Supplements

Yahan supplement ka matlab hai har woh cheez jo dukaan se baghair nuskhe ke mile aur khane ke saath, ya is ki jagah, li jaye: vitamin aur mineral, machhli ka tel, jari bootiyon wali dawaein aur paudon ke araq, aur menopause ke naam par bikne wali cheezein.

Women's Health Concern, jo British Menopause Society ka aam logon ke liye hissa hai, woh lakeer kheenchta hai jo aham hai. Is ka kehna hai ke jin jari bootiyon wali dawaon par dawaon ke kisi idare ki nigrani nahin, unhein mehfooz na samjha jaye, kyunke in ki taaqat aur asar bohat badalta hai aur in se side effects ho sakte hain ya doosri dawaon se takrao ho sakta hai. Yehi tanbeeh yeh mila kar banaye gaye bioidentical hormone ke baare mein bhi deti hai, jo kabhi kabhi qudrati HRT keh kar beche jate hain, aur jin par na sarkari nigrani hai na aam HRT (hormone ki dawa) jaisa meyaar ka control. Label par qudrati likha hone se yeh baat nahin badalti.

NICE NG23

NICE doctors se kehta hai ke jo auratein dawa ke ilawa doosre tareeqe aazmane ka soch rahi hon, unhein teen baatein batayen:

• jin hormone wali cheezon par sarkari nigrani nahin, un ka asar aur hifazat maloom nahin (1.4.5)
• aisi cheezon ke ajza kitne mehfooz, kis meyaar ke aur kitne khaalis hain, yeh maloom nahin ho sakta (1.4.6)
• kuch saboot hain ke isoflavones ya black cohosh hot flush (garmi lagti hai) aur raat ke paseenon mein aaram de sakti hain, magar in ki bohat si qismein bikti hain, woh aik doosre se mukhtalif hain, in ki hifazat pakki nahin, aur doosri dawaon se takrao ki reportein hain (1.4.7).

Isoflavones phytoestrogen ka aik group hain, jin ka apna safha hai.

Jin auraton ko chhaati ka cancer reh chuka ho ya jinhein is ka zyada khatra ho, un ke liye NICE kehta hai ke kuch saboot hain ke St John's wort hot flush mein madad kar sakti hai, magar yeh pakka nahin ke kitni miqdaar theek hai, asar kitni der rehta hai, qismein aik doosre se kitni mukhtalif hain, aur doosri dawaon se sanjeeda takrao ho sakta hai, jin mein tamoxifen, khoon patla karne wali dawaein aur mirgi ki dawaein shamil hain (1.4.8).

Pakistan Menopause Society

2026 ki sifarishaat ka section 6.5 kehta hai ke dukaan se milne wale supplement ehtiyaat se istemal kiye jayen, kyunke in ki hifazat aur asar ke pakke saboot kam hain. Phir yeh kai ke naam leta hai, saath in ki ehtiyaatein:

• zyada miqdaar wali haldi khoon patla karne wali dawaon ke saath ehtiyaat maangti hai
• mirgi wali auratein sage se bachein, aur estrogen se asar lene wale cancer wali auratein ise ehtiyaat se lein
• milk thistle un dawaon se takra sakti hai jo jigar se guzarti hain, khoon patla karne wali dawaein bhi, aur hormone se asar lene wale cancer wali ya hormone wala ilaaj lene wali auraton ke liye is ki sifarish nahin
• Asiai (Panax) ginseng mein estrogen jaisa asar hai, aur hormone se asar lene wali beemariyon wali auratein is se bachein
• zyada miqdaar wali haldi, vitamin E aur omega three supplement, har aik, chhaati par tamoxifen ka hifazati asar kam kar sakte hain.

Sifarishaat in mein se kai ki miqdaar bhi likhti hain. Hum woh yahan nahin likh rahe: miqdaar ka faisla aap ke doctor ka hai, label ka nahin.

