Izimbangela ezingaba khona zobuhlungu kuma-ovari ngaphambi kokuya esikhathini

Abesifazane abaningi bakhala ngobuhlungu ezinyane zamaqanda lapho bevakashela udokotela ngenxa yenhlalakahle yokuzala. Bavame ukukhathazeka ukuthi ngabe kuwuphawu lwesimo esithile sezempilo esingathinta ukukwazi kwabo ukuzala.

Abesifazane ngokuvamile baba nobuhlungu ezinyane zamaqanda ngaphambi kokuya esikhathini ngenxa yezizathu ezimbili ezijwayelekile, okuhlanganisa ukuya esikhathini nokuvuthwa kwamaqanda. Ungakwazi ukwahlukanisa lobu buhlungu bobabili ngosizo lwezinto ezifana nesikhathi sobuhlungu. Ezinye izimo zempilo zingabuye zibe yimbangela yobuhlungu bezinyane zamaqanda, okwenza lesi sihloko sibaluleke ukuthi siqondwe abesifazane [1].

Kule ndatshana, sizohlola izimbangela zobuhlungu bezinyane zamaqanda ngaphambi kokuya esikhathini, okuhlanganisa ubuhlungu obudalwe ukuvuthwa kwamaqanda, izikhathi zokuya esikhathini, nezinye izimo zempilo.

Ubuhlungu Obudalwe Ukuvuthwa Kwamaqanda

Imibiko ikhombisa ukuthi cishe amaphesenti angu-40 abesifazane babona ubuhlungu ezinyaweni zamaqanda ngesikhathi sokuvuthwa kwamaqanda [2]. Elinye igama elivamile lobuhlungu bokuvuthwa kwamaqanda "mittelschmerz." Lobu buhlungu luvame ukuzwa maphakathi nomjikelezo wokuya esikhathini, ngesikhathi sokuvuthwa kwamaqanda.

Esigabeni sokuvuthwa kwamaqanda, i-follicle evuthiwe kwesinye sezinyane ezimbili zamaqanda iyaqhuma bese ikhulula iqanda. Le nqubo ingadala ubuhlungu besikhashana ohlangothini olulodwa lwesisu esingezansi, kuye ngokuthi yiliphi isizalo samaqanda elikhulula iqanda kulowo nyanga.

Izizathu Zobuhlungu Bokuvuthwa Kwamaqanda

Ezinye izincazelo ezingaba khona zokuthi kungani uzwa ubuhlungu ezinyaweni zamaqanda ngesikhathi sokuvuthwa kwamaqanda zifaka:

1. Ukwelulwa Kobuso Besizalo Samaqanda: Ama-follicle yizakhiwo ezisesizalweni samaqanda, futhi i-follicle ngayinye iqukethe iseli leqanda. Amanye ala ma-follicle akhula umjikelezo ngamunye wokuya esikhathini futhi afinyelele usayizi wawo omkhulu ngaphambi nje kokuvuthwa kwamaqanda [3]. Lokhu kukhula kwe-follicle kungelula ingaphakathi lesinye seqanda, kuholele emzweni wokucindezeleka noma ubuhlungu obuncane.
2. Ukuqhuma Kwe-Follicle: Ngesikhathi sokuvuthwa kwamaqanda, elinye lama-follicle avuthiwe amaningi esinye seqanda liyaqhuma ukuze likhulule iqanda. Lokhu kuqhuma kungadala ubuhlungu obuzumayo, obubukhali obungahlala imizuzu embalwa kuya emahoreni ambalwa.
3. Ukukhishwa Koketshezi: Ngaphezu kwamaseli eqanda, ama-follicle aphinde abe noketshezi, okuhlanganisa namahomoni nama-enzyme, ukusekela ukuvuthwa kwamaseli eqanda [4]. Lapho i-follicle iqhuma, ikhipha lolu ketshezi futhi ngezinye izikhathi inani elincane legazi. Lolu ketshezi lungacasula izicubu ezizungezile, lubangele ukungakhululeki okuncane noma ubuhlungu.

Ukukhomba Ubuhlungu Bokuvuthwa Kwamaqanda

Ubuhlungu bokuvuthwa kwamaqanda bukhulu buvela cishe izinsuku ezingu-10 kuya ku-14 ngaphambi kokuqala kokuya esikhathini okulandelayo. Buvame ukugxila ohlangothini olulodwa lwesisu, kuye ngokuthi yiliphi iqanda elikhululayo, futhi abuhlali isikhathi eside njengobuhlungu bokuya esikhathini.

