STRAW+10: bachche paida karne ki umar dhalne ke mor

STRAW ka matlab hai Stages of Reproductive Aging Workshop, yani bachche paida karne ki umar ke dhalne ke moron par workshop. Is ka pehla nuskha 2001 mein aaya. Das saal baad 2011 ki aik workshop ne ise naya kiya, aur +10 wahin se aaya hai, aur Harlow aur un ke saathiyon ne 2012 mein nateeja shaya kiya. Is ke likhne wale ise un moron se milate hain jin se doctor bulooghat bayan karte hain.

Har cheez aik hi maqam se gini jati hai: aap ki aakhri mahwari, mor 0. Is se pehle ke moron ke number manfi hain, is ke baad ke moron ke musbat.

Aasaan lafzon mein mor

• Bachche paida karne ke saal (mor −5 se −3). Baqaida mahwari. Late reproductive stage, yani bachche paida karne ki umar ke aakhri hisse mein, bachche paida karne ki salahiyat kam hone lagti hai, aur is ke baad wale hisse, −3a, mein mahwari ka waqfa thora chhota ho sakta hai. Hormone ki tabdeeliyan mahwari badalne se pehle shuru ho jati hain.
• Early menopausal transition, yani tabdeeli ke daur ki shuruaat (mor −2). Mahwari ka waqfa badalne lagta hai: aik mahwari aur agli ke darmiyan saat din ya zyada ka farq, jo musalsal rahe. Musalsal ka matlab hai ke das mahwariyon ke andar yeh phir ho.
• Late menopausal transition, yani tabdeeli ke daur ka baad wala hissa (mor −1). 60 din ya zyada ka waqfa jis mein mahwari na aaye. Likhne walon ka andaza hai ke yeh ausatan aik se teen saal chalta hai, aur woh kehte hain ke hot flush aur raat ke paseenon ka imkaan yahan hota hai.
• Aakhri mahwari (mor 0). Yeh sirf peeche mur kar pata chalti hai, jab 12 mahine koi aur na aaye.
• Early postmenopause, yani menopause ke fauran baad ka waqt (mor +1a, +1b, +1c). Mor +1a aakhri mahwari ke baad ka pehla saal hai. +1a aur +1b mil kar taqreeban do saal chalte hain jab hormone abhi tezi se badal rahe hote hain, aur likhne wale kehte hain ke hot flush ka imkaan tab sab se zyada hota hai. Mor +1c teen se chhe saal ka thehrao ka waqt hai.
• Late postmenopause, yani menopause ke kaafi baad ka waqt (mor +2). Hormone ki tabdeeliyan sust ho jati hain aur jism ka aam burhapa asal baat ban jata hai. Andaam nihani ki khushki aur peshaab ki alamaat zyada aam ho jati hain.

STRAW+10 ke hisaab se perimenopause mor −2 se mor +1a ke aakhir tak chalta hai, yani aakhri mahwari ke aik saal baad tak. Menopause ke baad ka daur mor 0 se aage ka sab kuch hai.

Mahwari sab se pehle kyun

Likhne wale aisa nizaam chahte the jo aisi cheezon par bana ho jo thos hon, sasti hon, jism mein kuch daale baghair naapi ja sakein, aur har jagah kaam karein. Hormone ke test har jagah aik jaise nahin hote aur in par paisa lagta hai, aur yeh baat kam wasail wale mulkon mein sab se zyada aham hai, is liye mahwari ka pattern hi asal paimana rehta hai. Alamaat paimanon mein shamil nahin. Do qismein, hot flush aur andaam nihani aur peshaab ki tabdeeliyan, sirf saath ki tafseel ke taur par aati hain, kyunke likhne walon ke mutabiq menopause ki alamaat ka koi aisa majmooa tay nahin hua jo har nasl ki auraton par yaksaan ho.

Woh kehte hain ke STRAW+10 umar, nasl, jism ke size ya rehan sehan se qata e nazar laagu hota hai, jo 2001 wale nuskhe se aik tabdeeli hai, jis se bohat si auratein bahar reh gayi thin. Woh kam wasail wale mulkon ki auraton ke behtar adaad o shumar ko bhi research ki tarjeeh kehte hain. Pakistan ke liye yeh kami haqeeqi hai.

Yeh kin par theek nahin baithta

Likhne wale un auraton ko ginwate hain jin ka mor mahwari ke paimanon se tay nahin ho sakta:

• Woh auratein jin ki bachedani nikali ja chuki ho ya endometrial ablation, yani bachedani ki androoni teh khatam karne ka operation, ho chuka ho. Yahan sirf hormone ke test madad kar sakte hain, operation ke kam az kam teen mahine baad, aur aksar aik se zyada baar.
• Woh auratein jinhein ande dani ka waqt se pehle kaam chhor dena (POI) ho, jin ki ande dani baghair kisi andaze ke ruk aur chal sakti hai.
• Woh auratein jinhein polycystic ovary syndrome ho, ya hypothalamic amenorrhoea, yani dimagh ke aik hisse ki wajah se mahwari ka ruk jana, jin ki mahwari ande dani ki umar ke ilawa kisi aur wajah se beqaida ho ya aaye hi nahin.
• Woh auratein jin ka cancer ka ilaaj chal raha ho, ya jo kuch lambi beemariyon ke saath ji rahi hon.

Main kahan hoon? ise kaise istemaal karta hai

Main kahan hoon? pichhle aik saal ki aap ki mahwari ke baare mein STRAW+10 ke tareeqe se poochta hai. Pattern mein tabdeeli tabdeeli ke daur ki shuruaat ki taraf ishara karti hai. Do mahine ya zyada ke waqfe tabdeeli ke daur ke baad wale hisse ki taraf. Barah mahine ya zyada se mahwari na aana menopause ke baad ki taraf. Agar aap ki umar 40 ya zyada hai aur mahwari nahin badli lekin alamaat badal gayi hain, to STRAW+10 ke paas is ke sab se qareeb naam late reproductive stage hai, woh mor jis ka naam koi nahin leta. Agar pata nahin chalta, bachedani ke operation, hormone wali coil ya family planning ki wajah se, ya is liye ke mahwari kabhi baqaida thi hi nahin, to woh kehta hai ke woh mor nahin bata sakta, aur yeh ke doctor aap ki umar aur alamaat se andaza lagaye ga.

Yeh mor ka naam batata hai. Tashkhees nahin karta.

STRAW+10 aik naqsha hai, tashkhees nahin. Amali taur par Pakistan Menopause Society kehti hai ke 45 aur us se zyada umar ki sehatmand auraton mein, jin ki alamaat aam hon, perimenopause aur menopause ki tashkhees alamaat aur mahwari se hoti hai, laboratory ke test ke baghair (Table 3). Dekhein menopause ka pata kaise chalta hai.

Khoon aane ki kuch tabdeeliyan koi mor nahin hotin. PMS jinsi taalluq ke baad khoon aane, do mahwariyon ke darmiyan bila wajah khoon aane, aur achanak bohat bhaari ya lambi mahwari ko khatre ki nishaniyan kehti hai jin ki jaanch zaroori hai. Yehi baat 40 se pehle ki un alamaat ki hai jo premature ovarian insufficiency ki taraf ishara kar sakti hain. Dekhein beqaida mahwari, ke kya aam hai aur kya nahin.