PCOS ndi chiyani?

Maphunziro a Zaumoyo

Pamene Mick Jagger adatiwonetsa mayendedwe ake, ine ndi mnzanga tinkangoyimba-kuimba limodzi ndi nyimbozo ndikuwonetseranso chiwonetserochi. Ndipo zidachitikadi. Dzanja langa linatsuka chibwano changa, ndipo ndinamverera tsitsi loyambalo. Ndinali ndi zaka 14; Sindingayambe kumeta ndevu zanga… kodi ndingakhale ndi tsitsi lokula kumaso? Ndidakhala nawo konsati yonse ndikudula mwamphamvu kwa womenyera kotala-inchi pomwe Mick adadandaula kuti samatha kukhutira. Ili linali lingaliro langa loyamba lomwe ndinali nalo matenda a polycystic ovary (PCOS), vuto lodziwika bwino la mahomoni pakati pa azimayi azaka zobereka.

PCOS ndi chiyani?

PCOS ndi vuto la mahomoni lomwe limakhudza endocrine ndi njira zoberekera. Icho imakhudza pakati pa 5% ndi 13% azimayi azaka zapakati pa 15 ndi 44, ndipo amatha kuyambitsa mazira ochulukirapo kapena zotupa zazing'onoting'ono. Ndipokhapokha nditazindikira kuti ndili wachikulire pomwe ndidazindikira kuti azimayi ena ambiri m'moyo wanga ali ndi matenda omwewo. Ndizofala kwambiri kuposa momwe amayi ambiri amazindikira.

Kodi zizindikiro zoyamba za PCOS ndi ziti?

Zizindikiro za PCOS zimatha kusiyanasiyana pamunthu ndi munthu. Wina yemwe ali ndi Ma PC zitha kuwonetsa zina kapena izi:

• Msambo wosasamba, kuphatikiza kusamba, kusamba pafupipafupi, kutaya magazi kwambiri, kapena kutuluka magazi osakhwima
• Kulemera kapena kunenepa kwambiri
• Zovuta kutaya thupi
• Mavuto obereka kapena kusabereka
• Kupweteka kwa m'mimba
• Kukulitsa tsitsi kumadera monga nkhope, chifuwa, m'mimba, kapena ntchafu - zomwe nthawi zina zimatchedwa hirsutism
• Khungu lamafuta
• Ziphuphu, makamaka ngati zimakhala zovuta, zakuchedwa, komanso / kapena sizikugwirizana bwino ndi mankhwala owonjezera
• Acanthosis Nigricans (zigamba za mdima wandiweyani, khungu lowoneka bwino),zimapezeka m'makola a khosi, kukhwapa, kubuula, ndi madera ena

Nchiyani chimayambitsa PCOS?

Zomwe zimayambitsa PCOS sizikudziwika, akufotokoza Ann Peters , MD, gynecologist ndi dotolo ku The Gynecology Center ku Mercy Medical Center ku Baltimore, Maryland. PCOS ndi matenda ovuta omwe amakhulupirira kuti ndi gawo lobadwa nalo (gawo lobadwa nalo) komanso gawo lina lachilengedwe. PCOS ikhoza kuthamanga m'mabanja. Pafupifupi wodwala m'modzi mwa anayi omwe ali ndi PCOS ali ndi mayi yemwe adapezeka kuti ali ndi PCOS (m'maphunziro ena nambala iyi ndiyokwera kwambiri).

Ngakhale zikhalidwe za chilengedwe ndi zachilengedwe zikukayikiridwa, Geoffrey Cly , MD, OB / GYN ku Fort Wayne, Indiana, akuwonetsa kuti palibe kafukufuku amene wasonyeza motsimikiza chibadwa kapena zinthu zina zachilengedwe zomwe zimayambitsa PCOS.

Monga momwe zidandithandizira, PCOS nthawi zambiri imayamba unyamata, koma Dr. Peters akuti, matendawa amatha kuchedwa kwa zaka zingapo kutsatira kusamba kwa msambo, popeza kusamba kwamasamba kosazolowereka siachilendo ngati kulumikizana pakati paubongo, mazira, ndipo chiberekero chimakhwima.

Mapiritsi oletsa kubereka amatha kubisa zizindikiro ndikupangitsa zotsatira zoyeserera zolakwika, zomwe zimayambitsa kuchedwa pakati pakayambika kwa PCOS ndi matendawa. PCOS sangapezeke mpaka odwala atasiya njira zolerera kapena kuzindikira nthawi zosayembekezereka poyesa kutenga pakati, akufotokoza Dr. 20s.

