Dambudziko Rakamboitika Kuzvimwe Zvimwe Zvikosha
Sangano reUnited States Preventive Services Task Force -hurumende yekutanga yehurumende pamakiriniki ekudzivirira-anosimbisa mhedziso yayo yekutanga nezvemashandisirwo emishonga ekurapa kwemazuva ekudzivirira kwechirwere chekudzivirira zvirwere zvisingaperi. Kamwezve, Task Force yakabudisa urongwa uhwu tsamba ye "D," inoratidza chirevo pamusoro pacho zvichienderana neuchapupu huripo.
Kushandisa iyo yakananga uye yakakwirira mitemo yehuchapupu, uye kutarisa mubvunzo wekuti kana kuti kwete hupenyu huripo (HR) hunogona kukurudzirwa "kazhinji" kune vakadzi vose pavanenge vachienda kumwedzi nekuda kwekudzivirira chirwere chepfungwa, kenza, chirwere cheshuga, kuora mwoyo, osteoporosis, uye mungozi yekufa kusati yasvika yakabatana chero ipi zvayo, Task Force iri chokwadi. Mhinduro yemubvunzo iwoyo mune uchapupu huripo ndeye: kwete. Pane zvakawanda zvinogona kubatsira mahomoni ekuchinja, asi zvizhinji zvinogona kukuvadza pamwe chete, uye zvakakwana, deta kubva kune yakakura uye yakanakisisa miedzo inotarisana nechetsetse.
Asi nepo Task Force inopindura ingave yakasununguka, mubvunzo wavo ndeimwe nyaya. Mhedzisiro inosvika pamusoro pekushandiswa kweHommone pakupera kwemazuva evanhu vose, kune vakadzi vose zvavo, vanotendeseka zvakajeka kuva mazano akanaka kune mumwe mukadzi chaiye? Mukuona kwangu, hazviiti. Uye, nepo Task Force yekupedzisira inotevera zvinonzwisisika kubva pauchapupu hunosangana nepamusoro pemitemo yakakwirira, miganhu yehuchapupu ihwohwo inogonawo kupikiswa.
Zvinhu zvakawanda zvinokosha zvakakosha zvisati zvasarudzwa, zvisingadzidziswe, kana kuti zvinongororerwa mugungwa re data.
Zvipingamupinyi Zvina
Nekuremekedzwa kwose kwakakodzera kweBatk Force uye kugumisa kwavo, saka, ndinogovera maonero evamwe vandinoshanda navo kuti pane zvinogona kukuvadza mukupfupisa kutongwa pamusoro pesarmone replacement. Kunyanya, ndinofunga kuti Basa reBashk Force rinowanikwa mumatanda mana:
1) Kurapa Kupesana nekupwanya
Chero pose paanenge achidudzira dhepfenyuro pamusoro pehuwandu hwevanhu, pane zvisingadziviriki zvinowanikwa mumatambudziko maviri ekupikisa mazano: kunya, nekuparadzanisa. Kuchengeta apo apo nhengo dzakasiyana-siyana dzeboka guru dzinoshandiswa zvakafanana. Kupamba-famba apo apo mvumo inogadziriswa kukosha kwekusiyana mukati meboka, kazhinji kuburikidza nekutsvaga kweboka.
Nokuti basa reTabk Force nderekupa mazano anotaura nezvehuwandu hwevanhu, kana humwe chikamu chikuru chazvo, ivo vanowanzotarisana nematambudziko ekukanda.
Ndezvipi zvikwereti? Zvakanaka, mhedziso yavo maererano nekushandurwa kwehomoni inowanikwa zvikuru pane imwe yeruzhinji rukuru rwekuongorora panyaya iyi, Women's Health Initiative . Asi chiyero ichocho chakanyoresa vakadzi vaviri vakuru uye vaduku; vakadzi vakatanga HR munguva pfupi mushure mokunge vachembera, uye avo vakaitanga iyo makore gumi gare gare; vakadzi vakanga vaine hysterectomy uye vakanga, saka, vakakwanisa kutora estrogen voga; uye vakadzi vane chibereko chinoputika chaidiwa kubatanidza estrogen ne progesterone.
