Aap aik fehrist le kar andar jati hain: tooti neend, aisi fikr jo band hi nahin hoti, yaaddasht jo baar baar dhoka deti hai, wazan jo apni jagah badal gaya hai, mahwari jo apni marzi se aati hai, dukhte jor, aur dil jo raat ko tez dharakne lagta hai. Aur bahar aati hain "yeh umar ka taqaza hai", "yeh tension hai", ya kisi aisi dawa ka nuskha le kar jo asal masle ko chhooti tak nahin.

Bohat si auraton ke liye darmiyani umar tabdeeli ka mausam hai. Aksar yeh uljhan aur khamoshi ka mausam bhi hota hai.

Yeh baat saaf kehna zaroori hai: zyada tar doctor parwah karte hain. Woh bhare hue clinicon mein, kam waqt aur lambi fehrist ke saath kaam karte hain. Asal masla yeh hai ke doctoron ki tarbiyat mein menopause (mahwari ka band hona) ko kabhi zyada jagah nahin mili.

Aap akeli nahin

Auraton ki taal diye jane ki kahaniyan ikka dukka nahin.

Bartanvi hukoomat ke Women's Health Strategy survey mein, jis mein taqreeban aik laakh jawab aaye, 84 feesad auraton ne kaha ke aise mauqe aaye jab sehat ke amle ne un ki baat nahin suni. Sirf 64 feesad ne kaha ke woh sehat ke kisi maahir se menopause ke baare mein baat karne mein aaraam mehsoos karti hain.

Bayer ke liye The Harris Poll ke aik Amreeki survey mein paya gaya ke menopause ke dauran ya is ke baad ki 93 feesad auraton ko alamaat thin, phir bhi 34 feesad ne apne doctor se un ka zikr nahin kiya.

Jab auraton ko lagta hai ke un ki baat nahin suni ja rahi, to alamaat ankahi reh jati hain, fikron ko chhota kar diya jata hai, aur ilaaj der se aata hai.

Aisa kyun hota hai: tarbiyat ki kami

Aik wajah yeh hai ke doctoron ki tarbiyat mein menopause ko bohat kam jagah mili hai. Pakistan mein is par tehqeeq kam hai, aur taqreeban saari gynae doctoron ke baare mein hai.

185 gynae doctoron ke aik survey mein, jis ke shurka Karachi mein bharti kiye gaye aur jo May se December 2021 tak chala (Shah aur saathi, Pakistan Journal of Medical Sciences, 2023), 73% menopause ki hormone therapy tajweez karti thin. Sab se bari rukawat kharch tha. Zyada tar ke paas achhi aur taza maloomat niklin, magar haddi tootne se bachao, bechaini aur depression mein aaram, aur wazan barhne ke baare mein maloomat kam thin, aur likhne walon ne refresher courses maange. In 185 mein se 83% Sindh mein kaam karti thin, is liye yeh har soobe ki tasveer nahin.

Aik purana survey zyada mehdood hai. April 1999 mein Karachi ke aik teaching hospital ke 103 doctoron ne HRT ke baare mein sawalon ke jawab diye (Shafi aur saathi, Journal of the Pakistan Medical Association, 2001). Un mein se 35% khud HRT tajweez karne mein mutmain the aur 61.2% gynae doctoron ke paas bhej dete the. Yeh 1999 ke aik hospital ki baat hai, ise aaj ki tasveer na samjhein.

Phir dastaweezat. Pakistan Medical and Dental Council ki 2024 ki MBBS hidayat gynae ki 27 cheezon mein "Menopause & HRT (introduction)" shumar karti hain, aur family medicine ki fehrist mein menopause ki koi cheez nahin. College of Physicians and Surgeons Pakistan ke FCPS gynae ke taqaze HRT ke maujooda tasawwurat ki "aagahi" maangte hain. Dastaweezat yahi kehti hain. Hamein family doctoron ke baare mein menopause par Pakistan ki koi tehqeeq nahin mili, aur aisi bhi koi nahin jo naapti ho ke yahan doctoron ko menopause ki kitni parhayi milti hai.

Bairoon-e-mulk adaad aur sakht hain. Amreeka mein Mayo Clinic Proceedings ki aik tehqeeq ne paya ke family medicine, internal medicine aur gynae ke zer-e-tarbiyat doctoron mein se sirf 6.8 feesad khud ko menopause se guzarti auraton ki dekh bhaal ke liye munasib taur par tayyar samajhte the. Paanch mein se aik, yani 20.3 feesad, ne kaha ke apni tarbiyat ke dauran unhein menopause par koi parhai mili hi nahin.

Yeh kami practice tak chali jati hai. Bartania ke GPs, yani family doctoron, ke aik survey mein 77.5 feesad ne kaha ke medical college aur GP ki tarbiyat mein menopause ki parhai behtar honi chahiye, aur sirf 60.7 feesad menopause ke masail sambhalne aur HRT (hormone ki dawa) ya doosre ilaaj dene mein aaraam mehsoos karte the.

