U-Amenorrhea okanye ukungabikho kokuya esikhathini kunokubakho kokubili ngexesha lokutshatyalaliswa komntwana kwaye emva kwexesha kubomi bomfazi. I-amenorrhea yeprayimari yimeko ebonakaliswe ngokungabikho ngokupheleleyo kwenyanga ukusuka ekuzalweni ukuya kwiminyaka eyi-16. I-amenorrhea yesiSekondari iyenzeka emva kokuqala kokuya esikhathini kwaye ibonakaliswe ngokuphelelwa kamsinya komjikelezo. Ukuba umjikelo wakho wenyanga uphazanyiswa, amathuba, ingcinga yakho yokuqala iya kuba uyakhulelwa. Enyanisweni, kukho ezinye iinguqu ezininzi ezinokubambezeleka ngokuqhelekileyo. Ngoko, ukungabikho kokuya esikhathini: izizathu, unyango - isihloko sesincoko namhlanje.
I-Amenorrhea ayisoloko ibangelwa yisifo esibi. Nangona kunjalo, ukungaqiniseki malunga nezizathu zokuphelisa ngokukhawuleza kwimihla kunokubakho uxinzelelo kunoma yimuphi umfazi. Musa ukwesaba. Emva kokuziqonda ngokucacileyo imbali yakho yezobugqirha kunye nenkcazo ecacileyo yeempawu ngakwakho, ingcali inokukwazi ukuqonda imbangela yenkinga. Ukunyanga okwaneleyo kuya kubakhokelela ekupheliseni kwimihla.
Iimpawu ze-amenorrhea
Isalathisi esiphezulu sobuso be-amenorrhea kukungabikho kwimijikelezo yenyanga. Esi sifo sineentlobo ezimbini:
- Amanorrhea yaseprayimari - ukungabikho kwimihla eneminyaka eyi-16.
- I-amenorrhea yesi-Secondary - akukho mjikelezo wesisithuba seenyanga ezi-3-6 okanye ngaphezulu.
Ngokuxhomekeka kwimbangela ye-amenorrhea, unako ukufumana ezinye iimpawu okanye iimpawu, ezifana nokukhutshwa kwamanzi amhlophe amhlophe kwiintlobo, iintloko, iingxaki zombono okanye ukukhula ngokugqithiseleyo kweenwele zobuso kunye nomzimba.
Izizathu ze-amenorrhea
Amaminorrhea yaseprayimari
I-amenorrhea yeprayimali ithinta ngaphantsi kwe-1% yamantombazana ebusheni. Phakathi kwezizathu eziqhelekileyo zezi:
- I-Chromosomal engaqhelekanga. Zingakhokelela ekuphelelweni kwangaphambili kwamaqanda kunye neentollicle ezibandakanyekayo kwinkqubo yokwenza i-ovulation kunye nokuya esikhathini.
- Ingxaki nge hypothalamus. Ukuqwalaselwa ngokukhathazeka okusebenzayo kwe-hypothalamus - indawo yengqondo, elawula imisebenzi yomzimba kunye nomjikelezo wesini. Ukusebenza ngokweqile ngokomzimba, ukuphazamiseka kokutya, ezinjenge-anorexia, kunye noxinzelelo lwangokwenyama nangokwengqondo kunokubangela ukuphazamiseka komsebenzi oqhelekileyo we-hypothalamus. Kwiimeko ezinqabileyo kakhulu, ukubonakala kwe-tumor kwi-hypothalamus yisiseko sokumiswa kokusebenza kwayo ngokuqhelekileyo.
- Izifo zesifo. I-pituitary gland yintsipho engqondweni elawula umjikelezo wesini. Ubukho be-tumor okanye ezinye iintlobo zentuthuko enobudlova zingathintela ubuchule be-pituitary gland ukwenza imisebenzi yayo.
