Chii chinonzi PCOS?

Dzidzo yehutano

Sezvo Mick Jagger aitaridza mafambiro ake, shamwari yangu neni takanga tichipururudza-tichiimba pamwe nemumhanzi uye tichitora tarisiro. Uye zvakazoitika. Ruoko rwangu rwakakwesha chirebvu changu, uye ndakanzwa iro bvudzi rekutanga rine bvudzi. Ndakanga ndine makore 14; Ndingadai ndakatanga kuveura makumbo angu… ndingagona here kuve nebvudzi rinokura kubva kumeso kwangu? Ini ndakapedza iyo yakasara yekonzati ndichitsvaga ndichikwenya paquarter-inch invader ukuwo Mick achichema nekusagona kwake kuwana kugutsikana. Ichi chaive zano rangu rekutanga randaive naro polycystic ovary chirwere (PCOS), chirwere chinowanzoitika chehomoni pakati pevakadzi vezera rekubereka.

Chii chinonzi PCOS?

PCOS mamiriro ehormonal anosanganisira endocrine uye ekubereka masisitimu. It inobata pakati pe5% ne13% yevakadzi vari pakati pemakore gumi nemashanu kusvika makumi mana nemana ekuberekwa, uye inogona kukonzera mazai akawedzera kana madiki maovarian cysts. Yakanga iri chete mushure mekuongororwa kwangu sevechiri kuyaruka ndipo pandakaziva kuti vangani vamwe vakadzi muhupenyu hwangu vane mamiriro akafanana. Yakanyanya kuwanda kupfuura vakadzi vazhinji vanoziva.

Ndezvipi zviratidzo zvekutanga zvePCOS?

Zviratidzo zvePCOS zvinogona kusiyana kubva pamunhu kuenda kumunhu. Mumwe munhu ane PCOS inogona kuratidza zvimwe kana zvese zvinotevera.

• Nguva dzisina kumwedzi dzekuenda kumwedzi, kusanganisira kusamboenda kumwedzi, kugara uchirasikirwa nemwedzi, kubuda ropa kwakanyanya, kana kubuda ropa pasina ovulation
• Kurera huremu kana kufutisa
• Zvakaoma kurasikirwa uremu
• Matambudziko ekubereka kana kushaya mbereko
• Kurwadziwa kwepamuviri
• Bvudzi rakawandisa kukura munzvimbo dzakaita sekumeso, chifuva, mudumbu, kana chidya - dzimwe nguva zvinonzi hirsutism
• Ganda rine mafuta
• Acne, kunyanya kana iri yakaoma, kunonoka-kutanga, uye / kana kusapindura mushe pakurapa kwepamusoro
• Acanthosis Nigricans (zvigamba zve rima, rakakora, velvety ganda),inowanikwa mumapanga emutsipa, muhapwa, kugomera, nedzimwe nzvimbo

Chii chinokonzera PCOS?

Chikonzero chePCOS hachizivikanwe, anotsanangura Ann Peters , MD, chiremba wechikadzi uye chiremba muThe Gynecology Center paMercy Medical Center muBaltimore, Maryland. PCOS chirwere chakaomarara icho chinofungidzirwa kuti chiri muchikamu chekuzvarwa (nhaka) uye muchidimbu zvakatipoteredza. PCOS inogona kumhanya mumhuri. Anenge mumwe chete wevarwere vana vane PCOS vane amai vaive vaonekwa kuti vane PCOS futi (mune kumwe kuongorora nhamba iyi yakatokura).

Nepo majini uye zvakatipoteredza zvinhu zviri kufungidzirwa, Geoffrey Cly , MD, OB / GYN muFort Wayne, Indiana, inotaura kuti hapana zvidzidzo zvakanyatso kuratidza hukama hwechibereko kana chinhu chakakomberedza chinokonzera PCOS.

Sezvazvakandiitira, PCOS inowanzo kukura mukuyaruka, asi Dr. Peters vanoti, kuongororwa kwacho kunogona kunonoka kwemakore akati wandei zvichitevera kutanga kwemazuva, sekusajairika kwekuenda kumwedzi zvisiri zvakajairika sekutaurirana pakati pehuropi, mazai, uye chibereko chinokura.

Mapiritsi ekudzivirira kuberekwa anogona kuvhara zviratidzo uye kukonzera zvisizvo mhedzisiro, izvo zvinokonzeresa kunonoka pakati pekutanga kwePCOS uye kuongororwa. PCOS inogona kunge isingawanikwe kudzamara varwere varega nzira dzekudzivirira kuberekwa kana kuona nguva dzisina kujairika pavanenge vachiedza kubata pamuviri, anotsanangura Dr. Peters, achiwedzera kuti mune dzimwe nguva PCOS inoonekwa gare gare muhupenyu - kunyanya kuvakadzi vane huremu hwakateedzana zvichiteedzana vachiri kuyaruka nekutanga 20s.