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Yeh adaad mil kar wohi baat kehte hain jo bohat si auratein barson se mehsoos kar rahi hain. Nisaab ki dastaweezat batati hain ke tarbiyat mein menopause kahan khara hai. Woh yeh nahin batatin ke koi aik doctor kya jaanta hai, is liye is sab mein aap ke samne baithe doctor ke khilaf koi faisla nahin. Yeh tayyari ke saath jane ki wajah hai.

Baat tayyari ki hai, ilzaam ki nahin

Bohat kam doctor auraton ki baat taalne ke iraade se shuru karte hain. Bohat son ko bas hormone, perimenopause (mahwari band hone ke aas paas ka waqt) aur in barson mein aane wali tarah tarah ki alamaat ke baare mein kaafi sikhaya hi nahin gaya.

Aur menopause sirf hot flush (achanak garmi lagna) se kahin zyada hai. Yeh neend, mood, yaaddasht, fikr, wazan, khwahish, dil, haddiyon aur zindagi se lutf uthane par asar daal sakta hai. Phir bhi ise aksar auraton ki sehat ka buniyadi hissa samajhne ki bajaye aik zimni mauzoo samjha gaya. Is se donon phans jate hain: aik jawab dhoond rahi hai, doosra ise achhi tarah karne ki tarbiyat, waqt ya sahare ke baghair madad karne ki koshish kar raha hai.

Record itna aham kyun hai

Perimenopause ki alamaat ko taalna aasaan hai, khud us aurat ke liye bhi jo un ke saath jee rahi hai, kyunke woh aati jati rehti hain. Chand raatein neend nahin, phir aik achhi raat. Fikr ki aik lehar, phir sukoon. Mahwari jo chhoti hoti hai, lambi hoti hai, ghaib hoti hai aur wapas aa jati hai. Dhund jo chhatti hai aur phir chha jati hai.

Das minute ya is se bhi kam ki mulaqat mein yeh samjhana mushkil hai. Hafton ka record ise aasaan kar deta hai. Aap aadhi yaad baaton ki bajaye pakki baatein le kar jati hain, doctor rujhan dekh sakta hai, aur baat kisi nateeje tak pohanchti hai.

Apni baat sunwane ke paanch tareeqe

1. Apni alamaat likhein. Yaaddasht par bharosa na karein. Apni neend, mood, mahwari, hot flush, raat ke paseene, tawanai, fikr aur dimaghi dhund likhein. Roshara ka rozana haal taqreeban tees second leta hai, aur aap yeh record apne doctor ko email kar sakti hain.

2. Jaane se pehle tayyari karein. Apni teen sab se bari fikrein likhein, har aik kab se hai, aur aap ke din par kya asar daalti hai. "Hafte mein teen raatein paseene mein bheeg kar aankh khulti hai" par doctor ke liye kuch karna "main apne jaisi mehsoos nahin kar rahi" se kahin aasaan hai.

3. Un ke tajurbe ke baare mein poochein. Larne ki zaroorat nahin. "Aap perimenopause ya menopause ki alamaat ke ilaaj mein kitna aaraam mehsoos karte hain?" aik jaiz sawal hai, aur is ka jawab bohat kuch batata hai. Waqt lete hue aap lady doctor ka bhi keh sakti hain.

4. Sirf ehsaas nahin, notes bhi le jayen. Aap ka ehsaas har haal mein maani rakhta hai. Kya badal raha hai aur kab, is ka record mayoosi ko aisi cheez mein badal deta hai jis par doctor kaam kar sake.

5. Zaroorat ho to doosri raaye lein. Agar aap taale jane ka ehsaas le kar niklein, ya baghair kisi asal baat cheet ke kaha jaye ke "yeh bas umar ka taqaza hai", to kisi aur ko dikhana jaiz hai. Doosri raaye lena par hamara safha batata hai kaise.

Kya badalna chahiye

Agar aap ko doctor ke kamre mein andekha mehsoos hua hai, to aap hargiz akeli nahin. Adaad aur nisaab ki dastaweezat batati hain ke doctoron ki tarbiyat mein menopause ko, Pakistan mein bhi aur bahar bhi, bohat kam jagah mili hai, aur HRT aur darmiyani umar ki auraton ki sehat ki poori tasveer ko bhi. Is se doctor dushman nahin ban jate. Is se menopause ki behtar tarbiyat fauri zaroorat ban jati hai.

Auratein suni jane ki haqdar hain, aur doctor behtar tarbiyat ke. Jab tak donon nahin hote, aap ki apni alamaat ka saaf record yeh yaqeeni banane ka sab se achha tareeqa hai ke baat sahi jagah se shuru ho.

Agli mulaqat se pehle Mulaqat ki tayyari parhein aur apne teen sawal likh lein.