Ukungabikho kwezitho zobulili. Ngamanye amaxesha ngethuba lokuphuhliswa kwamanzi, iziphumo ezinokukhubazeka zenzeke, kubangelwa ukuba amantombazana azalwe engenamalungu amaninzi kwenkqubo yokuzala, njengesizalo, isisu somzimba okanye isisu. Kule meko, ukungabikho kokuya esikhathini okanye i-amenorrhea kubangelwa ngqo kukungaphuhliswa kwenkqubo yokuzala.
- Izigulane zesisu zesigxina. Iipathologies zesakhiwo sesithintelo sangasini sinokuthintela ukuphuma kwindoda ebonakalayo. Ngamanye amaxesha ibhinqa ivalwe ngumlenze okanye umqobo, ovimbela ukugeleza kwegazi kwi-uterus kunye nomlomo wesibeleko.
I-amenorrhea yesiSekondari
I-amenorrhea yesiSekondari ixhaphake kakhulu kuneyona ndawo. Isizathu salo sinokuba:
- Ukukhulelwa. Kubasetyhini beminyaka yobudala, ukukhulelwa yisona sizathu esiqhelekileyo sokungabikho kokuya esikhathini. Xa iqanda elichumayo lizaliswa eludongeni lwesisu, ludonga lwe-uterine oluqala ukondla umbungu.
- Inzala ithetha. Amanye amabhinqa athabatha iipilisi zokulawula ukuzalwa awanaso umjikelezo ocacileyo wokuya esikhathini. Emva kokuyeka ukuthatha i-contraceptive ngomlomo, ukuqheleka kungathatha inyanga ezintathu ukuya ezintandathu ngaphambi kokuba ivuselelwe rhoqo kunye nokuya esikhathini. Ulwaphulo kunye nezixhobo zangaphakathi kwe-progesterone nazo zingabangela i-amenorrhea.
- Ukuncelisa. Oomama abahlengikazi nabo bahlala behlushwa yi-amenorrhea. Nangona banesisindo, kodwa ukuya esikhathini akunjalo. Kubalulekile ukwazi ukuba kwimeko le ntokazi inokukhulelwa kwakhona! Kwaye nangaphandle kokuya esikhathini.
- Uxinzelelo. Ukuxinezeleka ngokomzwelo kunokuba kancinci komsebenzi we hypothalamus - inxalenye yengqondo elawula i-hormone elawula umjikelezo. Ngenxa yoko, i-ovulation kunye nokuya esikhathini kunokumiswa. Umjikelezo wenyanga rhoqo uqala emva kokunciphisa ubunzima bexinzelelo.
- Amachiza. Ukusetyenziswa kweentlobo ezithile zeziyobisi kunokukhokelela ekupheleni komjikelezo wesini. Ngokomzekelo, i-anti-depressants, i-neuroleptics, ezinye iziyobisi zamachiza kunye ne-corticosteroids zingakhokelela ekuqaleni kwe-amenorrhea.
- Izifo. Izifo ezingapheliyo zingalinda okanye ziyeke ukuya esikhathini. Emva kokubuyiselwa kwimizi ngokuqhelekileyo kuqhubeka kwakhona.
- Ukungalingani kweHormonal. Isizathu esiqhelekileyo se-amenorrhea okanye isijikelezo esingavumelekanga sisifo esaziwa njenge-polycystic ovary syndrome. Le meko ibangela ukwanda kwenani kwi-hormone ye-estrogen kunye ne-androgens emzimbeni. Ngenxa yoko, izinga lama-hormone akhiqizwa yi-pituitary gland liyancipha, elikhokelela ekungabikho kwimihla. I-Polycystic i-ovary syndrome iholele ekutyebeni, kaninzi kuphuma igazi elininzi ngokungaqhelekanga, i-acne, kunye namaxesha amaninzi obuninzi obusweni.
- Ubunzima bomzimba. Ubunzima bomzimba obugqithiseleyo buphazamisa umsebenzi wama hormone amaninzi emzimbeni kwaye unokumisa i-ovulation. Abasetyhini abaneengxaki zokutya, ezifana ne-anorexia okanye i-bulimia, ngokuqhelekileyo abanalo umjikelezo wenyanga enye ngenxa yeenguqu ze-hormone.