Iyo Mayo Clinic inotaura yakakwira insulin mazinga-iyo mahormone inoenzanisa mashuga eropa, kuwanda uyerogen kugadzirwa, uye yakaderera-giredhi kuzvimba sezvinhu zvine njodzi zvinogona kuita basa muPCOS, asi kusvika nhasi chikonzero chaicho hachizivikanwe.

PCOS yakakomba here?

Nepo zvimwe zviratidzo zvePCOS, senge rakawandisa bvudzi kana acne inyaya dzezvipenga, PCOS inosanganisirwa nemamwe matambudziko akakomba ehutano.

Vakadzi vane PCOS vari panjodzi yekuwedzera yezvinetso zvehutano, Dr. Peters anodaro. [Izvi zvinosanganisira] metabolic syndrome (boka renyeredzi rekuongorora zvinosanganisira kukwirisa kweropa, kusagadzikana kwepombi, uye kufutisa), insulin kudzvinyirira pairi nematanho epamusoro erudzi rwechipiri chirwere cheshuga, chirwere chemwoyo, kushaya mbereko, uye uterine / endometrial[mutsara wechibereko]gomarara.

Zvimwe zvinonetsa zvinogona kusanganisira kurara kufema, kutadza kurara steatohepatitis (yakakomba chiropa kuzvimba kunokonzerwa nekuunganidzwa kwemafuta muchiropa), gestational chirwere cheshuga, uye kupererwa nemimba kana kuberekwa nguva isati yakwana.

Izvi hazvireve kuti vakadzi vese vane PCOS vanozovandudza aya mamiriro, asi kuwedzera kwehutano hutano kunoreva kurapa PCOS kwakakosha. Dr. Peters vanonongedza kuti PCOS chirwere chehupenyu hwese.

PCOS inogona zvakare kukanganisa hutano hwepfungwa. Kushungurudzika uye kusagadzikana kwepfungwa [inyaya] dzakakosha nyaya dzisingafanire kusiiwa dzisingarapwa nekupangwa mazano, kurapwa kweboka, uye / kana mishonga pazvinenge zvichidikanwa, Dr. Cly anodaro.

Chidzidzo inotarisirwa neColumbia University Chikoro cheNursing purofesa Nancy Reame, MSN, Ph.D., uye yakaburitswa mu Zvinyorwa zveKuzvibata Hutano Services & Tsvagiridzo vakawana kuti kumwedzi kumisidzana kwaive chiratidzo chakanyanya kusangana nezvinetso zvepfungwa.

PCOS inoonekwa sei?

Nhanho yekutanga kuona yako mupi wezvehutano. Wako wezvechiremba nzvimbo yakanaka yekutanga. Zvichienderana nezviratidzo zvako uye kurapwa kunodiwa, Chiremba wako anogona kukutumira kunoona chiremba wehutano hwevakadzi kana vamwe vana mazvikokota senge gynecologist, endocrinologist, uye / kana dermatologist.

Chiremba wako anogona kubvunza nezve ako zviratidzo uye kuti vange varipo kwenguva yakareba sei, pamwe nemishonga ipi yauri kutora. Ivo vanogona zvakare kukutumira iwe kunoongororwa kweropa, kunyanya kuti utarise yakakwira mamazinga e androgen,kureva testosterone(murume mahormone).

Iyo ultrasound yekutarisa ovarian cysts inogona zvakare kurairwa. Vakadzi vasina PCOS vanogona zvakare kunge vane ma cysts, asi vashoma pane gumi nevaviri havasviki maitiro ekuongororwa, anonyora Dr. Jessica Chan, mutevedzeri purofesa we Obstetrics uye Gynecology kuCedars-Sinai uye reproductin endocrinologist ine hunyanzvi muPCOS.

Dr. Chan anonongedzerawo kuti vamwe vakadzi vane PCOS vanogona kunge vasina cysts zvachose. Ndakawira muchikamu ichi panguva yekuongororwa kwangu uye kwemakore mazhinji mushure. Chiremba wangu akanditsanangurira ipapo kuti nekuti PCOS chirwere, ovarian cysts haidi kuvepo kuita PCOS kuongororwa kana zvimwe zviratidzo zviripo.

Dr. Chan anonyora maitiro ePCOS kuongororwa sekupa pamwe nezviviri kana kupfuura zvinotevera.

