Ukuqonda Ubuhlungu Bokuvuthwa Kwamaqanda Obuhlobene Ne-Endometriosis: Izimbangela Nokunciphisa Ubuhlungu

I-Endometriosis yisimo esingapheli lapho izicubu ezifanayo nengxenye yangaphakathi yesibeletho (i-endometrium) zikhula ngaphandle kwesibeletho. Lezi zicubu zinganamathela ezithweni ezifana nama-ovari, amashubhu e-fallopian, ngaphandle kwesibeletho, futhi kwezinye izimo, amathumbu nesinye. Lapho izicubu ze-endometrium zikhula kulezi zindawo, ziziphatha ngendlela efanayo nokuzenza ngaphakathi kwesibeletho: ziba nzima, zibhidlika, futhi zopha ngesikhathi somjikelezo wokuya esikhathini. Kodwa-ke, ngenxa yokuthi lezi zicubu azinakho lapho zingaphuma khona emzimbeni, ziyagcinakala, okuholela ekuvuvukaleni, ekwakhekeni kwezicubu zokululama (adhesions), nasebuhlungwini obukhulu.

Enye yezingxenye ezinzima kakhulu zalesi sifo ubuhlungu bokukhishwa kwamaqanda obuhlobene ne-endometriosis, okungubuhlungu obenzeka ngesikhathi sesigaba sokukhishwa kwamaqanda emjikelezweni wokuya esikhathini. Ukukhishwa kwamaqanda inqubo lapho iqanda likhishwa khona esibelethweni, ngokuvamile cishe ngosuku lwe-14 lomjikelezo wezinsuku ezingama-28. Nakuba ukungakhululeki okuncane ngesikhathi sokukhishwa kwamaqanda (okwezinye izikhathi okubizwa ngokuthi "mittelschmerz") kujwayelekile, abesifazane abane-endometriosis bavame ukuba nobuhlungu obukhulu, obuhlala isikhathi eside obungathatha izinsuku [1].

Kungani i-Endometriosis Idala Ubuhlungu Ngesikhathi Sokukhishwa Kwamaqanda

Ukukhishwa kwamaqanda ngokuvamile kubandakanya ukukhululwa iqanda esibelethweni. Kulabo abanalesi sifo i-endometriosis, izicubu ezingaphandle kwesibeletho zisabela ezifananeni nezinguquko zamahomoni ezenzeka engxenyeni yangaphakathi yesibeletho. Lokhu kusabela kungadala ukuvuvukala, ukuqubuka, ngisho nokopha ezindaweni ezithintekile. Lesi simo sithinta u-10% kuya ku-15% wabesifazane abaneminyaka yokuzala. Kwezinye izimo, kwakheka izicubu zokululama (adhesions) ezizungeze ama-ovari namashubhu e-fallopian, okungakhulisa kakhulu ubuhlungu ngesikhathi sokukhishwa kwamaqanda njengoba lezi zicubu ezilimele zelanekiswa futhi zidonswe [2].

I-Endometriosis nobuhlungu bokuvuthwa kwamaqanda kuvame ukuvela njengemizwa ebukhali, efana nokuhlaba engxenyeni engezansi yesisu noma ku-pelvis. Abanye bangase babe nobuhlungu emhlane noma emathangeni ngenxa yokusabalala kwezilonda ze-endometrial ezicutshini ezizungezile. Ubuhlungu bungahlala isikhathi eside kunokungakhululeki okuvamile kokuvuthwa kwamaqanda, kwesinye isikhathi budlule amahora angama-48.

Ezinye Izimpawu Ezihambisana Nobuhlungu Bokuvuthwa Kwamaqanda

Ngaphezu kobuhlungu be-pelvic, ubuhlungu be-endometriosis ngesikhathi sokuvuthwa kwamaqanda bungahambisana nezinye izimpawu ezifana nobuhlungu ngesikhathi socansi, ukopha kakhulu, isicanucanu, nezinkinga zokugaya ukudla ezifana nobuhlungu ngesikhathi sokuchama noma ukuya endlini encane enkulu. Lezi zimpawu zivame ukuba phezulu eduze nesikhathi sokuvuthwa kwamaqanda futhi zingaqhubeka kuze kufike esigabeni sokuya esikhathini.

