Ambiri amadziwika kuti nthawi ya kusamba ndi njira yachilengedwe ya kusintha kwa zaka zomwe zimakhudzana ndi kutha kwa ntchito yobereka. Komabe, zizindikiro zokhudzana ndi matenda nthawi zina zimangopangitsa mkazi kusokonezeka, komanso zimakhudza kwambiri khalidwe la moyo ndi mphamvu za ntchito. Pochita kusintha kwa mahomoni, zotsatirazi zikuwoneka:
- maganizo;
- vegetative ndi mtima;
- Matenda a machitidwe okhudza zachilengedwe;
- kuchepetsa chilakolako chogonana.
Ndipo iyi si mndandanda wathunthu wa nthawi zonse zosasangalatsa zomwe zimakhudzana ndi kuchepa kwa estrogen yomwe imapangidwa mu thupi lachikazi ndi kusamba.
Estrogens ali ndi kusamba
Pochepetsa kuchepetsa maonekedwe a zizindikiro zokhudzana ndi kutha kwa thupi, mankhwala a estrogen amakhala ogwiritsidwa ntchito nthawi zambiri. Chomwe chimatchedwa kuti "hormone substitution therapy" chimagwiritsidwa ntchito pofuna kuteteza ndikukonza matenda omwe akugwera pansi pa mlingo wa estrogen pakutha. Zokonzekera ntchito za HRT zimagawidwa m'magulu awiri molingana ndi maonekedwe awo:
- Zomwe zili ndi estrogen. Nthawi zambiri amasankhidwa pambuyo pa opaleshoni (kuchotsa chiberekero).
- Ali ndi estrogen ndi progesterone . Progesterone imagwiritsidwa ntchito poteteza endometrium.
Tiyenera kukumbukira kuti ndi mankhwala osokoneza bongo ndi estrogens ayenera kuperekedwa mosamala kwambiri, popeza ali ndi zotsutsana. Zimaletsedweratu kugwiritsa ntchito mankhwala a estrogenic kwa amayi omwe ali ndi matendawa:
- khansa ya m'mawere, endometrium, chiberekero, khansa ya khansa;
- Matenda a chiwindi, tsamba la biliary, mtima, matenda ozungulira (matenda a mtima, sitiroko, thrombophlebitis, etc.);
- Kutuluka magazi kwa chiyambi chosadziwika.
Komanso, kukonzekera ndi estrogens sikovomerezeka kwa amayi odwala matenda a menopa omwe ali ndi endometriosis , mazira a chiberekero, amayi omwe ali ndi kuthamanga kwa magazi.
Ngakhale kulibe kutsutsana kwakukulu kwa kugwiritsidwa ntchito kwa maantirogen pokonzekera kusamba, HRT iyenera kulamulidwa pokhapokha kuyang'aniridwa ndi dokotala, kuganizira za umunthu wa thupi ndi kusonyeza zizindikiro. Mukamamwa mankhwalawa, kufufuza kosalekeza nthawi zonse n'kofunika. Odwala omwe amagwiritsira ntchito mankhwala osokoneza bongo a progesterone kuwonjezera pa kafukufuku wamakono ayenera kuperekedwa kwa chiwopsezo cha khansa kapena kusintha kwapadera kwa endometrium.