• Nguva dzisina kujairika, dzinorema, kana dzakarasika nekuda kwekushaya ovulation (ichi chingave chikonzero chekushaya mbereko)
• Zviratidzo zvepamusoro-kupfuura-zvakajairwa mazinga e androgens, ayo anogona kusanganisira akawandisa muviri bvudzi munzvimbo varume vanowanzokura bvudzi (kumeso, chifuva, musana, nezvimwewo), kana kurasikirwa nevhudzi. Androgen mazinga anogona zvakare kuongororwa kuburikidza neropa.
• 12 kana anopfuura ovarian cysts (akakura kupfuura akajairwa mazai follicles) sezvakaratidzwa kuburikidza ne ultrasound.

Rondedzero yemiedzo inowanzo rairwa kutonga kunze kwekuvapo kwechero kumwe kusagadzikana kwehomoni.

PCOS inogona kurapwa here?

Nehurombo, hapana mushonga wePCOS, asi izvo hazvireve kuti vanhu vanoonekwa vaine mamiriro acho vanofanira kutambura. Zviratidzo zvePCOS zvinobudirira kwazvo nemishonga uye shanduko yemararamiro, Dr. Peters anotsanangura. Kunyangwe kushaya mbereko kunowanikwa nevarwere vePCOS kunogona kubudirira kukunda nemishonga.

PCOS inorapwa sei?

Zviratidzo zvePCOS zvinorapwa mune imwe kana musanganiswa wenzira nhatu: mararamiro anochinja, mishonga, uye (kashoma) kuvhiyiwa.

Mararamiro Ekuchinja

Hupenyu hwehupenyu shanduko uye kurasikirwa uremu ndizvo zvakakosha pakurapa kwePCOS, Dr. Peters anodaro.

Kurera huremu uye kudya zvine hutano ndiyo mishonga isingabatsiri yekurapa, anotsinhira Dr. Cly, achiwedzera, Kuvandudza muPCOS kunotanga nekurasikirwa nehuremu kwe [mukuru kupfuura] 5% yehuremu hwese hwemuviri. Iko kuvandudzwa kwezviratidzo kwakatokura nekuwedzera uremu.

Mune chinyorwa chake cheCedars-Sinai, Dr. Chan anokurudzira varwere vane PCOS kuti varambe vachishanda, kusanganisira maminetsi makumi matatu kusvika kumana ekurovedza muviri mazuva matatu kana mana pasvondo. Anoratidza zvakare kutora yakaderera-makabhohaidhiretsi chikafu. Vakadzi vane PCOS havawanzo gadzira makabhohaidhiretsi sevamwe vakadzi. Akawandisa macarhydrate akacheneswa seshuga anogona kutungamira kukudzivirira insulin uye kuwedzera huremu, anodaro.

Mishonga

Mishonga yakajairika ndeye mahormone ekudzivirira kuberekwa muchimiro chemapiritsi kana chigamba kana mhete, anodaro Dr. Cly, nekuti izvo zvinodzora zvinoenda kumwedzi… uye zvakare zvinoderedza huwandu hwe testosterone kutenderera saka zvinobatsira mukukura kwebvudzi zvakare.

Metformin , chinodhaka chinonyanya kushandiswa kudzora shuga yakakwira muvanhu vane chirwere cheshuga cheshuga, uye mimwe mishonga yeshuga dzimwe nguva inorayirwa PCOS nekuti inoderedza insulin kushorwa.Iyo inoshandiswa seyakaregedzwa-chinodhaka sezvo Kudya neDrug Administration (FDA) isina kuibvumidza kurapwa kwePCOS nekuti mugadziri haana kutsvaga kubvumidzwa; zvisinei neyakajeka kiriniki yekutsvaga data, inowanzo shandiswa mishonga.Dr. Cly haavakurudzire nekuti zvidzidzo zvenguva refu hazvina kuratidza kukosha kukuru. Dr. Cly vanotsanangudza mumwe musiyano, Zvisinei, kana mukadzi ari kuyedza kubata pamuviri achiwedzera metformin kuna Clomid kana Femara ichawedzera mikana yake yekuzvitakura katatu zvakapfuura pane ne (ovulation inokurudzira mishonga) Clomid / Femara chete.

RELATED: Uchishandisa Metformin ye off-label PCOS kurapwa

Dr. Cly na Dr. Peters vese vanotaura spironolactone sekushanda uri wega kana musanganiswa nemimwe mishonga yekudzikisa emahormone evarume; asi Dr. Cly vanoyambira kuti ine, iine njodzi isingawanzoitika yehunhu hwepabonde muvacheche vechirume kana mukadzi akabata pamuviri achiitora.Nekudaro, varwere vanofanirwa kunge vari pakubata pamuviri uye kuongororwa kweropa kuongorora maelektrolyte anodiwa kazhinji.

Nezvevhudzi risingadiwe, Dr. Peters anoratidza eflornithine hydrochloride cream (mushonga wemusoro unogona kushandiswa kudzora bvudzi kukura) senzira yekuwedzera nzira dzekubvisa bvudzi dzakadai sekuomesa, kuveura, kana electrolysis / laser kubvisa bvudzi.

