Kudwala kwa Mkazi Ali Pafupi Kusamba—Kuli Kongoganizira Kapena ndi Kwenikweni?

Khalidwe lake limasinthasintha ndipo lili losatsimikizirika. Apa wavomera; pena watsutsa. Amalankhula motaya mtima. Mosasamala kanthu za mawu anu otonthoza, amakwiya nazo zimene mumanena ndi kuchita. Mwinamwake nkhani yaing’onong’ono ikula kukhala mkangano wowopsa. Patapita masiku angapo, kapena mlungu umodzi, mkazi “wina” ameneyu amasintha mwadzidzidzi, ndipo amakhalanso munthu wabwinobwino . . . kwakanthaŵi.

ZOONA, si akazi onse amene khalidwe lawo limasintha kwambiri motero. Komabe, asanayambe kusamba, akazi ena angakhale atazindikira kuti amafanana ndi mkazi mnzawoyo womasinthasintha ngati namzikambe. Kodi chimachititsa kusintha khalidwe kumeneko nchiyani? Kodi kusintha kwa panyengo ya kusamba kumachititsadi khalidwe lotero?

Kodi PMS Nchiyani?

Malinga ndi American Journal of Psychiatry, akazi amene amakhala ndi “zizindikiro zosatha zimene zimakhala zosautsa kwakuti zimasokoneza mbali zina za moyo” ndi zimene nthaŵi zonse zimachitika kusamba kuli pafupi, angakhale ndi PMS (premenstrual syndrome [kudwala kwa mkazi ali pafupi kusamba]). Ngakhale kuti palibe njira zopimira m’malaboletale zimene zingapeze PMS, akazi omwe ali ndi PMS amapeza bwino panthaŵi ina kwa mlungu umodzi kapena iŵiri mkati mwa nyengo ya kusamba. Mwa njira imeneyi, madokotala amayerekezera kuti 10 peresenti yokha ya akazi ndiwo amadwala PMS.

Madokotala ena amaona PMS mosiyana. Amanena kuti akazi ochuluka, pakati pa 40 ndi 90 peresenti, amadwala PMS. Amati liwulo limaphatikizapo madandaulo osiyanasiyana amene akazi amakhala nawo, monga kunenepa, kutopa, kuphwanya m’mfundo, kupweteka m’mimba, mutu wa litsipa, kukwiyakwiya, kufeŵa maŵere, kuliralira, kulakalaka chakudya, ndi kusintha khalidwe. PMS ili ndi zizindikiro zoposa 150. Akazi, kuphatikizapo aja amene analeka kusamba, angakhale ndi zizindikiro zilizonse kapena zingapo mwa zimenezi. Komabe, mkazi nthaŵi zambiri amadwala PMS m’zaka zake za m’ma 30. Kwa akazi ochuluka, zizindikiro za PMS zili zosautsa koma zopiririka. M’nkhani ino tidzakambitsirana za akaziwa okhala ndi PMS yaing’ono.

Nancy Reame, wofufuza wa pa University of Michigan, anasimba kuti PMS imaonedwa monga “nthenda yachisawawa” ku United States, koma m’maiko ena pali kusiyana kwambiri kwa mitundu ndi ukulu wa zizindikiro zake. “Ena amasimba za zizindikiro zazikulu koposa zosonyezedwa ndi thupi, ndipo maiko ena amasimba za zizindikiro zambiri zosonyezedwa ndi mtima,” iye anatero. Reame, amene wafufuza nkhaniyo ku China, anatchula Atchayina monga chitsanzo. “Malinga ndi mwambo wa Atchayina si kwabwino kukhala ndi zizindikiro zosonyezedwa ndi mtima.” Chotero akazi amatchula kwambiri za kupweteka m’mimba atafunsidwa za zovuta za kusamba, iye anatero.

