Tsohon Rukunin Bayanai zuwa Tsarin Farko na Musamman
Babban Jami'in Harkokin Tsaro na Amurka - Dokar Firayim Minista a kan ayyukan kare lafiyar jiki - ya tabbatar da ƙaddamar da shi game da tsarin maye gurbin hormone a mazauna mata don hana rigakafin cutar. Bugu da kari, Ƙungiyar Ƙungiyar ta bada wannan sakon wasika na "D," yana nuna wani shawarwari game da shi bisa ga shaidar da aka samu.
Yin amfani da takaddun shaida na musamman da kuma matsayi na musamman, da kuma magance matsalar ko maye gurbin hormone (HR) za a iya ba da shawarar "a gaba ɗaya" ga dukan mata a mazauna mata don yin rigakafin cututtukan zuciya, ciwon daji, ciwon sukari, lalata, osteoporosis, da kuma hadarin mutuwar da ba a taɓa mutuwa ba dangane da kowane daga cikin waɗannan, Ƙungiyar Ƙungiyar ta tabbatacce ne. Amsar wannan tambayar a cikin shaidar da ake samuwa shine: a'a. Akwai dama mai yawa na maye gurbin hormone, amma yawancin halayen mawuyacin hali, kuma gaba ɗaya, bayanan daga mafi girma da mafi kyawun gwajin da aka ƙayyade ba daga amfani ta net.
Amma yayin da rundunar tsaro ta amsa ba ta da wata amsa, tambayar su wani abu ne. Shin ƙarshe ya zo game da maye gurbin hormone a menopause a general, ga dukan mata a general, za a iya fassara shi da kyakkyawar shawara ga kowane mace? A ganina, ba haka ba. Kuma, yayin da Ƙungiyar Ƙungiyar Taswira ta biyo bayan ƙaddarar daga bayanan da ke tattare da matsayinsu na matsayi, za a iya ƙalubalancin waɗannan shaidun.
Yawancin mahimmancin sharuddan sun kasance ba a taɓa rikicewa ba, waɗanda ba a taɓa nazarin su ba, ko kuma suna kau da kai a cikin teku na bayanai.
Four Pitfalls
Tare da girmamawa ga Ƙungiyar Taskoki da kuma ƙaddamarwa, to, ina raba ra'ayi na abokan aiki cewa akwai wata mummunan rauni a yanke hukunci game da maye gurbin hormone. Musamman, Ina tsammanin shawarar da rundunar ta bayar, ita ce ta sha kashi hudu:
1) Juye-tafiye zuwa Tsarin
A duk lokacin da aka fassara bayanai game da yawancin mutane, akwai matsala masu wuya a wurare biyu masu adawa: rushewa, da rabu. Lumping shi ne lokacin da dukkanin ƙungiyoyi daban-daban na babban ƙungiya duk suna bi da wannan. Hanya shine lokacin da aka ba da izini don muhimmancin bambancin a cikin rukuni, gaba daya ta hanyar bincike na rukunin sub-group.
Saboda aiki na Ƙungiyar Tarayya ita ce bayar da shawarwarin da ya shafi jama'a a manyan, ko kuma wani ɓangare mai yawa daga gare shi, sun kasance masu haɗari ga ƙididdigar lumping.
Wace wajibai ne? To, maƙasudinsu game da maye gurbin haɓaka an kafa shi ne mafi yawa a kan gwajin da aka fi sani da shi a kan wannan batun, Dokar Kula da lafiyar mata . Amma wannan fitina ta shigar da tsofaffi da ƙananan mata; matan da suka fara damar kare hakkin dan Adam bayan da suka yi aure, da wadanda suka fara shi shekaru goma bayan haka; matan da suka yi hawan jini kuma sun kasance, saboda haka, suna iya daukar isrogen kadai; da kuma matan da ke cikin mahaifa wanda yake da bukatar hada hade da estrogen tare da progesterone.