Dr. Peters vanotaura zvakare kuti yakakwira cholesterol nyaya, chirwere cheshuga, kurara kufema, uye chakakora chiropa chirwere, mamiriro ayo anowanzoonekwa kune vanhu vane PCOS, vanorapwa nenzira imwecheteyo ivo vangave vari mumunhu asina PCOS.

Pamatambudziko ekubereka, pamusoro pemishonga yakataurwa naDr Cly naDr Peters, chiremba wako anogona kukurudzira letrozole kana gonadotropin.

Letrozole inononoka kugadzirwa kweestrogen uye inokonzeresa kuti muviri ugadzire yakawanda follicle-inosimudzira mahormone (FSH), iyo mahormoni inodiwa kuti ovulation. Nepo a National Institute of Mwana Hutano uye Kubudirira Kwevanhu- inotsigirwa kudzidza vakawana kuti letrozole inoshanda zvakanyanya kupfuura clomiphene mukukonzera ovulation nekuvandudza kurarama-kuberekwa mareti, zvidzidzo zve letrozole mumhuka zvakaratidza kuti zvinokonzeresa kuremara kwekuberekwa kana ikashandiswa panguva yekuzvitakura. Pakave pasina kuongororwa kwechirwere ichi mumadzimai akazvitakura.Ichowo chiri kure-chitaridzi kurapwa.

Gonadotropin mahormone anokonzera ovulation. Vanopihwa sejekiseni. Nekuti kurapwa uku kune njodzi huru yekuzvitakura kwakawanda, chiremba wako anogona kuraira kwakawanda bvunzo uye maastround ekuongorora muviri wako panguva yekurapwa.

Kuvhiya

PCOS haigone kugadziriswa nekuvhiyiwa, asi kumwe kuvhiya kunogona kubatsira nemamiriro ezvinhu ePCOS.

Kufutisa, chirwere cheshuga, uye metabolic syndrome inogona, muzviitiko zvakanyanya, kutarisirwa nekuvhiyiwa bariatric, Dr. Peters anodaro.

Dr. Cly anowedzera, Vakadzi vanorasikirwa nehuremu hwakakosha mushure mekuvhiyiwa kwepamuviri vanoratidza dzinowanzoitika nguva uye kuomarara kwezviratidzo zvavo.

Ovarian kuchera sarudzo yekurapa yekushaya mbereko yakabatana nePCOS. Ongororo dzichangoburwa dzakaratidza kuti Laparoscopic Ovarian Drilling, LOD, (ichibvisa imwe yecystic ovarian tishu) inoguma nehupamhi hwepamuviri nhumbu paunenge uchiedza kubata pamuviri uchienzaniswa necomomid wega, anodaro Dr. Cly. Zvisinei, kudzidza kuchangobva kuitika yakaratidza izvozvo Femara(letrozole)yaingove inoshanda sekuvhiya kweLOD mukuwana nhumbu. Uyezve, kuvhiyiwa hakubatsire kunatsiridza zviratidzo kana kuwanikwa kwePCOS kana mukadzi asiri kuyedza kubata pamuviri.

Chii chiri kuvimbisa nezvePCOS?

Kunyange PCOS inogona kunge iinewe kwehupenyu hwese, zviratidzo hazvifanirwe kunge zviri. Marapirwo acho akabudirira zvakanyanya mukudzvinyirira zviratidzo, anovimbisa Dr. Cly.

Dr. Chan anopawo simbiso : Paunenge wapedza kuenda kumwedzi, estrogen uye testosterone mahormone anouya pasi zvakasununguka, uyezve zviratidzo zvePCOS zvinogona kusimukira. Rangarira kuti kuburikidza nedanho rega rega rerwere, kunyangwe isu tisingakwanise kuripora, tinogona kubata zviratidzo.

Zvidzidzo zvakatenderedza PCOS zvinoramba zvichipa tariro. Zvakanaka kuziva kuti kune mimwe mhinduro dziri kuongororwa uye tinotarisira kuti kuchave nemushonga wePCOS munguva iri kure, Dr Cly vanodaro.

Ndichine PCOS uye ini ndichiri kuda kubata zvimwe zvezviratidzo zvangu. Ini zvakare ndine vakomana vaviri vakanaka vandakaitisa nhumbu pasina chikonzero chekurapa mbereko, uye chirongwa chiri munzvimbo yekudzora kana kudzivirira yakawanda mhedzisiro yePCOS sezvandinogona. Kuongororwa kwePCOS kunogona kutyisa-sekutyisa sekutsvaga bvudzi rebvu pane konzati yeRolling Stones - asi zvakajairika, zvinogoneka, uye zvinokwanisika kurarama hupenyu hwakazara, hune hutano neCPOS.