Chiyambi Chake cha PMS

Amene anayamba kufotokoza za PMS anali Dr. Robert T. Frank wa ku New York mu 1931 m’nkhani yake yakuti “Mahomoni Ochititsa Nsautso Nthaŵi ya Kusamba Ili Pafupi.” Anaona akazi omwe anavutika ndi kutopa, kusaganiza bwino, ndi kupsinjika mtima asanayambe kusamba.

Patapita zaka 22, Katharina Dalton ndi Raymond Greene, madokotala a ku England, anafalitsa nkhani ina m’magazini a zamankhwala mmene anapeka liwulo “premenstrual syndrome” (kudwala kwa mkazi ali pafupi kusamba). Dr. Dalton anati PMS ndiyo “nthenda yofala koposa, ndipo mwinamwake yakale koposa padziko.” Ziyambukiro zimene iye anapeza zimene PMS ingakhale nazo pa khalidwe la mkazi zinadziŵika mu 1980. Iyeyo ndi madokotala ena anapemphedwa kupima akazi aŵiri Achibritishi amene anazengedwa mlandu wambanda. Iwo ananena kuti khalidwe la mkazi likhoza kusintha chifukwa cha kusinthasintha kwa mahomoni panyengo yake ya kusamba. Chifukwa cha zimene anapeza pa kupima kwawo PMS, ziweruzo za kupha pamilandu iŵiriyo zinachepetsedwa. Pogamula mlandu wolakwa mmodzi anapezeka ndi mlandu wocheperapo wa kupha munthu chifukwa cha “kusokonezeka maganizo.”

Kukhala ndi khalidwe lowononga kwa akazi, monga m’nkhaniyo, sikumachitikachitika. Zochititsa khalidwe lotero ndi zizindikiro zina zazing’ono zosautsa zimene akazi ambiri amakhala nazo panyengo ya kusamba zikukhalabe nkhani yamkangano m’magazini a zamankhwala ndi magazini a nkhani zina.

Kodi kusinthasintha kwa mahomoni m’thupi la mkazi ndiko kumachititsadi khalidwe lotero? Kapena kodi kunena kuti ndi mahomoni osakhazikika ndi thupi losalamulirika la mkazi kuli kongoganizira chabe? Pali kusiyana malingaliro ponena za chiyambukiro chimene kusinthasintha kwa mahomoni kumakhala nacho pathupi la mkazi, ngati chilipo nkomwe. Ofufuza ambiri ndi madokotala amavomereza kuti kumvetsetsa kugwirizana kwa ubongo ndi mahomoni a kuchimake cha mazira panyengo ya kusamba ndiko njira yodziŵira chimene akazi ena amadwalira PMS.

Nyengo ya Kusamba

Pafupifupi kamodzi pamilungu inayi iliyonse, thupi la mkazi limaloŵa m’nyengo yocholoŵana kwambiri ya kusinthasintha kwa mahomoni. Liwulo “menstruation” (kusamba), limene ambiri amati ndi “temberero,” latengedwa ku liwu Lachilatini la mensis, lotanthauza “mwezi.”

Kuti nyengoyo iyambe, hypothalamus ya ubongo imatumiza uthenga ku pituitary gland. Italandira uthengawo, pituitary imatulutsa FSH (follicle-stimulating hormone). FSH imayenda m’mwazi kupita kuzimake za mazira ndi kusonkhezera kupangika kwa estrogen. Pamene estrogen iwonjezeka, pituitary imayamba kutumiza LH (luteinizing hormone). LH imachedwetsa kutuluka kwa FSH. Dzira limodzi limakhwima ndi kutuluka kuloŵa m’chibaliro. Dziralo litatuluka, homoni ya progesterone imatulutsidwa. Ngati dziralo siligwirizana ndi ubwamuna, milingo ya progesterone ndi estrogen imatsika mofulumira.

Popanda mahomoni ouchirikiza, muyalo wa chibaliro umafooka, ndipo mwazi, madzi, ndi minofu ina zimatulukira kumpheto. Kumatenga masiku atatu kapena asanu ndi aŵiri kuti chibaliro cha mkazi chimalize kutulutsa muyalo wake, kuthetsa nyengo imodzi ya kusamba. Nyengoyo itapita, ubongo umatulutsanso mahomoni, kuyambitsa nyengo yatsopano.