Shin duk waɗannan matan daban-daban suna da irin wannan sakamako daga HR? Ba daga gare ta ba. Abokan hulɗa kuma na wallafa wani bincike a shekarar 2013 a cikin Jarida ta Amirka na Lafiya ta Jama'a , bisa ga bayanai daga Mataimakin Lafiya na Mata, amma ya mai da hankali ne a kan sakamako mai dadewa a cikin matan da suka yi amfani da sutura kuma suna daukar isrogen kadai.
Lokacin da waɗannan matan suka fara ciwon isrogen a kusa da ko kafin shekaru 50, lokacin da aka fara yin jima'i da farko, sun sami raguwa ƙwarai a cikin dukkanin lamarin da ke haifar da mace-mace. Ma'anarmu ita ce, ga wannan rukuni na mata, lamarin da yawansu ya kai miliyoyin miliyoyin miliyoyin Amurka, rashin nasarar yin amfani da isrogen na maye gurbin dubban dubban wadanda basu mutu ba a cikin shekaru goma. Irin wannan, to, halayen lalata ne.
2) Na Baby da Bathwater
Abun haɗari da alaka da shi shine rashin nasarar bambanta jariri da wanka a kan hanya zuwa yanke hukunci. Bayanai daga gwajin da Dokar ta bayar ya nuna muhimmancin shekarun lokacin maye gurbin hormone, lokaci game da farawa da mazaunawa, kuma yayinda ake amfani da estrogen da progesterone ko a'a.
Yayinda shawarwari ga dukkan mata suyi amfani da HR za su kasa yin watsi da wankaccen ruwa, wani shawarwarin da zai iya kare shi don ceton jariri.
3) Dokar ta uku na Newton
Shahararren doka na uku na motsa jiki shine: ga kowane mataki, daidai kuma ƙiyayya . A cikin karni na baya, mun tafi da karfin gaske game da maye gurbin hormone, zuwa gagarumar sha'awar bisa al'amuran da ake yi, na dawowa da ƙwarewa bisa ga gwajin gwagwarmaya. Yayinda kowane bayani na layi ya sanar da bayanan da bayanai na yau, haka ma, a wani ɓangare, wani abu ne ga maimaitawa a gaban kullun. Masana kimiyya bazai zama kamar yadda ya dace da wannan ka'idar motsi ta sauƙaƙe a matsayin wani ɓangaren flotsam, amma hangen nesa na ba shi da gaba ɗaya ba shi da shi, ko dai.
4) Rashin Shaidun Shaida akan Shaida na Babu
Tsarin halayen da aka yi da bincike da Ƙungiyar Ƙungiyar ta gani ta tabbatar da cewa shaidar da suke amfani da ita za ta kasance mai kyau. Amma menene tabbacin da aka bayar game da babu shaidar da take da muhimmanci ga yanke shawara sosai? Babu, gaske. Tabbas, Ƙungiyar Ƙungiyar zata yanke shawara ko shaidar da ta samo ta isa don tallafawa taƙaitaccen ra'ayi, kuma suna da takardun wasiƙa don nuna lokacin da ba haka ba. Amma duk da haka, aiwatar da hujjoji na duba yiwuwar tabbatar da babu shaidar don shaida akan rashin.
Abin da ke nufi a cikin wannan mahallin mahallin shine kusan dukkanin bayanan gwajin da aka kwatanta da cewa "maye gurbin hormone" a gaba ɗaya shine, a gaskiya, iyakance ga takamaiman takamaiman, maras kyau matsala na maye gurbin hormone: amfanin Premarin (siffar estrogen daga dawakai, ba mutane ba), da kuma Provera (medroxyprogesterone acetate, wani haɗari da haɓaka mai karfi). An hada haɗin waɗannan "Prem / Pro". Shin abin da muka sani game da waɗannan halayen nan na musamman sun sanar da mu game da duk sauran? A'a, ba haka ba - wannan ne inda shaidar ba ta da shi. Ƙungiyar Ayyuka ta yi la'akari da cewa "shaidar da ba ta nan ba" kamar dai za mu iya tabbatar da cewa ya dace da ra'ayi cewa akwai alamar tabbaci na amfanin da ba a nan ba daga maye gurbin hormone, koda lokacin da ake amfani da kayan aiki mafi kyau. Gaskiyar ita ce, ba mu sani ba.
