Ande dani ka waqt se pehle kaam chhor dena (POI)

Premature ovarian insufficiency, ya POI, yani ande dani ka waqt se pehle kaam chhor dena: jab 40 se pehle ande dani theek se kaam karna band kar de, aur mahwari beqaida ho jaye ya ruk jaye.

Yeh kitni aam hai, yeh is par munhasir hai ke aap kis se poochein. British Menopause Society aur Australasian Menopause Society ke mutabiq yeh taqreeban har 100 mein se 1 aurat ko hoti hai. 2024 ki aik bain-ul-aqwami hidayat, jo ESHRE, ASRM, CRE-WHiRL aur International Menopause Society ne mil kar likhi, nayi tehqeeq ki buniyad par ise har 100 mein se 3.5 batati hai. Donon adaad mein woh POI shamil nahin jo operation ya cancer ke ilaaj ki wajah se ho.

Yeh naam soch samajh kar chuna gaya hai. Pakistan Menopause Society ise premature ovarian failure ya premature menopause par tarjeeh deti hai, kyunke ande dani ruk ruk kar phir bhi kaam kar sakti hai, aur kabhi kabhar hamal ho jata hai. Kami, nakaami nahin.

NHS ki website 40 se pehle ke menopause ko premature menopause kehti hai, aur 45 se pehle ke menopause ko waqt se pehle menopause, yani waqt se pehle menopause.

Urdu mein Roshara woh English naam rakhta hai jo doctor pehchane ga, aur use samjha deta hai: ande dani ka waqt se pehle kaam chhor dena.

Early aur premature menopause ko saath bayan karte hue, NHS ki website kehti hai ke sab se bari nishani yeh hai ke 45 se pehle mahwari baqaida na rahe, ya ruk jaye. Doosri alamaat mein hot flush (achanak garmi lagna) aur raat ke paseene, andaam nihani ki khushki, neend ki mushkil, udaasi ya bechaini, jinsi khwahish mein kami, aur yaaddasht ya tawajjo ke masail ho sakte hain.

Phir woh hai jo kisi fehrist mein nahin aata. Yeh sunna ke yeh stress hai, ya wazan, ya kuch bhi nahin. Yeh sochna ke un bachchon ka kya ho ga jo aap abhi bhi chahti hain.

NHS ki website kehti hai ke early ya premature menopause ka imkaan zyada hai agar yeh aap ke khandan mein chalta ho, aap ki mahwari jaldi shuru hui ho, aap cigarette peeti hon ya aap ka wazan kam ho. Yeh doosri beemariyon ke ilaaj se bhi ho sakta hai: radiotherapy ya chemotherapy, kuch hormone wali dawaein, ya ande daniyan nikalne ka operation.

WHO 40 se pehle ke menopause ki mumkina wajoohat mein chromosome ki kuch beemariyan aur autoimmune beemariyan, yani jin mein jism ka difai nizaam apne hi jism par hamla karta hai, bhi ginwata hai, aur kehta hai ke kabhi kabhi wajah maloom nahin hoti. European Menopause and Andropause Society (EMAS) aik aur mumkina wajah batati hai: endometriosis, yani jab bachedani ki androoni teh jaisa tissue bachedani se bahar barhne lage, ya is ka ilaaj.

Tashkhees

NICE NG23 yeh 40 se kam umar ki auraton ke liye batata hai. Doctoron ko aap ki beemariyon, operationon aur khandan ki history ko saamne rakhna chahiye (1.7.1). Tashkhees menopause ki alamaat par hoti hai, jin mein mahwari ka na aana ya kabhi kabhar aana shamil hai, aur saath mein kuch hafton ke farq se liye gaye khoon ke do namoonon mein barha hua FSH (1.7.2), kabhi bhi sirf aik test par nahin (1.7.3). Agar shak ho, to NICE kehta hai ke menopause ya bachche paida karne ke ilaaj ke kisi specialist ke paas bheja jaye (1.7.5).