Chipatala cha Mayo amatchula kuchuluka kwa insulini-mahomoni omwe amafanizira kuchuluka kwa shuga m'magazi, kuchuluka kwa ma androgen, komanso kutupa kotsika pang'ono ngati zinthu zomwe zingayambitse PCOS, koma mpaka pano chifukwa chenicheni sichikudziwika.

Kodi PCOS ndiyofunika?

Ngakhale zizindikilo zina za PCOS, monga tsitsi lopitilira muyeso kapena ziphuphu zimakhala nkhani zodzikongoletsera, PCOS imalumikizidwa ndi mavuto ena akulu azaumoyo.

Amayi omwe ali ndi PCOS ali pachiwopsezo chachikulu cha zovuta zingapo zamankhwala, Dr. [Izi ndi][akalowa chiberekero]khansa.

Zovuta zina zingaphatikizepo matenda obanika kutulo, steatohepatitis yopanda mowa (kutupa kwa chiwindi koopsa komwe kumachitika chifukwa cha kuchuluka kwa mafuta m'chiwindi), matenda ashuga obereka, komanso kupita padera kapena kubadwa msanga.

Izi sizitanthauza kuti azimayi onse omwe ali ndi PCOS azikhala ndi izi, koma chiwopsezo chowonjezeka chazaumoyo chimatanthauza kuti kuchiza PCOS ndikofunikira. Dr. Peters akuwonetsa kuti PCOS ndi matenda okhalitsa.

PCOS ikhozanso kukhudza thanzi lam'mutu. Matenda okhumudwa komanso kusokonezeka kwamalingaliro [ndi] nkhani zofunika kwambiri zomwe siziyenera kusiyidwa popanda upangiri, chithandizo chamagulu, ndi / kapena mankhwala pakafunika kutero, a Dr. Cly akutero.

Phunziro yoyang'aniridwa ndi pulofesa wa University of Nursing ya Columbia University Nancy Reame, MSN, Ph.D., ndikufalitsidwa mu Zolemba pa Behaeveal Health Services & Kafukufuku anapeza kuti kusasamba kwa msambo chinali chizindikiro chomwe chimakhudzana kwambiri ndi mavuto amisala.

Kodi PCOS imapezeka bwanji?

Gawo loyamba ndikuwona wothandizira zaumoyo wanu. Dokotala wanu ndi malo abwino kuyamba. Kutengera ndi zomwe mukudziwa komanso chithandizo chomwe mungafune, a GP anu angakutumizeni kukaonana ndi azimayi azachipatala kapena akatswiri ena monga azachipatala, a endocrinologist, ndi / kapena dermatologist.

Dokotala wanu akhoza kufunsa za zomwe mukudwala komanso kutalika kwa nthawi yomwe akhala akupezeka, komanso mankhwala omwe mukumwa. Akhozanso kukutumizirani kukayezetsa magazi, makamaka kuti muwone kuchuluka kwa androgen,mwachitsanzo testosterone(mahomoni amphongo).

An ultrasound kuti ayang'ane ma ovarian cysts amathanso kulangizidwa. Amayi omwe alibe PCOS amathanso kukhala ndi zotupa, koma ochepera 12 samakwaniritsa njira yodziwira, analemba Dr. Jessica Chan, pulofesa wothandizira wa Obstetrics and Gynecology ku Cedars-Sinai ndi endocrinologist wobereka wodziwika mu PCOS.

Dr. Chan ananenanso kuti azimayi ena omwe ali ndi PCOS sangakhale ndi zotupa konse. Ndinagwa m'gululi panthawi yomwe ndimapezeka komanso kwazaka zambiri pambuyo pake. Dokotala wanga adandifotokozera kuti chifukwa PCOS ndimatenda, ma cyst ovarian sayenera kupezeka kuti apange matenda a PCOS ngati pali zina.

Dr. Chan adalemba zofunikira pa matenda a PCOS monga kupereka ndi ziwiri kapena zingapo zotsatirazi:

• Nthawi zosasinthasintha, zolemetsa, kapena zosowa chifukwa chosowa ovulation (izi zitha kukhala chifukwa cha kusabereka)
• Zizindikiro za milingo yayikulu kuposa yachibadwa ya ma androgens, omwe atha kuphatikizira tsitsi lochulukirapo m'malo omwe amuna amakula tsitsi (nkhope, chifuwa, kumbuyo, ndi zina), kapena kutayika tsitsi. Magulu a Androgen amathanso kuwunikidwa kudzera pamagazi.
• 12 kapena ma ovarian cysts (akulu kuposa mazira abwinobwino a dzira) monga akuwonetsera kudzera pa ultrasound.