NHS

NHS ki website evening primrose oil, black cohosh, angelica, ginseng, St John's wort aur red clover ko un jari bootiyon wali dawaon mein ginti hai jo kuch auratein leti hain. Yeh kehti hai ke kuch mein paudon ke hormone hote hain, aur menopause ki alamaat mein in ke kisi faide ke peeche science ka saboot nahin. Yeh khabardar karti hai ke khaas taur par St John's wort doosri dawaon ke saath lene se sanjeeda side effects de sakti hai.

British Menopause Society

BMS ka ghiza wala tool kehta hai ke perimenopause (mahwari band hone ke aas paas ka waqt) aur is ke baad auraton ke liye woh sirf aik ghizai supplement ki sifarish karti hai, vitamin D, aur baqi supplement sirf tab liye jayen jab koi tibbi zaroorat ho. Pakistan Menopause Society Pakistan mein vitamin D ki zaroorat ko ghar ke andar rehne wali zindagi aur parde se jorti hai (Table 5). Miqdaar doctor ka kaam hai; baqi hamara vitamin D aur calcium wala safha batata hai.

BMS ka ghair hormone wale ilaaj par consensus statement mazeed kehta hai ke black cohosh, tamoxifen ke kaam mein rukawat dalti hai aur tamoxifen lene wali auraton ko is se bachna chahiye.

The Menopause Society

The Menopause Society, jo America ki hai, 2023 mein saboot ka jaiza le kar hot flush ke liye supplement ya jari bootiyon wali dawaon ki sifarish nahin karti, kyunke saboot ya to in ke khilaf hain ya bohat kam. Is ki list mein black cohosh, wild yam, dong quai, evening primrose oil, maca, ginseng, chasteberry, milk thistle, pollen extract, omega three aur vitamin E shamil hain. Black cohosh par yeh NICE se aage jati hai, jis ki raaye oopar hai.

Wild yam par yeh saaf baat karti hai. Jism ke paas is paude ke diosgenin ko progesterone mein badalne ka koi raasta nahin, is liye yam cream progesterone ka kaam nahin kar sakti. Jin yam creamon ki jaanch hui, un mein aksar yam tha hi nahin, aur bohat si mein aise hormone mile hue the jo label par nahin likhe the, jin mein estrogen aur progesterone bhi the.

Haddiyon ke liye, is ka 2021 ka haddiyon ki kamzori (osteoporosis) wala bayan koi pakka saboot nahin pata ke boron, zinc, black cohosh, berberine ya DHEA menopause ke baad haddiyon ki mazbooti (bone density) barhate hain ya haddi tootne se bachate hain.

Agar aap hot flush ya neend ke liye kuch dhoond rahi hain aur HRT aap ke liye nahin, to hidayat mein doctor ki likhi hui doosri dawaein bhi hain. Dekhein ghair harmoonal ilaaj.

Apne doctor aur pharmacist ko har woh cheez batayen jo aap leti hain, jari bootiyon wali cheezein aur ghar ke totke bhi. NHS mashwara deta hai ke dawa ke ilawa koi doosra tareeqa shuru karne se pehle GP ya pharmacist se pooch lein.

Yeh sab se zyada tab aham hai jab aap ko chhaati ka cancer ya hormone se asar lene wali koi aur beemari reh chuki ho, aap tamoxifen ya koi aur hormone wala ilaaj leti hon, khoon patla karne wali dawa leti hon, ya aap ko mirgi ho. Yehi woh haalatein hain jin ka NICE aur Pakistan Menopause Society khaas taur par zikr karte hain.

Agar aap black cohosh leti hain, to The Menopause Society woh tanbeeh batati hai jo America mein is ke label par likhni lazmi hai: agar aap ko jigar ka koi masla hai, ya is ki nishaniyan dikhen, jaise pait mein dard, gehre rang ka peshaab, ya jild ya aankhon ka peela hona, to ise chhor dein aur doctor ko dikhayen.

Totke aksar mohabbat ke saath aate hain: maan ka nuskha, bahar se aaye kisi rishtedaar ka tohfa. Aik ko mana karna us shakhs ko mana karne jaisa lag sakta hai. Yeh kehna ke pehle doctor se pooch loon, mohabbat rakh leta hai aur khatra chhor deta hai.