Pakistan Menopause Society 40 se pehle ki un alamaat ko, jo POI ki taraf ishara karein, un khatre ki nishaniyon mein ginti hai jin ki jaanch ya specialist ke paas bhejna zaroori hai (2.3). Is ki Table 3 doctoron se kehti hai ke POI ki tasdeeq karein, bachche paida karne ki salahiyat aur lambe arse ki sehat ko dekhein, aur jahan zaroorat ho specialist ka mashwara lein.

Lambe arse ki sehat

NHS ki website kehti hai ke agar menopause 45 se pehle shuru ho to kami wale hormone poore karna aham hai, kyunke haddiyon aur dil ke masail ka imkaan zyada hota hai. PMS ki sifarishaat, jahan mumkin ho, haddiyon ki mazbooti ke scan par ghaur karne ki wajoohat mein POI ko bhi ginwati hain (Table 4).

BMS Junoobi Asiai auraton ke liye aik khaas khatre ki taraf ishara karti hai: chunke aksar 35 ke aas paas tak khandan poora ho chuka hota hai, is liye ho sakta hai POI par dhyan na jaye aur ilaaj na ho, aur aage chal kar dil ki beemari, dementia aur haddiyon ki kamzori (osteoporosis) ki soorat mein is ka nateeja nikalta hai. EMAS bhi kehti hai ke POI ka ilaaj na ho to haddiyon ki kamzori, dil ki beemari aur dementia ka khatra barh jata hai.

NICE NG23 sifarish karta hai ke hormone ki kami poori karne ka ilaaj pesh kiya jaye, jis mein HRT (hormone ki dawa) ya hormone wali mushtarka family planning (combined hormonal contraceptive) mein se intikhab ho, siwaye is ke ke koi wajah roke, jaise hormone se barhne wala cancer (1.7.6). Pakistan Menopause Society kehti hai ke POI mein HRT di jani chahiye aur is ki sifarish ki jati hai (5.1).

NICE doctoron se kehta hai ke kai baatein samjhayen (1.7.7). Ilaaj aham hai, aur kam az kam qudrati menopause ki umar tak chalna chahiye, jab tak rukne ki koi wajah na ho. 40 se kam umar mein chhaati ke cancer aur dil ki beemari jaisi beemariyon ka buniyadi khatra bohat kam hota hai. Blood pressure ke liye HRT mushtarka goli se behtar ho sakti hai. Donon haddiyon ki hifazat karti hain. Aur HRT se hamal nahin rukta.

The Menopause Society mazeed kehti hai ke Women's Health Initiative, yani bari umar ki auraton par HRT ke bare tajurbaat, ke nateeje POI wali auraton par laagu nahin hote.

Jo auratein hormone nahin le saktin, jaise kuch cancer ke baad, un ke liye NICE kehta hai ke haddiyon aur dil ki sehat aur alamaat sambhalne par mashwara diya jaye (1.7.8).

Agar aap ki umar 40 se kam hai aur mahwari beqaida ho gayi hai ya ruk gayi hai, to doctor ko dikhayen. Is intezar mein na rahein ke khud theek ho jaye gi. Agar aap ko kaha gaya hai ke yeh stress hai aur tabdeeliyan jaari hain, to yeh poochna aap ka haq hai, naam le kar, ke kya POI ke baare mein socha gaya hai.

Jin gharon mein aur bachchon ki umeed ho, wahan POI aik beemari ki bajaye aurat par faisle ki tarah aa sakti hai. Yeh aik beemari hai jis ka naam hai, hidayat hain aur ilaaj hai.

NHS ki website kehti hai ke POI se hamal theherna mushkil ho sakta hai, aur raaston mein apne munjamid kiye gaye andon ya kisi aur aurat ke diye hue andon se IVF, surrogacy, yani kisi aur aurat ke zariye bachcha paida karwana, aur bachcha god lena ginwati hai. In mein se kuch deen ke sawal uthate hain, aur bohat si auratein yeh sawal poochti hain. In ke liye kisi mustanad aalim ke paas jayen, aur tibbi pehlu ke liye bachche paida karne ke ilaaj ke kisi specialist ke paas.