Ukuzivocavoca ngokweqile. Abasetyhini ababandakanyeka kwimidlalo efuna ukunyamekela emzimbeni, njengobhalti, ukuqhuba umgama omde okanye i-gymnastics, bahlala behlulwa ngumjikelezo wesimo ongavamile. Izinto ezibangela ukungabikho komjikelezo wokuya esikhathini kubadlali - umlinganiselo omncinci wamafutha angaphantsi, uxinzelelo oluphezulu kunye namandla angaphezulu.
- I-thyroid. Umsebenzi ophantsi we-thyroid gland (hypothyroidism), ngokuqhelekileyo kubangele ukuphazamiseka kunye nokungabikho kokuya esikhathini. Izifo zesifo se-thyroid zingakhokelela kumgangatho ophantsi okanye ophakamileyo wokuveliswa kweprolactin - ihomoni eveliswa yi-pituitary gland. Ukutshintsha kwinqanaba leprolactin kunokuchaphazela umsebenzi we-hypothalamus nokuphazamisa ukuhamba kwimijikelezo yokuya esikhathini.
- Ukuxhamla kwintsimbi ye-pituitary. Izicubu ze-Benign ze-pituitary gland (i-adenoma okanye i-prolactinoma) zingabangela ukuveliswa kweprolactin ngokweqile. Ukugqithisa kweprolactin kunokuphazamisa imisebenzi ye-pituitary gland, njengomlawuli wesigidi sokuya esikhathini. Olu hlobo lwesifo sinokuphathwa ngamachiza, kodwa ngamanye amaxesha ukutshatyalaliswa kokufunwa kuyadingeka.
- Izikrakra ze-intrauterine kunye nokunamathela. Kule meko, urhulumente uvela apho umbane uqokelela kwi-membrane ye-uterus. Ngamanye amaxesha oku kwenzeka ngenxa yeenkqubo zonyango ezinxulumene nesisu, njengokwandiswa kunye nokuhluthwa, icandelo lesaha okanye unyango lwe-uterine fibrosis. Ukubambisana kwama-intrauterine kunye nezikrakra ziphazamisa ukukhula okuqhelekileyo kunye nokukhula kwesibindi, okubangela ukuba kunciphise okanye kungabikho kokuphela kwesimo.
- Ukumiswa komzimba kwangaphambili. Njengomthetho, ukuphuma kwindoda kwenzeka kumabhinqa aneminyaka engama-45 ukuya kuma-55 ubudala. Xa oku kwenzeka kuminyaka engaphambili, ukuphela komntu kuchazwa nje kwangaphambi kwexesha. Ukungabikho komsebenzi okwaneleyo wee-ovari, inani lokujikeleza i-estrogen emzimbeni liyancipha, nto leyo ekhokelela ekunciphiseni umlenze we-mucous of uterus kunye nokungabikho kwesimo. Ukuphuma kwimihla yokuphuphuma komzimba kungabangela umbane wezinto eziphilayo okanye isifo sokuzimela. Ngokuqhelekileyo, nangona kunjalo, izizathu zalo azihlali.