Mndandanda wamayeso nthawi zambiri amalamulidwa kuti athetse kupezeka kwa zovuta zina zamthupi.

Kodi PCOS ingachiritsidwe?

Tsoka ilo, palibe mankhwala a PCOS, koma sizitanthauza kuti anthu omwe amapezeka kuti ali ndi vutoli ayenera kuvutika. Zizindikiro za PCOS zimayendetsedwa bwino ndi mankhwala komanso kusintha kwa moyo, Dr. Peters akufotokoza. Ngakhale kusabereka komwe odwala PCOS amatha kuthana nako kumatha kuthana ndi chithandizo chamankhwala.

Kodi PCOS imathandizidwa bwanji?

Zizindikiro za PCOS zimathandizidwa mwanjira imodzi kapena kuphatikiza njira zitatu: kusintha kwa moyo, mankhwala, ndi (kawirikawiri) opaleshoni.

Kusintha Kwamoyo

Kusintha kwa moyo ndi kuwonda ndizofunikira kwambiri pochiza PCOS, a Dr. Peters atero.

Kuchepetsa thupi komanso kudya bwino ndi mankhwala osagwiritsa ntchito mankhwala, akutero Dr. Cly, ndikuwonjezera kuti, Kukweza kwa PCOS kumayamba ndi kuchepa kwa thupi [kwakukulu kuposa] 5% ya thupi lonse. Kusintha kwa zizindikilo ndikokulirapo ndikuchepetsa thupi.

M'nkhani yake ya Cedars-Sinai, Dr. Chan amalimbikitsa odwala PCOS kukhalabe achangu, kuphatikiza mphindi 30 mpaka 40 zolimbitsa thupi masiku atatu kapena anayi sabata. Amanenanso za kudya zakudya zopatsa mphamvu kwambiri. Amayi omwe ali ndi PCOS nthawi zonse samakonza chakudya mofanana ndi akazi ena. Zakudya zambiri zoyengedwa ngati shuga zimatha kubweretsa kukana kwa insulin komanso kunenepa, akutero.

Mankhwala

Mankhwala omwe amapezeka kwambiri ndi awa mahomoni oletsa kubereka mu mawonekedwe a mapiritsi kapena chigamba kapena mphete, atero Dr. Cly, chifukwa omwe amayendetsa msambo… komanso amachepetsa kuchuluka kwa testosterone komwe kumazungulira kotero zithandizanso pakukula kwa tsitsi.

Metformin , mankhwala omwe amagwiritsidwa ntchito makamaka poletsa shuga wambiri mwa anthu omwe ali ndi matenda amtundu wa 2, ndipo mankhwala ena ashuga nthawi zina amapatsidwa PCOS chifukwa amachepetsa kukana kwa insulin.Amagwiritsidwa ntchito ngati mankhwala osokoneza bongo popeza Food and Drug Administration (FDA) sanavomereze kuti athandizidwe ndi PCOS chifukwa wopanga sanafune kuvomerezedwa; komabe ndi chidziwitso chazachipatala, ndi mankhwala omwe amagwiritsidwa ntchito kwambiri.Dr. Cly sawalimbikitsa chifukwa maphunziro a nthawi yayitali sanawonetse phindu lalikulu. Dr. Cly akufotokoza chimodzi chosiyana, Komabe, pamene mayi akuyesera kutenga pakati kuwonjezera metformin ku Clomid kapena Femara kumawonjezera mwayi wake woyembekezera katatu kuposa (ovulation stimulating drugs) Clomid / Femara yekha.

ZOKHUDZA: Kugwiritsa ntchito Metformin pochotsa PCOS mankhwala

Dr. Cly ndi Dr. Peters onse akutchula spironolactone kukhala wogwira mtima yekha kapena kuphatikiza mankhwala ena ochepetsa mahomoni amphongo; koma Dr. Cly akuchenjeza kuti ali, pachiwopsezo chochepa chazovuta zakumaliseche mwa makanda achimuna ngati mayi atenga pakati pomwe akutenga.Chifukwa chake, odwala ayenera kukhala pa kulera komanso kuyesa magazi kuti awone ma elekitirodi amafunika nthawi zonse.

Kwa tsitsi losafunikira, Dr. kirimu cha eflornithine hydrochloride (mankhwala opatsirana omwe angagwiritsidwe ntchito poletsa kukula kwa tsitsi) ngati njira ina kuwonjezera pa njira zochotsera tsitsi monga kupukuta, kumeta, kapena electrolysis / laser kuchotsa tsitsi.