Ukuphatha Ubuhlungu Bokuvuthwa Kwamaqanda nge-Endometriosis

Nakana ukuthi i-endometriosis nobuhlungu bokuvuthwa kwamaqanda kungaba nzima ukuphatha, zikhona izindlela eziningana ezinganika ukudambisa:

1. Imithi yokudambisa ubuhlungu etholakala ngaphandle kadokotela: Imithi elwa nokuvuvukala engeyona eye-steroid (NSAIDs) efana ne-ibuprofen ingasiza ukunciphisa ukuvuvukala nokudambisa ubuhlungu.
2. Ukwelashwa ngokufudumeza: Ukufaka ukushisa ngethawula elifudumele, i-heating pad noma ukugeza ngamanzi afudumele kungasiza ukukhulula imisipha nokunciphisa ukungakhululeki [3].
3. Ukwelashwa ngama-hormone: Amaphilisi okulawula ukuzala, ama-hormonal patches, noma imijovo kungasiza ukulungisa umjikelezo wokuya esikhathini nokunciphisa ukuguquguquka kwama-hormone okubangela ubuhlungu [4].
4. Izinguquko zendlela yokuphila: Ukuhlanganisa ukudla okulwa nokuvuvukala, ukuphuza amanzi anele, nokuzivocavoca okukhanyayo njenge-yoga noma ukuhamba kungasiza ukuphatha lezi zimpawu.

Kubantu abanemiqondo evelele kakhulu yezimpawu, ukungenelela kwezokwelapha njengokuhlinzwa nge-laparoscopic ukususa izicubu ze-endometrial kungase kudingeke. Lolu khetho lungasiza ukunciphisa ubuhlungu nokuvimbela ezinye izinkinga, nakuba luvamise ukugcinelwa amacala asephambili.

Isiphetho Esiyinhloko

Uma ubuhlungu bakho be-endometriosis ngesikhathi se-ovulation buba bucasukisa kakhulu noma buhlala isikhathi eside kunokujwayelekile, kubalulekile ukubonana nochwepheshe wezempilo. Ubuhlungu obuqhubekayo obuphazamisa imisebenzi yansuku zonke, hamwe nezimpawu ezifana nokopha kakhulu noma izinkinga zohlelo lokugaya ukudla, akufanele bunganakwa. Ukutholakala kusenesikhathi nokuphathwa kwesimo kubalulekile ekuthuthukiseni izinga lempilo nasekugwemeni ezinye izinkinga ezihlobene ne-endometriosis.

Sengiphetha, noma ubuhlungu be-ovulation obubangelwa i-endometriosis bungaba yinselele, zikhona izindlela zokuphatha nokunciphisa ukungakhululeki. Ngokukuqonda izimbangela nokuhlola izinhlobo ezahlukene zokwelashwa, abantu bangathatha izinyathelo ezisebenzayo zokuphatha lesi simo ngendlela ephumelelayo.

Ingabe kungenzeka ukhulelwe? Sikhuluma ngezimpawu zokuqala zokukhulelwa kwenye i-athikili.

 Imithombo

1. Wilcox AJ, Dunson D, Baird DD. Isikhathi se-"fertile window" kumjikelezo wokuya esikhathini: ukulinganisa okuthile kosuku ocwaningweni oluqhubekayo. BMJ. 2000 Nov 18;321(7271):1259-62. doi:10.1136/bmj.321.7271.1259. PMID: 11082086; PMCID: PMC27529.
2. Rahmioglu, N., Mortlock, S., Ghiasi, M. et al. Isisekelo sofuzo se-endometriosis nokuhambisana kwayo nezinye izimo zobuhlungu nezokuvuvukala. Nat Genet 55, 423–436 (2023). https://doi.org/10.1038/s41588-023-01323-z 
3. Qiong Chen, Jing Wang, Xiaoya Ding, Qingfei Zhang, Ping Duan. Amasu amasha okwelapha i-endometriosis. Biomedical Technology, Volume 7. 2024, Pages 46-62. ISSN 2949-723X. https://doi.org/10.1016/j.bmt.2024.08.002 
4. Vannuccini, S., Clemenza, S., Rossi, M. et al. Ukwelashwa ngehomoni kwe-endometriosis: isisekelo se-endocrine. Rev Endocr Metab Disord 23, 333–355 (2022). https://doi.org/10.1007/s11154-021-09666-w