Nkhondo ya Mahomoni?

Ena amanenetsa kuti kusalingana kwa mlingo wa estrogen ndi wa progesterone ndiko kumachititsa kudwala kwa mkazi ali pafupi kusamba. Amati mahomoni nthaŵi zambiri amagwira ntchito pamodzi kuti pakhale kulingana kwabwino. Pamene ina ipangika yambiri kuposa inayo, pamakhala nkhondo, ndipo ziyambukiro zake zimatsala m’thupi la mkazi.

Kuchuluka kwambiri kwa estrogen kungachititse akazi ena kukwiyakwiya. Mwa ena, progesterone imachuluka, ikumawachititsa tondovi ndi kutopa.

Ofufuza ena amatsutsa lingaliro lakuti kusalingana kwa mahomoni kumachititsa PMS. Amatsutsa kuti mkhalidwe wa maganizo ndi wa malo umathandizira kwambiri kudwala kwa akazi ena ali pafupi kusamba. Patient Care, pofotokoza zochititsa PMS, ikuti “palibe kusiyana kotsimikizirika komwe kwapezeka konena za mkhalidwe, ziŵerengero, unyinji, kapena nthaŵi ya mahomoni akuzimake za mazira mwa akazi okhala ndi PMS yaing’ono kapena yaikulu.”

Mwachitsanzo, kupsinjika mtima kungafulumize, kuchedwetsa, kapena kukulitsa zizindikiro za PMS. Buku lakuti PMS—Premenstrual Syndrome and You: Next Month Can Be Different likuti: “Kupsinjika mtima kumaletsa kutuluka kwa mahomoni ndipo mlingo wosakwana wa mahomoni ungachititse mahomoni kusalingana, ukumawonjezera zizindikiro za PMS.” Zothetsa nzeru za thanzi, za ndalama, kapena za banja zingaoneke kukhala zazikulu kwambiri ndi zosalamulirika kusamba kusanayambe.

Kuwopa Mnyozo

Ofufuza ena amatsutsa kuti mkazi angaonedwe kukhala wantchito kapena wopanga zigamulo wosafunika kwenikweni ngati asonyeza zizindikiro za kusamba kwake. “Ndiyo njira imene anthu amaikira akazi pa malo otsika. Ukadwala kamodzi pamwezi, ndiye kuti suyenera kuchita zinthu zazikulu, zamphamvu, ndi zofunika zimenezi,” akutero Barbara Sommer, katswiri wa zamaganizo.

Ofufuza ena amatsutsa kuti akazi avomereza PMS chifukwa chakuti imawalola kugwiritsira ntchito mkhalidwewo monga chifukwa chokhalira ndi khalidwe lawo lina. Pakufunsa kwa m’magazini a Redbook Dr. Carol Tavris, wolemba The Mismeasure of Woman, akuti PMS “imalola akazi kunena kuti, ‘Kodi ndadwala matenda ŵanji?’ osati kuti, ‘Kodi chalakwika nchiyani m’moyo wanga chimene chikundisautsa?’”

Mu 1985, akatswiri achikazi a nthenda zamaganizo a mu Committee on Women ya APA (American Psychiatric Association) analimbikira kuti PMS isaikidwe mu Diagnostic and Statistical Manual ya APA. Ngakhale kuti ikusonyezedwa pampambo wa mawu m’buku lomwe lilipo (la 1987) monga “late luteal phase dysphoric disorder,” kagulu ka APA kanena kuti kadzalemba “premenstrual dysphoric disorder” (PMDD) mkati mwa kope lake lotsatira. Kuiika mkati mwa bukulo kudzaipatsa malo a nthenda ya maganizo yodziŵika.

“Ilibiretu malo m’bukulo chifukwa chakuti siili nthenda ya maganizo,” akutero Dr. Paula Kaplan, amene kale anali phungu wa kaguluko. “Mtsogolomu mkazi akasankhidwa kukhala loya wamkulu, adzafunsidwa kuti: ‘Kodi munadwalapo PMDD?’” iye anatero.