Dr. Peters ananenanso kuti matenda a cholesterol, matenda ashuga, kugona tulo, ndi matenda a chiwindi, zomwe zimawoneka mwa anthu omwe ali ndi PCOS, amachitiridwa chimodzimodzi momwe angakhalire mwa munthu yemwe alibe PCOS.

Pazovuta zakubereka, kuwonjezera pa mankhwala omwe Dr Cly ndi Dr. Peters adawauza, adokotala angavomereze letrozole kapena gonadotropin.

Letrozole imachedwetsa kupanga estrogen ndipo imapangitsa kuti thupi lizipanga mahomoni ambiri opatsa mphamvu (FSH), mahomoni ofunikira ovulation. Pomwe a National Institute of Child Health and Human Development - kafukufuku wothandizidwa anapeza kuti letrozole ndi yothandiza kwambiri kuposa clomiphene poyambitsa ovulation ndikusintha miyezo yobadwira, maphunziro a letrozole m'zinyama asonyeza kuti imayambitsa zolakwika zobereka zikagwiritsidwa ntchito panthawi yapakati. Sipanakhale maphunziro a mankhwalawa mwa amayi apakati.Imeneyi ndi mankhwala ochotsera chizindikiro.

Gonadotropin ndi mahomoni omwe amachititsa ovulation. Amapatsidwa ngati jakisoni. Chifukwa mankhwalawa ali pachiwopsezo chachikulu chotenga mimba zingapo, dokotala wanu amatha kuyitanitsa mayeso ndi ma ultrasound kuti awunikire thupi lanu mukamalandira chithandizo.

Opaleshoni

PCOS sichingakonzedwe ndi opareshoni, koma maopaleshoni ena atha kuthandiza pazovuta zina za PCOS.

Kunenepa kwambiri, matenda ashuga, ndi matenda amadzimadzi amatha, nthawi yayitali, amatha kuthandizidwa ndi opaleshoni ya bariatric, Dr.

Dr. Cly akuwonjezera kuti, Amayi omwe amataya thupi pambuyo poti opareshoni ya m'mimba amawonetsa nyengo zanthawi zonse ndikukhazikika kwazizindikiro zawo.

Yobowola yamchiberekero Ndi njira yothandizira osabereka yokhudzana ndi PCOS. Kafukufuku waposachedwa awonetsa kuti Laparoscopic Ovarian Drilling, LOD, (kuchotsa ena mwa ma cystic ovarian minofu) kumabweretsa kuchuluka kwa mimba poyesa kutenga pakati poyerekeza ndi clomid yokha, atero Dr. Cly. Komabe, kafukufuku waposachedwa kwambiri adawulula kuti Femara(letrozole)zinali zothandiza monga opaleshoni ya LOD pathupi. Kuphatikiza apo, opareshoni siyothandiza kusintha zizindikilo kapena zotsatira za PCOS pomwe mayi sakufuna kutenga pakati.

Kodi ndikulonjeza chiyani za PCOS?

Ngakhale PCOS ikhoza kukhala nanu moyo wonse, zizindikilo siziyenera kukhala. Mankhwalawa ndi opambana kwambiri pakuchepetsa zizindikirazo, akutsimikizira Dr. Cly.

Dr. Chan amaperekanso chilimbikitso : Mukamaliza kusamba, mahomoni a estrogen ndi testosterone amabwera mwachilengedwe, kenako zizindikiro za PCOS zimatha kusintha. Kumbukirani kuti gawo lililonse la matendawa, ngakhale sitingathe kuwachiza, titha kuthana ndi zizindikirazo.

Kafukufuku wozungulira PCOS akupitilizabe kupereka chiyembekezo. Ndizosangalatsa kudziwa kuti pali mayankho ambiri omwe akufufuzidwa ndipo tikukhulupirira kuti pakhala mankhwala a PCOS posachedwa kwambiri, Dr. Cly akutero.

Ndili ndi PCOS ndipo ndikufunikirabe kuthana ndi zina mwazizindikiro zanga. Ndili ndi anyamata awiri okongola omwe ndidatenga pakati osafunikira chithandizo chamankhwala, ndi njira yomwe ingathetsere kapena kupewa zovuta zambiri za PCOS momwe ndingathere. Kuzindikira kwa PCOS kumatha kukhala kowopsa-kowopsa ngati kupeza tsitsi la chibwano pa konsati ya Rolling Stones - koma ndizofala, ndizotheka, ndipo ndizotheka kukhala ndi moyo wathanzi, wathanzi ndi PCOS.