Haddiyon ki sehat

NHS ki website kehti hai ke menopause ke baad kai saal tak auraton ki haddiyan zyada tezi se ghatti hain, kyunke ande daniyan taqreeban estrogen banana band kar deti hain, jo haddiyon ki hifazat karta hai. Pakistan Menopause Society ki sifarishaat aakhri mahwari ke baad ke pehle paanch chhe saal ko haddiyan tezi se ghatne ka waqt batati hain (1.2.7.1). Yeh amal kaafi aage barh jaye to haddiyon ki kamzori (osteoporosis) ban jata hai: haddiyan itni kamzor ke aasani se toot jayen.

NHS tezi se ghatne ko estrogen kam hone se jorta hai. Pakistan Menopause Society saath mein aik ehtiyaat rakhti hai: darmiyani umar ka har masla estrogen ki wajah se nahin hota, umar, rehen sehen aur doosri beemariyan bhi apna hissa daalti hain (Table 1).

Pakistan ki auraton ke liye Pakistan Menopause Society teen baatein ginwati hai jo aik doosre par charhti jaati hain: menopause ki ausat umar ka kam hona, poore mulk mein phaili vitamin D ki kami ke saath osteoporosis ka bhaari bojh, aur warzish ki kami (section 4.1). Jaldi menopause ka matlab hai us ke baad ke saal zyada. Is ki sifarishaat ghar ke andar ki zindagi aur parde ko woh wajhein batati hain jin se Pakistan mein vitamin D itna aham ho jata hai, aur Pakistan ki auraton ke liye un ka mashwara hai ke jahan mumkin ho vitamin D baqaidagi se check kiya jaye (Table 5).

NHS ki website yehi baat doosri taraf se kehti hai. Jin girohon ko kaafi vitamin D na milne ka khatra zyada hai, un mein woh un logon ka naam leti hai jo kam hi bahar jaate hain, jo bahar nikalte waqt aam taur par jism ka zyada tar hissa dhaanp kar rakhte hain, aur gehri rangat wale log, jin mein junoobi Asiai nasl ke log bhi shamil hain. Yeh parhne wali bohat si auraton par shayad teenon baatein poori utarti hon.

• Khana. NHS ki website calcium ke achhe zaraye mein doodh dahi, hari patton wali sabziyan jaise bhindi, broccoli aur band gobhi, soya bean, tofu, meve, woh aata jis mein izafi ghizaiyat milayi gayi ho, aur haddiyon samet khayi jaane wali machhli ginwati hai. Pakistani bawarchi khane ke liye aik baat: woh kehti hai ke palak mein calcium to hai magar saath mein oxalate bhi, jo calcium ka jazb hona kam kar deta hai, is liye palak calcium ka achha zariya nahin. Miqdaar ke liye neeche diya gaya NHS ka safha aur vitamin D aur calcium dekhein, aur chai ke liye chai aur caffeine.
• Harkat. Pakistan Menopause Society aisi warzish ko jis mein jism apna wazan khud uthaye, jaise chehal qadmi aur halki aerobics, haddiyon ki sehat ke liye zaroori kehti hai, khaas taur par osteoporosis ke bhaari bojh ko dekhte hue, aur saath mein wazan uthana bhi ginwati hai (Table 6).
• Cigarette (tambaku noshi). Yehi sifarishaat cigarette, naswar aur shisha chhorne ko haddiyon ki mazbooti behtar karne wala batati hain (Table 7). Cigarette, naswar aur shisha dekhein.

NICE ki hidayat NG23 faidon aur khatraat wali apni table mein batati hain ke HRT (hormone ki dawa) haddiyon ke liye kya karti hai: jab tak HRT li ja rahi ho, haddi tootne ka khatra (fragility fracture) kam rehta hai. Isi table ke mutabiq yeh faida ilaaj ke dauran rehta hai aur ilaaj rukne ke baad kam hota jata hai. Pakistan Menopause Society haddiyon ki sehat barqarar rakhne ko MHT, yani HRT ke liye us ke lafz, ki bari wajoohaat mein ginti hai (5.1).

Is ka matlab yeh nahin ke HRT har aurat ke liye haddiyon ka ilaaj hai. Yeh aap ke liye theek hai ya nahin, yeh aap ki sehat ki tareekh par hai, aur aap ka doctor aap ke saath mil kar yeh dekhta hai. Osteoporosis ke liye hormone ke baghair wali dawaein bhi hain, jin ki baat haddiyon ki kamzori (osteoporosis) mein hai.

Menopause ki kisi bhi mulaqat mein apni haddiyon ke baare mein poochein. NICE ki hidayat NG23 doctoron se kehti hain ke yeh mashwara dein aur jaize ki mulaqaton mein is par laut kar aayen.

Pakistan Menopause Society doctoron se kehti hai ke zyada khatre wali auraton mein haddi tootne ke khatre ka andaza lagayen, aur jahan sahoolat ho wahan DXA scan (haddiyon ki mazbooti naapne ka scan) par ghaur karein: jin ki haddi maamooli chot se toot chuki ho; jinhein waqt se pehle menopause, yani waqt se pehle menopause, ya premature ovarian insufficiency, yani ande daniyon ka waqt se bohat pehle kaam kam kar dena, ho; jinhon ne lambe arse tak steroid liye hon; jo baar baar girti hon; ya jin ka qad wazeh taur par kam hua ho (Table 4). Agar in mein se koi baat aap par laagu hoti hai to doctor ko batayen.

Maamooli girne par haddi toot jaye, ya qad wazeh taur par kam ho jaye, to agli maamool ki mulaqat ka intezaar karne ke bajaye jald baat karein.

Jism dhaanpna imaan ka intekhab hai, aur yahan kuch bhi aap se ise badalne ko nahin kehta. Pakistan Menopause Society parde ko un wajhon mein se aik batati hai jin se Pakistan mein vitamin D aham hai, aur wahan is ka mashwara hai ke jahan mumkin ho is ki satah check ki jaye. Doctor se is ki baat karna amli sawal hai, mazhabi nahin.

Aap ke khandan ki bari umar ki auratein bhi is ka hissa hain. Jhuki kamar wali ammi ya khala, ya koi buzurg jin ka kulha girne ke baad toot gaya ho, yeh khandan ki tareekh hai jo mulaqat mein batane ke qaabil hai.