Yin hukunci akan abin da ke daidai a gare ka
Kamar matakan da ke sama, to alama cewa shawarar da ma'aikatar ta bayar ba ta ba da hankali ga abubuwa uku masu muhimmanci - muhimmancin da za su iya sanar da kanka da yanke shawara na sirri:
1) Daidai Menene?
Masana sun yarda cewa shirye-shiryen hormone ya bambanta a yalwace sakamakon su. Bayanan shari'ar da aka ƙaddamar da shi ba kawai ba ne don yawancin shirye-shiryen irin waɗannan masana sun bada shawarar sosai. Duk da yake ba za mu iya sanin tabbas shirye-shiryen da aka yi na gaba ba ne na ƙaddamar da ƙananan cuta a lokacin da Prem / Pro bai yi ba, gwaji na Prem / Pro ba zai iya raba irin wannan amfanin ba. Koda a cikin bayanai masu samuwa, sakamakon ciwon estrogen da progesterone, tare da estrogen kadai, suna da bambanci sosai.
2) Daidai Lokacin?
Hanyoyin maye gurbi suna bambanta da lokaci. Yin amfani da mata masu ƙananan, kusa da lokacin yin jima'i, ya ba da ƙarin amfana da rashin haɗari fiye da amfani da baya. Babban gwaje-gwajen da aka ƙaddamarwa ya kasance yana amfani da karin amfani da latti, yayin da yake juye bayanai daga waɗannan rukuni tare.
3) Mene Ne?
Mata da suka yi amfani da suturata zasu iya daukar estrogen ba tare da yaduwa ba. A farkon lokacin da aka fara yin jima'i, mafi girma shine amintaccen tasiri na maye gurbin hormon. Ƙididdigar tasiri akan hadarin mutum yana iya bambanta da tarihin iyali na mutum da kuma hadarin martaba. Yayin da ake wajan Ƙungiyar Ɗaukaka don samar da jagoranci na yawan jama'a, wannan matsala ne idan mafi kyau tsarin kulawa don rigakafi shi ne wanda ya dace. Wannan shine cikar ƙarshe da manyan kungiyoyin da ke kula da lafiyar mata, da kuma takamaiman tambaya game da hadarin da ya shafi mazauni.
A ƙarshe, ana amfani da HR don magance cututtuka, maimakon rage yawan hadarin cutar. Babbar shawarwarin da aka yi game da amfani da HR ga wanda zai iya yin kuskure, kuma ba daidai ba, yayi magana da mata da likitoci daga amfani da shi don ɗayan. Duk da yake HR ba zai iya rage haɗarin cutar na kullum ga mata ba, bazai kara yawanta ba; kawai game da "wanke". Wasu hadari sun tashi, wasu sun sauka. Amfani da HKI na ɗan gajeren lokaci don taimakawa bayyanar cututtukan mazaopausal ya kasance abin da zai yiwu, mai dacewa, kuma mai mahimmancin haɗari.
Hanya daga duk wannan ita ce, yayin da Task Force ta samar da abin dogara, shaidar shaida ta hanyar tambaya game da mata a general, wannan tambaya bazai dace da kowane mace ba musamman. Tabbatar da tsarin rayuwar rayuwa don rage haɗarin cutar na kullum yana bada shawarar ga kowa, amma ana iya bada shawarar ga HR. Hanya mafi kyau don inganta amsar mutum shine tambayi likitan ku game da abin da hankali ba ga jama'a ba, amma a gareku.