Vose ava vakadzi vakasiyana vakave nemigumisiro yakafanana kubva kune HR? Kure kure nazvo. Vandinoshanda navo uye ini ndakabudisa tsvakurudzo muna 2013 muAmerican Journal of Public Health , yakabva pane imwe nhoroondo kubva kuHarare Women's Health Initiative, asi yakarongedzera pamusoro pemigumisiro yenguva refu yevakadzi vakanga vatora hysterectomy uye vakanga vachitora estrogen voga.
Apo vakadzi ava vakatanga chirwere cheesrogen kana kuti vasati vava nemakore makumi mashanu, nguva yepakatikati yekupera kwemwedzi, vakawana kuderedzwa kukuru kwezvinhu zvose-zvinokonzera kufa kwevanhu. Tsanangudzo yedu ndeyokuti boka iri revakadzi, raive mumakumi makumi emamiriyoni muUnited States, kusakwanisa kushandisa kushandiswa kweesrogen kwaiita kuti makumi ezviuru zvevanhu vasati vafa kare mumakore gumi nerimwe. Izvozvo, zvino, ndizvo zvinetso zvekudzikisa.
2) Checheche neBhatiwater
Chirwere chakanyatsobatana chakadai ndiko kukundikana kwekusiyanisa mwana uye mvura yekushambidza munzira inoenda muchidimbu chirevo. Nhoroondo kubva kune miedzo inoshandiswa neHurk Force kukurudzira inoratidza kukosha kwezera panguva yekushandiswa kwehomoni, nguva yekutanga kwekuguma kwemwedzi, uye kana isarogen uye progesterone inofanira kusanganiswa.
Kunyange zvazvo kukurudzirwa kune vakadzi vose kushandiswa kweH HR kunokundikana kubvisa mvura yekushambidza, chirevo chinotarisana pamusoro pekukundikana kuponesa mwana.
3) Mutemo Wechitatu weNewton
Mutemo wechitatu wekutsvaga unozivikanwa ndewekuti: pane zviito zvose, zvakaenzana uye zvinopesana . Muzana remakore rapera, takabva pane zvakakosha pamusoro pekushandiswa kwehomoni, kupararira kushingaira pamusana pekucherechedza miedzo, kudzokera kune hutsika hunoonekwa pamusoro pematambudziko akasiyana-siyana. Nepo imwe neimwe iyo yakasununguka ye pendulum inonzwisiswa nehuwandu hwemashoko uye data, iyo zvakare, mune chimwe chikamu, kupindira kune yakatanga kufambidzana mune zvakasiyana. Scientific maonero angave asina kufanana nemutemo wakajeka wekufambisa sebhokisi re flotsam, asi maonero angu haasi kunyatsodzivirirwa nawo, kana.
4) Kusasipo kweUchapupu Kusiyana Nehuchapupu hwekusabatwa
Iko mitemo yakakwirira yekutsvakurudza inokurukurwa neTagk Force chivimbo chokuti uchapupu hwavanoshandisa huchava hwakanaka. Asi ndezvipi zvinopihwa zvinopiwa pamusoro pokusavapo kwouchapupu hunokosha pakuita chisarudzo chakanaka? Hapana, chaizvoizvo. Zvechokwadi, Basa reMabasa rinofanira kusarudza kana uchapupu huripo hwakakwanira kutsigira chirevo chakajeka, uye kunyange vane mavara emakadhi kuti aratidze kana zvisiri. Asi zvakadaro, nzira yehupupuridzo yekudzokorora inokurumidza kusimbisa kusavapo kwehuchapupu huchapupu hwokusavapo.
Zvinorevei munyaya iyi ndeyokuti inenge yose yezvinyorwa zvese zvekuedza zvinonzi zvinoreva "hurimoni" kunowanikwa, pane imwechete, inopera kune imwechete, iyo inonyanya kushaya yakawanda yehomoni inotsiviwa: kushandiswa kwe Premarin (chimiro chestrogen kubva kumabhiza, kwete vanhu), uye Provera (medroxyprogesterone acetate, a synthetic uye high-potency progesterone). Kubatanidzwa kweizvi kunozivikanwa se "Prem / Pro." Izvo chatinoziva nezvemahomoni aya anotiudza zvakakwana nezvevamwe vose? Kwete, haiti-apo ndipo pane uchapupu husiripo. Basa reMabasa rakaratidza kuti "kusina uchapupu" sekunge isu tinogona kuva nechokwadi kuti inopindirana nemaonero kuti kune uchapupu hwechokwadi hwekusavapo huripo kubva kune humoni huchigadziriswa, kunyange kana zvirongwa zviri nani zvinoshandiswa. Ichokwadi chiripo ndechokuti, isu hatizivi chaizvo.
