Ghair harmoonal ilaaj

Ghair harmoonal ilaaj estrogen wapas dale baghair menopause ki alamaat kam karte hain. In mein se zyada tar dawaein pehle kisi aur cheez ke liye bani thin, jaise depression ya mirgi, isi liye British Menopause Society likhti hai ke menopause ki alamaat ke liye in ka istemal aksar off-licence hota hai. Off-licence ka matlab hai ke dawa ka licence hai, bas is kaam ke liye nahin, is liye aap ke doctor ko samjhana chahiye ke yeh kyun tajweez ki ja rahi hai.

Kuch option dawa hain hi nahin. CBT in mein se aik hai, aur Women's Health Concern is ke hisse ke taur par aahista saans (paced breathing) sikhata hai. Akele aahista saans ke baare mein Australasian Menopause Society ko hot flush (achanak garmi lagna) ke liye is ke haq mein kaafi saboot nahin milta.

Fezolinetant

Aik nayi goli jo dimagh ke aik signal ko rokti hai jise BMS hot flush aur raat ke paseenon se jorti hai. NICE is ki sifarish tab karta hai jab HRT theek na ho, aur PMS ki table ilaaj se pehle aur is ke dauran jigar ke test likhti hai. Poora safha: fezolinetant.

SSRIs aur SNRIs

Yeh depression ki dawaein hain. PMS ki table hot flush ke liye paroxetine aur escitalopram (SSRIs), aur venlafaxine aur desvenlafaxine (SNRIs) ginti hai. BMS likhti hai ke paroxetine aur fluoxetine se tamoxifen ka asar kam ho sakta hai, jabke citalopram, escitalopram aur venlafaxine ka is par bohat kam asar hota hai, ya koi nahin. NHS ki website mazeed kehti hai ke jahan depression ya bechaini ki tashkhees ho chuki ho, wahan depression ki dawaein mood ki alamaat mein madad kar sakti hain. Mazeed menopause ke liye SSRIs mein.

Gabapentin

Mirgi aur nason ke dard ki dawa. PMS ki table ise raat ke hot flush aur bohat tooti hui neend ke liye off-label option likhti hai. BMS is ke side effects mein munh khushk hona, chakkar aana aur neend si rehna ginti hai.

Oxybutynin

Aik anticholinergic dawa. PMS ki table ise hot flush ke liye off-label likhti hai, aur kehti hai ke yeh un auraton ke liye munasib ho sakti hai jinhein saath hi baar baar peshaab aane ki shikayat (overactive bladder) bhi ho (dekhein peshaab aur masane ki takleef). Australasian Menopause Society bari umar ki auraton mein ehtiyaat ka kehti hai, kyunke yaaddasht aur sochne samajhne ki salahiyat kam hone ka khatra hai.

Clonidine

Blood pressure ki aik dawa. NHS ki website kehti hai ke yeh hot flush aur raat ke paseene kam karne mein madad kar sakti hai, aur BMS likhti hai ke us ki mutabadil ki fehrist mein yehi wahid dawa hai jis ka licence is kaam ke liye hai. Yeh PMS ki table mein nahin. Jin auraton ko chhaati ka cancer ho chuka ho, un ke liye British Menopause Society hot flush ke jin ghair harmoonal options ki sifarish karti hai, un mein clonidine bhi shamil hai.

Goliyon se aage

PMS ki sifarishaat stellate ganglion block ka zikr karti hain, yani gardan ke qareeb aik injection, jo specialist ke haathon doosre darje ka option hai, aur jis par ab tak chhote trial hi hue hain (section 6 aur 7.1.2). America ki The Menopause Society kehti hai ke yeh darmiyane se bohat shadeed hot flush wali kuch auraton ki madad kar sakta hai, magar khabardar karti hai ke yeh aik aisa tareeqa (procedure) hai jis ke apne khatre hain, is liye ise ghaur se tolna chahiye.

Doosra clinical hypnosis hai, yani maahir ki rehnumai mein zehan ko gehre sukoon ki haalat mein le jana. The Menopause Society ise hot flush ke liye tajweez karti hai aur is ke saboot ko mazboot darje ka maanti hai; yeh kisi tarbiyat yafta maahir ke saath ya smartphone ki app se kiya ja sakta hai. Jin Bartanvi idaron ko hum ne dekha, un mein se koi bhi in donon ka naam nahin leta.

NICE NG23 sifarish karta hai ke jo auratein HRT le sakti hain, unhein hot flush aur raat ke paseenon ke liye pehle HRT pesh ki jaye (1.5.1). Jin auraton ke liye HRT theek nahin, un ke liye woh fezolinetant ko aik option kehti hai. Woh yeh bhi kehti hai ke sirf hot flush aur raat ke paseenon ke liye SSRIs aur SNRIs wali depression ki dawaein, ya clonidine, aam taur par pehle ilaaj ke taur par nahin di jani chahiyen.

The Menopause Society hot flush ke options ko saboot ke darjon mein rakhti hai: CBT, clinical hypnosis, SSRIs aur SNRIs, gabapentin aur fezolinetant mazboot saboot par, oxybutynin mazboot se mehdood saboot par, aur wazan kam karna aur stellate ganglion block is se bhi mehdood saboot par. European Menopause and Andropause Society (EMAS) mazeed kehti hai ke ghair harmoonal dawaein aam taur par HRT se kam kaam karti hain.

Pakistan mein NICE ki yeh baat aham hai. Rawalpindi ke aik hospital mein depression ki tashkhees wali 45 se 55 saal ki 250 auraton ke aik audit mein, jo 2024 mein aik conference mein pesh kiya gaya, 78% mein perimenopause (mahwari band hone ke aas paas ka waqt) ki wazeh alamaat milein jo nazar andaaz ho gayi thin (Gul, 2024).

Agar side effects tang kar rahe hon, ya munasib arsa aazmane ke baad bhi ilaaj se faida na hua ho, to doctor ko dikhayen. Chhorne se pehle dawa likhne wale se baat karein: PMS ki table likhti hai ke in mein se kai dawaein chhorte waqt aahista aahista kam karni parti hain.

Agar aap tamoxifen ya koi aur lambi chalne wali dawa leti hain to kuch bhi naya shuru hone se pehle bata dein.

Hot flush ke liye depression ki dawa haath mein aana chubh sakta hai. BMS likhti hai ke junoobi Asiyai communities mein zehni sehat par zyada baat nahin hoti, is liye yeh nuskha aik label jaisa lag sakta hai. Zaroori nahin ke ho: in mein se kai dawaein khud hot flush ke liye istemal hoti hain. Poochein ke yeh kis liye hai, aur khul kar poochein.

Kuch auratein deen ki wajah se hormone se bachna pasand karti hain. Koi khaas dawa deen ke lihaaz se theek hai ya nahin, yeh kisi mustanad aalim se poochne ka sawal hai. Roze wale din ise kab lein, yeh dawa likhne wale ka sawal hai.