Kufunafuna Mpumulo

Madokotala akupitiriza kukangana pankhani ya PMS. Pakubuka mafotokozedwe ambiri onena za chochititsa PMS ndi machiritso ake. Madokotala ena amaganiza kuti payenera kukhala mitundu 18 ya PMS, iliyonse ikumasonyeza zizindikiro zosiyana. Kufufuza kwina kwa posachedwa kunasonyeza kuti zinc ingakhale ikuthandizira kuyambitsa zizindikiro za PMS. Kufufuza kwina kunasonyeza kuti chochititsa vutolo chingakhale kusoŵa vitameni-B₆, komachititsa ena tondovi pang’ono.

Akazi ofunafuna mpumulo pa zizindikiro zosaleka za PMS amayesa njira zambiri zochiritsa monga kusamala kadyedwe ndi zinthu zina, kusintha nthaŵi ya kugona, machitidwe akupumula kwambiri, mankhwala oletsa tondovi, ndi mankhwala a progesterone oika mu mpheto. Kufikira lero, sipanapezeke njira yothandiza kwambiri yachikhalire yochiritsa.

Akazi amene amakhala ndi zizindikiro zosalamulirika kusamba kusanayambe ayenera kuonana ndi dokotala. PMS iliyonse imakhala yapadera, ndipo mkazi aliyense ayenera kupatsidwa malangizo abwino ndi dokotala limodzi ndi chisamaliro choyenera. Popeza kuti PMS ingachite ngati matenda ena aakulu, monga nthenda ya ma thyroid gland, endometriosis, ndi tondovi, kupima m’thupi nkofunika.

Ndi bwino kuti asanakaonane ndi dokotala nthaŵi yoyamba, mkazi asunge dayale kapena mpambo wa zizindikiro zonse zosonyezedwa ndi thupi ndi mtima zimene amakhala nazo ali pafupi kusamba. Kudziŵa masiku pamene khalidwe lake limakonda kusinthasintha, pamene amakwiyakwiya, kapena kuchita tondovi kungamthandize kusintha zochita zake malinga ndi mkhalidwewo. Kungamthandizenso kudziŵa ngati akudwala PMS.

Madokotala anganene za kuchepetsa zinthu zimene zimamchititsa kupsinjika mtima. Chakudya chomanga thupi ndi maseŵero olimbitsa thupi zingagonjetse PMS. Chakudya cha makabohaidireti ambiri koma cha maproteni ochepa chinawongolera khalidwe la akazi ena ochita tondovi ali pafupi kusamba, kufufuza kwa pa yunivesite kunasonyeza zimenezo. Maseŵero olimbitsa thupi kapena kuyenda ndawala masana nthaŵi zonse kungathandizenso polimbana ndi kutopa ndi kunyong’onyeka.

Ndithudi, apabanja, makamaka mwamuna, akhoza kuthandiza. Ayenera kuyesayesa kukhala okoma mtima kwambiri, achifundo, ndi ozindikira bwino pamene nyengo ya kusamba ya mkazi imvutitsa.

Mkanganowo Ukupitiriza

Ena amati kunena kuti kusintha kwa thupi ndi mtima kumene mkazi amakhala nako panyengo yake ya kusamba kuli “kudwala” si kolondola. Ena amakana kuti kulibe PMS, akumati imanyoza akazi.

Komabe, akazi ambiri amadwaladi PMS. Mwezi uliwonse, amakhala ndi zizindikiro zimene zimawavutitsa kuchita ndi banja ndiponso ndi ntchito. Kufunafuna mpumulo ndi chithandizo kumakhala kogwetsa ulesi pamene madokotala ndi anthu wamba ambiri apitiriza kukangana za kukhalako kwa PMS.

[Chithunzi patsamba 15]

Apabanja akhoza kuthandiza mwa kukhala okoma mtima kwambiri ndi achifundo