Kusarudza Zvakakunakira Iwe
Kufanana nematambudziko ari pamusoro apa, zvinoratidzika kuti mazano eBashk Force anokundikana kutarisira kukosha kwezvinhu zvitatu zvinokosha-zvinokosha zvinogona kuzivisa iwe pachako, kugadzira chisarudzo:
1) Chaizvoizvo Chii?
Nyanzvi dzinoshamisa kwazvo dzinobvumirana kuti mahomoni ekugadzirira anowirirana zvikuru mumigumisiro yavo. Randomized trial data haisi kuwanika kune zvizhinji zvekugadzirira iyo nyanzvi dzinowanzokurudzira. Kunyange zvazvo tisingakwanisi kuziva chokwadi kuti kumwe kumwe kugadzirira kunoita kuti kuderedzwa kwechirwere chisingaperi chisati chaitika kana Prem / Pro isingaiti, miedzo yePrm / Pro haigoni kubvisa kubatsirwa kwakadaro. Kunyangwe mune data iripo, migumisiro ye estrogen pamwe neprogesterone, maererano neserogen yoga, yakasiyana zvakasiyana.
2) Zvakananga Rini?
Migumisiro yekushandiswa kwehomoni inopesana zvakajeka nenguva. Kushandiswa nevakadzi vaduku, pedyo nenguva yekuenda kumwedzi, kunopa humwe huwandu hwekubatsira uye huwandu huwandu hunoshandiswa kupfuura hushandiswa. Miti mikuru yakawanda yakarongeka yakasanganisira kushandiswa kwekushandisa kwenguva refu, apo ichichera deta kubva kumapoka aya pamwe chete.
3) Chaizvoizvo Ndiani?
Vakadzi vakawana hysterectomy vanogona kutora estrogen pasina progesterone. Iko kutanga kwekutanga kwekuguma kwemwedzi, iyo yakanyanya kufanana nayo inogona kubatsirwa nehomoni inotsiviwa. Mambure ekugadzirisa panjodzi yemunhu pachake inogona kunge yakasiyana nemhuri yehupenyu uye yeupfumi. Kunyange zvazvo Task Force inosungirwa kupa hutungamiri hwehuwandu hwevanhu, izvi zvinonetsa apo nzira yakanakisisa yekudzivirira inonyanya kukwaniswa nomunhu. Icho ndicho chaicho chakagadziriswa nemasangano anotungamirira akazvipira kune hutano hwevakadzi, uye mubvunzo chaiwo wezvipingamupinyi zvine chokuita nekuenda kumwedzi.
Pakupedzisira, HR inowanzoshandiswa kurapa zviratidzo, panzvimbo pokuderedza zvirwere zvisingaperi. Izvo zvakakurumbira mazano pamusoro pekushandiswa kweHR kune imwe zvingave zvisinganzwisisiki, uye zvisina kunaka, taurai vakadzi nevanachiremba kunze kwekushandisa kwayo kune imwe. Kunyange zvazvo HR isingatsigiri zvakakwana dambudziko rechirwere chisingagumi kuvakadzi vose, haritauri zvakawanda; zvinongova "kushambidza." Dzimwe njodzi dzinokwira, dzimwe dzinodzika. Kushandiswa kwenguva pfupi kweH HR kusunungura zviratidzo zvevanhu vane chirwere chinoramba chiri chakanaka, chinonzwisisika, uye chinowanzosarudzira dambudziko.
Kutora kubva pane izvi zvose ndechokuti nepo Task Force yakaita mhinduro yakavimbika, inopupurirwa nehupupuriro kumubvunzo wakabvunzwa pamusoro pevakadzi vazhinji, mubvunzo iwoyo haufaniri kuva wakarurama kune mukadzi chero upi zvake. Kuvimba nemararamiro emararamiro ekuderedza dambudziko rezvirwere zvisingaperi zvinokurudzirwa kune vose, asi HR inogona kukurudzirwa kune vamwe. Nzira yakanakisisa yekugadzirisa mhinduro yemunhu ndeyekumubvunza chiremba wako pamusoro pezvinoita zvinonzwisisika kwete kuvanhu, asi kwauri.