Iwe Unogona Kutora Estrogen Nekenza Yemazamu
Kwemakore, vakadzi uye vanachiremba vavo vane hanya kuti kutora estrogen kunokonzera kenza yepamu. Ndakapfupikisa kuti nei izvi zvisirizvo mandiri munguva pfupi kuti ibudiswe bhuku, The Estrogen Window, uye sei esrogen, inotorwa muestrogen yewindo rako, inowedzera kukanganisa kenza yemazamu. Zvisinei, kutya kutora estrogen kwave kwakanyanya kwazvo zvokuti vakadzi vane kare vane kenza yemazamu zvinonzwisisika havashandisi chero mararamiro eesrogen, kusanganisira vaginal estrogen.
Izvo zvakagadzira dambudziko guru kwazvo kuvakadzi vane kenza yemazamu. Mukuwedzera kune kuchinja kwemuviri kunoitika semugumisiro wokubviswa kushandiswa kwekenza kana mune dzimwe nguva, pachipfuva, kunewo zviratidzo zvekuenda kumwedzi. Mashoko akanaka ndeokuti zvinhu zvepanyama zvinogona kurongedzwa nekuvhiyiwa kwekugadzirisa uye nepo zvisingaiti sarudzo yakakwana, iyo inokosha yekugadzirisa kushandiswa kwekurapwa kwemigumisiro.
Zvisinei, zviratidzo zvekuenda kumwedzi zvakanyanya kuoma kutarisa sezvo isrogen ndiyo mushonga unobatsira zvikuru uripo. Pakave nemishonga miviri isiri-estrogen yakagamuchirwa kugadzirisa zviratidzo zvekuenda kumwedzi. Nokuda kwechiedza chinopisa (Brisdelle) uye nokuda kwekudzivirira kwechikadzi (Osphena), asi kuomeswa kwemadzimai uye zvepabonde zvinorwadza zvichiri nyaya huru kuvakadzi vazhinji vanotora kenza yemazamu echeche.
Iye zvino pane mharidzo-yemutambo inoshandiswa yakabudiswa neAmerican College of Obstetricians uye Gynecologists (ACOG).
Bhuku reNational Opinion kubva kuAmerican College of Obstetricians uye Gynecologists (Nhamba 659, March 2016) inotaura kuti ACOG inotenda kuti kune uchapupu hwakakwana hwokuti hwakanaka (kushanda newe oncologist) yevakadzi vane kenza yemazamu echerostro inotora vaginal vaginal estrogen . Kunyange zvazvo estrogen inopinda muropa, haifaniri kuchinja zvinoguma.
Ropa remvura harifaniri kupfuura izvo zvinowanzoitwa ropa reesrogen mazinga ari pakuguma kwemwedzi.
Uye pane humwe uchapupu hwokuti uite zvakare. Kunyangwe iwe uri kurwara ikozvino kwekenza yepazamu, wakabatwa nekenza yengema munguva yekare, uye kunyange iwe uri kutora Tamoxifen, iyo inorwisa anti-estrogen, zvinoguma kubva pakushandisa vaginal estrogen hazvisi zvakasiyana kana iwe usingaiti tora. Ndinotaura pamusoro peizvi uye ndakabatanidza ruzivo rwakakosha pamusoro peesrogen mubhuku rangu idzva, The Estrogen Window.
Izvi zvakakura kune vakadzi nokuti kenza yepazamu ndiyo kenza inowanzoonekwa kune vakadzi mukati memarudzi ose. Ndicho chikonzero chikuru chinokonzera kenza kufa pakati peSpainan. MuUnited States, kenza yemazamu inokanganisa mumwechete pavakadzi vasere uye iye zvino kune vakadzi vanopfuura mamiriyoni maviri eUnited States avo vakambobatwa nekenza yepamu.
Kune marudzi mazhinji emudzimai weserogen:
| Iyo yakapiwa sei | Chii chiri Mariri | Izvozvo zvakatorwa sei |
| Vaginal Cream | 17 beta isradiol | Kazhinji 1-2 gramu zuva rimwe nerimwe kwemavhiki maviri, ipapo 1 gramu 1-3 nguva / vhiki |
| Vaginal Cream | Akabatanidza equine estrogen | Zvichifamba 0,5 gramu kwemazuva makumi maviri nemaviri kubva ipapo mazuva manomwe, kana kaviri vhiki kana zvisinganyanyi kuoma |
| Vaginal Ring | 17 beta isradiol | 2-mg ring releasing 7.5 micrograms / day for 90 days |
| Vaginal Tablet | Estradiol hemihydrate | Imwe 10 microgram tablet / zuva kwemavhiki maviri ipapo Imwe 10 microgram tablet / zuva 2-3 mara / vhiki |
Mishonga yemakemikrapa yakawanda inoshandiswa pakushanda kwekenza yemazamu muchikamu nekubvisa kana kuvhara zvose zvigadzirwa zveestrogen. Somugumisiro, vakadzi vanorwara nevakadzi vanoramba vachienda kumwedzi vanongopedzisira vachienda kumwedzi uye vakadzi vatova nekuguma kwemazuva avo iye zvino vane zvikamu zvakadzika zveesrogen vanopiwa mishonga yokurapa iyo inotora mahara eestrogen madiki uye inoikurira kune imwe.
Chimwe chemigumisiro yakaipisisa yekusina eserogen ndeyemadzimai akaoma, kuonda kwemukadzi uye chikwata chinonzi atrophic vaginitis. Izwi idzva rezvokurapa nokuda kweizvi ndiGenitourinary Syndrome of Menopause (GSM) iyo Uye inokonzera zvepabonde zvinorwadza uye dzimwe nguva inopesana hukama.
Uyu ndiwo mutsara mukuru wemutambo kuvakadzi vane kenza yemazamu. Kunyange zvazvo ndave ndichipa vaginal estrogen zvakasarudzwa nevarwere vepabonde kwemakore kwemakore, vazhinji vakaramba kurapwa nokuti avo oncologists vakati havafaniri kuitora uye vakanzwisisika vakangwarira. Kenza yepabonde chete yakaipa zvakakwana. Uye kunyange zvisingaiti-mahomoni zvinokwana kurapa zviratidzo zveGMM kune vamwe, hapana mubvunzo kuti vakadzi vakawanda vanozobatsirwa nekushandiswa kwechikadzi yeserogen; ndiyo nzira yakanakisisa yekugadzirisa zviratidzo zveGMM. Iye zvino isrogen ichava nzira inogamuchirwa kune vazhinji vevakadzi vane kenza yemazamu.