhini ezama ukukhulelwa esongeza i-metformin kwi-Clomid okanye i-Femara iya konyusa amathuba okukhulelwa amaxesha aphindwe kathathu kunokuba (iyeza lokukhuthaza amayeza) I-Clomid / i-Femara yodwa.

Ezinxulumene: Sebenzisa iMetformin kunyango lwePCOS lwelebheli engekhoyo

UGqirha Cly kunye noGqr. Peters bobabini bayakhankanya spironolactone njengokusebenza wedwa okanye ngokudibeneyo namanye amayeza okunciphisa amanqanaba ehomoni yamadoda; kodwa uGqirha Cly ulumkisa ukuba, unengozi enqabileyo yokuphazamiseka kwilungu lobufazi kwiintsana ezingamadoda ukuba owasetyhini ukhulelwe ngelixa ethatha.Ngenxa yoko, abaguli kufuneka babe kuthintelo lokukhulelwa kunye novavanyo lwegazi ukujonga ii-electrolyte ziyafuneka rhoqo.

Kwiinwele ezingafunekiyo, uGqirha uPeter ucebisa I-eflornithine hydrochloride cream (iyeza elinokusetyenziswa ekuthinteleni ukukhula kweenwele) njengenketho ukongeza kwiindlela zokususa iinwele ezinjengokuthambisa, ukutsheva, okanye ukususwa kweenwele ze-laser.

Ugqirha Peters ukwakhankanya ukuba imiba ephezulu ye-cholesterol, isifo seswekile, i-apnea yokulala, kunye nesifo esinamafutha esibindi, iimeko ezihlala zibonakala kubantu abane-PCOS, baphathwa ngendlela efanayo abaya kuba ngayo kumntu ongenayo i-PCOS.

Ngeengxaki zokuchuma, ukongeza kumayeza akhankanywe nguGqirha Cly kunye noGqirha Peters, ugqirha wakho unokucebisa nge-letrozole okanye i-gonadotropins.

Iletrozole icothisa imveliso ye-estrogen kwaye ibangela ukuba umzimba wenze i-follicle-evuselela i-hormone (FSH), ihomoni efunekayo kwi-ovulation. Ngelixa IZiko leSizwe lezeMpilo yaBantwana noPhuhliso lwaBantu-isifundo esixhaswayo ifumanise ukuba i-letrozole isebenza ngakumbi kune-clomiphene ebangela i-ovulation kunye nokuphucula amazinga okuzalwa, izifundo ze-letrozole kwizilwanyana zibonise ukuba ibangela iziphene zokuzalwa xa zisetyenziswa ngexesha lokukhulelwa. Khange kubekho zifundo ngeli chiza kubafazi abakhulelweyo.Kwakhona unyango olungabikho kwilebula.

IiGonadotropins zihomoni ezibangela i-ovulation. Banikwa njengezitofu. Ngenxa yokuba olu unyango lunomngcipheko ophezulu wokukhulelwa okuninzi, ugqirha wakho unokuyalela iimvavanyo ezininzi kunye ne-ultrasound yokujonga umzimba wakho ngexesha lonyango.

Ugqirha

I-PCOS ayinakulungiswa ngoqhaqho, kodwa olunye unyango lunokunceda kwiimeko ezithile zePCOS.

Ukutyeba kakhulu, isifo seswekile, kunye nesifo se-metabolic syndrome, kwiimeko ezinzima, sinokulawulwa ngoqhaqho lwe-bariatric, utshilo uGqirha Peters.

UGqirha Cly wongeza, Abasetyhini abaphulukana nobunzima obukhulu emva kotyando lokudlula esiswini babonisa amaxesha aqhelekileyo kunye nokuqheleka kweempawu zabo.

Ukubhola kwe-Ovarian lukhetho lonyango lokungachumi oluhambelana ne-PCOS. Izifundo zamva nje zibonise ukuba iLaparoscopic Ovarian Drilling, i-LOD, (isusa ezinye izicwili ezongezelelweyo ze-cystic ovarian) kukhokelela kwinqanaba eliphezulu lokukhulelwa xa uzama ukukhulelwa xa kuthelekiswa ne-clomid yodwa, utshilo uGqirha Cly. Nangona kunjalo, isifundo esandula ukwenziwa Utyhile ukuba uFemara(ilerozole)yayisebenza ngokuchanekileyo njengokuhlinzwa kwe-LOD ekufezekiseni ukukhulelwa. Ukongeza, utyando aluncedisi ukuphucula iimpawu okanye ukufunyanwa kwe-PCOS xa owasetyhini engazami ukukhulelwa.

Yintoni ethembisa ngePCOS?

Ngelixa i-PCOS inokuba kunye nawe ubomi, iimpawu akufuneki zibekho. Unyango luphumelele kakhulu ekucinezeleni iimpawu, uqinisekisa uGqirha Cly.

UGqirha Chan naye unika isiqinisekiso : Xa ugqibile ukuya exesheni, iihomoni ze-estrogen kunye ne-testosterone zehla ngokwendalo, emva koko iimpawu ze-PCOS zinokuphucuka. Khumbula ukuba kwinqanaba ngalinye lesifo, nangona singenakukuphilisa, sinokulawula iimpawu.

Izifundo ezijikeleze iPCOS ziyaqhubeka ukunika ithemba. Kulungile ukwazi ukuba zininzi iimpendulo eziphandwayo kwaye ngethemba lokuba kuya kubakho unyango lwe-PCOS kungekudala, utshilo uGqirha Cly.

Ndisenayo iPCOS kwaye kusafuneka ndizilawule ezinye zeempawu zam. Ndinamakhwenkwe amabini amnandi endithe ndawakhulelwa ngaphandle kwesidingo sonyango lokuchuma, kunye nesicwangciso sokulawula okanye ukuthintela iziphumo ezininzi zePCOS njengoko ndinakho. Ukuxilongwa kwe-PCOS kunokuba yinto eyoyikisayo-eyoyikisayo njengokufumana iinwele ze-chin kwikonsathi ye-Rolling Stones-kodwa kuyinto eqhelekileyo, iyalawuleka, kwaye kunokwenzeka ukuba uphile ubomi obupheleleyo, obunempilo kunye ne-PCOS.