Hot flush

Garmi ki aik lehar jo kahin se bhi aa jati hai, umooman seene se uth kar gardan aur chehre tak.

Jab yeh neend mein aaye aur aap paseene mein bheeg jayen, to is ka apna naam hai: raat ke paseene. Doctor in donon ko mila kar vasomotor symptoms kehte hain, aur hidayat mein aap ko yehi lafz milega.

Seene se garmi oopar charhti hai, jabke kamre mein baqi sab aaram se baithe hain. Baat karte karte chehra laal ho jata hai. Dupatte ke neeche baalon ki jaron mein paseena. Dil bilawajah tez dharakne lagta hai, ya garmi aane se zara pehle aik dam ghabrahat. Phir kabhi kabhi, garmi guzar jane ke baad, thand aur kapkapi.

Zyada tar auratein kehti hain: garmi lagti hai. Kuch doctor ko batati hain ke baar baar bukhar ho jata hai, aur hot flush pehchana hi nahin jata. Sehat ke chaar sarkari Urdu pamphlets mein bhi hot flush ka tarjuma halka bukhar likha gaya.

Pakistan Menopause Society ki sifarishaat bayan karti hain ke hot flush is liye hote hain ke estrogen badalne se dimagh ka garmi sardi sambhalne wala nizaam tawazun kho baithta hai. Yun samjhein jaise thermostat zaroorat se zyada hassas ho gaya ho aur thandak ke saare intezaam aik saath chala de: chehre ki surkhi, paseena, tez dharkan.

Isi liye sardiyon ke beech, thande kamre mein bhi hot flush aa sakta hai. Kamra nahin badla. Andar ki setting badal gayi hai.

• NHS ki website halke kapron, raat ko thande kamre, thande paani se nahane, pankhe ya thande mashroob, stress kam karne ke tareeqon, baqaida warzish aur sehatmand wazan ka zikr karti hai. Jin cheezon se bachne ya unhein kam karne ko kehti hai, kyunke woh hot flush ko chher sakti hain, un mein mirch masale wala khana, caffeine, garam mashroobat aur cigarette shamil hain.
• European Menopause and Andropause Society (EMAS) kehti hai ke warzish se hot flush kam hote hain ya nahin, is par shawahid mile jule hain. Woh phir bhi mazboot haddiyon aur girne ka khatra kam karne ke liye warzish ka mashwara deti hai. Bas is se yeh umeed na rakhein ke hot flush thande par jayenge.
• Wazan par, The Menopause Society kehti hai ke mehdood shawahid batate hain ke wazan kam karne se kuch auraton mein hot flush kam ho sakte hain, aur jab yeh daur abhi shuru hi hua ho to is ka asar zyada ho sakta hai.
• British Menopause Society bhi caffeine ko un cheezon mein ginti hai jo hot flush barha sakti hain. Chai par, Pakistan Menopause Society kehti hai ke Pakistan mein chai bohat pi jati hai, aur doctoron se kehti hai ke aap ke saath is par baat karein, kab peeti hain aur kitni, donon (Table 7).

NICE NG23 aur PMS ki sifarishaat, donon HRT (hormone ki dawa) ko hot flush ke liye pehle darje ka option likhti hain, un auraton ke liye jo ise le sakti hon. Aap le sakti hain ya nahin, yeh doctor ka faisla hai. NHS ki website kehti hai ke ho sakta hai HRT un auraton ke liye theek na ho jinhein chhaati, ande dani ya bachedani ka cancer raha ho, jin ka high blood pressure baghair ilaaj ke ho, ya jinhein jigar ki beemari ho, aur NICE NG23 doctoron se kehta hai ke jis aurat ko koi aisi beemari ho jis par HRT ka asar par sakta ho, us ke liye kisi maahir se mashwara lene par ghaur karein (1.8.2).

NICE NG23 teen aur baatein kehta hai jo har aurat ko maloom honi chahiyen:

• CBT par: NICE kehta hai ke doctor menopause se jure vasomotor symptoms ke liye menopause ke liye khaas CBT (baat cheet ki therapy) ko aik option ke taur par dekhein (1.5.2). PMS ki sifarishaat bhi hot flush aur mood ke liye CBT ki sifarish karti hain, aamne saamne, group mein ya door baithe, online (4.2.4.1).
• Baghair hormone ki aik nayi dawa par: NICE kehta hai ke jab HRT munasib na ho, to darmiyane se shadeed vasomotor symptoms ke ilaaj ke liye fezolinetant aik option ke taur par tajweez ki jati hai (1.5.3).
• Depression ki dawaon par: NICE kehta hai ke sirf vasomotor symptoms ke liye SSRIs, SNRIs ya clonidine ko mamool ke taur par pehla ilaaj na banaya jaye (1.5.4).

Yeh aakhri baat yahan khaas ahmiyat rakhti hai. Rawalpindi ke Benazir Bhutto Hospital mein depression ki tashkhees wali 45 se 55 saal ki 250 auraton ke aik audit ne, jo 2024 mein aik conference mein pesh hua, paya ke un mein se 78% mein perimenopause ki numayan alamaat theen jo nazar andaaz ho gayi theen (Gul, 2024). Agar sirf hot flush ke liye depression ki dawa di jaye, to yeh poochna bilkul theek hai ke yeh kis liye hai.

EMAS yeh bhi kehti hai ke baghair hormone wali dawaein, jin mein fezolinetant aur depression ki kuch dawaein shamil hain, umooman HRT se kam asar karti hain.

Agar hot flush naye hain, ya aap ki neend ya kaam kharab kar rahe hain, to appointment lene ke liye yehi kaafi wajah hai.

Jaldi doctor ko dikhayen agar garmi ke saath bohat tez bukhar ho, ya garmi, thand aur kapkapi, khansi ya pait chalna ho, ya wazan baghair koshish ke kam ho raha ho. NHS ki website raat ke paseenon ke saath in alamaat ko aisi nishaniyan kehti hai jinhein GP ko dekhna chahiye, kyunke yeh menopause ke ilawa kisi aur cheez ki taraf ishara kar sakti hain.

Roze ke din hot flush aur bhi bhaari parta hai. Maghrib tak paani nahin, iftar ke waqt garam bawarchi khana, taraweeh mein bhari hui saff. Auratein poochti hain ke kya yeh garmi roze ke baare mein kuch badalti hai, aur unhein is ka seedha jawab kam hi milta hai. Roze ke baare mein sawal kisi mustanad aalim se poochein. Ramzan mein dawa kab lein, yeh sawal us doctor se poochein jis ne dawa likhi hai.

Ghar mein aksar sab se mushkil yeh hota hai ke laal chehra aur paseene se bheegi qameez aise shohar ya saas ko kaise samjhayen jis ne yeh lafz kabhi suna hi nahin. Aik aisa lafz hona jo aap oonchi awaaz mein keh sakein, aik shuruaat hai.