Ukuxilongwa kwe-amenorrhea
Nangona i-amenorrhea ingabonakali nje ngenxa yezifo ezisongela ubomi, ingakhokelela kwiinkalo ezinzima ze-hormonal. Ukutyhila imbangela yangempela ye-amenorrhea inokuthatha ixesha elide kwaye ifuna ukusetyenziswa kweemvavanyo eziliqela. Okokuqala, ugqirha uya kukucela ukuba uthathe uvavanyo lokukhulelwa. Ukongezelela, uvavanyo olupheleleyo lwe-gynecological luya kwenziwa ukwenzela ukuba lukhange iimpawu zokukhulelwa okanye ezinye iingxaki ezinokuzala. Ukuba awukhulelanga, ugqirha uya kuqhuba uviwo kwaye uza kukubuza imibuzo malunga nempilo yakho kunye nembali yengonyango. Kwababhinqa abaselula, oku kuhlaziywa kubandakanya ukuvavanywa kwempawu kunye neempawu ezibonisa ukutshatyalaliswa. Isinyathelo esilandelayo kukuba kwenziwe ukuhlolwa kwegazi ukujonga izinga lama-hormone, ukuvavanya umsebenzi we-thyroid kunye nenqanaba le-hormone yeprolactin. Kananjalo, oogqirha banokucebisa okubizwa ngokuba yi-progestin, apho isigulane sithatha izidakamizwa ze-hormone (progestogen) iintsuku ezingama-7-10. Isilwayo sibangele ukuphaphaza. Iziphumo zolu vavanyo zibonisa ukuba i-amenorrhea ihambelana nokungabikho kwe-estrogen.
Ngokuxhomekeka kwimpawu kunye neempawu, kunye neziphumo zovavanyo neemvavanyo zegazi, ugqirha unokufuna iimvavanyo ezongezelelweyo. I-tomography yekhompyutheni, i-resonance yamagnetic okanye i-ultrasound ingakwazi ukufumana izicubu kwi-pituitary gland kunye nezinye izifo ezinokwenziwa kwimizimba yokuzala. Okokugqibela, i-laparoscopy okanye i-hysteroscopy ngamanye amaxesha icetyiswa. Ezi zikhusela iindlela zokurhafisa, apho izitho zangasese zangaphakathi zingahlolwa.
Unyango lwe-amenorrhea
Unyango, ukuba kukho na, kuxhomekeke kwisizathu se-amenorrhea. Ngamanye amaxesha ugqirha ugunyazisa utshintsho kwindlela yokuphila, kuxhomekeke kwisisindo somguli, umsebenzi wokusebenza kunye nokunyaniseka kwengcinezelo. Ukuba ufumana i-polycystic ovary syndrome okanye i-amenorrhea yezemidlalo, ugqirha wakho unokunika umyalelo wokukhulelwa komlomo ukusombulula le ngxaki. I-Amenorrhea ngenxa yokuphulwa kwe-thyroid gland okanye i-pituitary gland ibonisa enye unyango.
Indlela efanelekileyo yokuphepha ukungabikho kokuya esikhathini kukukholisa impilo enempilo:
- Shintsha ukutya kwakho kwaye uhlanganyele emisebenzini yomzimba ukuze uphumelele kwaye ugcine ubunzima kwindawo ephilileyo.
- Gcina ukulinganisela kwempilo kwansuku zonke-umsebenzi, ukuphumla nokuphumula.
- Qinisekisa ukuba zeziphi iingxaki kunye neemeko zobomi bakho, kwaye uzame ukuziphepha. Ukuba awukwazi ukunciphisa impembelelo yoxinzelelo kuwe-buza intsapho yakho, abahlobo, okanye ugqirha uncedo.
Gcina utshintsho kwimijikelezo yokuya esikhathini, kwaye ukuba kukho into exhalabisa okanye ikukhathazayo-funa iingcebiso kwiingcali. Gcina idayari kunye nenyanga nganye uphawu lokuqala kwimijikelezo nganye yokuya esikhathini, ubude bayo kunye naziphi na iimpawu ozifumanayo. Thetha nonyoko, udade, okanye omnye umhlobo wesibini osondeleyo kwaye ufumane ukuba unengxaki efanayo. Olu hlobo lwazi lunokunceda ugqirha ukuba aqaphele imbangela ye-amenorrhea kuwe. Maxa wambi i-amenorrhea ibangele ukuxhalaba kunye nokuxhalabisa. Emva koko ugqirha uya kuhlola iimpawu zokungabikho kokuya esikhathini, izimbangela, unyango lweli gciwane. Ngogqirha, unokufumana indlela yokulawula umjikelezo wenyanga.