Umfazi angakwazi ukubona ukuthi uhlangabezana nobuhlungu bokuvuthwa kweqanda uma eqonda iphethini yomjikelezo wakhe wokuya esikhathini. Ezinye izimpawu nezibonakaliso zokuvuthwa kweqanda, ezifana nokuqunjelwa ngemva kokuvuthwa kweqanda, nazo zingakhombisa ukuthi ubuhlungu ozwa emaqandeni bungenxa yokuthi iqanda liyavuthwa. Ukusebenzisa isengezo sokusekela ukuvuthwa kweqanda kunganikeza umzimba izakhamzimba ezidingekayo ukuze lonke le nqubo ihambe kahle.

Ubuhlungu Obubangelwa Ukuya Esikhathini

Iqanda elikhishwayo ngesikhathi sokuvuthwa kweqanda lilinda isidoda ukuze kwenzeke ukuchumiseka. Uma ukuchumiseka kwenzeka, isinyathelo esilandelayo ukufakwa kweqanda elichumile kungqimba lwesibeletho.

Nokho, lapho ukuchumiseka kungenzeki, umzimba uyaqonda ukuthi awusadingi ungqimba lwesibeletho oluqinile bese uqala ukuzilungiselela ukuya esikhathini. Njengoba umzimba uzilungiselela ukuya esikhathini, udlula ezinguqukweni eziningi ezingaholela ebuhlungwini bamaqanda ngesikhathi sokuya esikhathini.

Lezi zinguquko zihlanganisa:

1. Ukuchithwa Kongqimba Lwangaphakathi Lwesibeletho

I-endometrium, okungungqimba lwangaphakathi lwesibeletho, iyaqina ngemva kokuvuthwa kweqanda ngenxa yomthelela wehomoni i-progesterone [5]. Kodwa uma ukukhulelwa kungenzeki, umzimba uqala ukuzilungiselela ukuya esikhathini.

Ngaphambi kokuba kokuya esikhathini kuqale, isibeletho siqala ukucindezela ukuze sikhiphe lolu ngqimba lwangaphakathi. Lona msebenzi ubangelwa ukwehla kwamazinga amahomoni, ikakhulukazi i-progesterone [5]. Njengoba imisipha yesibeletho icindezela ukuze ikhuphe ungqimba lwangaphakathi, ungase uzwe ukuqunjelwa esiswini esingezansi. Lobu buhlungu ngezinye izikhathi bungasabalala bufike endaweni yamaqanda, bukwenze uzizwe sengathi amaqanda ayalimala.

2. Izinguquko Zamahomoni

Ukuguquguquka kwamahomoni ngaphambi kokuya esikhathini kungaholela ekungakhululeki endaweni yamaphaphu. Ukwehla kwamazinga e-estrogen ne-progesterone kungenza izicubu ezisemgodini wamaphaphu zibe buthaka kakhulu. Lokhu kubuthaka kungaba yimbangela yobuhlungu noma ukucasuka okuthambile emaqandeni.

Ukuhlonza Ubuhlungu Bokuya Esikhathini

Enye yezimpawu ezinkulu zobuhlungu bamaqanda ngaphambi kokuya esikhathini wukuthi buzizwa phakathi kwezinsuku ezingu-1 kuya kwezi-3 ngaphambi kosuku olulindelekile lwokuya esikhathini [6]. Lokhu kwenza kube lula ukuhlukanisa lobu buhlungu nobubangelwa ukuvuthwa kweqanda ngoba kwenzeka kuze kufike emasontweni amabili ngaphambi kosuku olulindelekile lwokuya esikhathini.

Ngesikhathi sobuhlungu besikhathi sokuya esikhathini, umzimba wakho ukhombisa nezinye izimpawu eziningana zokuthi ukuya esikhathini sekuza, okungakusiza ukubona lolu hlobo lobuhlungu. Isibonelo, uqala ukuhlangabezana nezimpawu ezifana nokushintsha kwemizwa, ukucasuka, ukukhathala, nokuvuvukala kwamabele, okuphawula ukuthi isikhathi sakho sokuya esikhathini sesisondele [7].

Ukuhlukanisa Ubuhlungu Besikhathi Sokuya Esikhathini Nobuhlungu Be-Ovulation

Nazi ezinye izici ezisemqoka phakathi kwalezi zinhlobo zobuhlungu ezingakusiza ukubona imbangela:

Ukuhlonza lezi zici kungakwenza kube lula kuwe ukuhlukanisa izimbangela zobuhlungu bakho bama-ovary. Lezi zici zingakusiza futhi uqonde amaphethini kumjikelezo wakho wokuzala futhi zikwenyusele amathuba okukhulelwa.

Ezinye Izizathu Zobuhlungu Bama-Ovary

Uma uzwa ubuhlungu ku-ovary, kungenzeka kakhulu ukuthi bubangelwa i-ovulation noma ukuya esikhathini. Nokho, ezinye izimo zezokwelapha nazo zingadala ubuhlungu ema-ovary, futhi kubalulekile ukuthi lezo zimo zitholakale ngesikhathi ukuze kugwemeke umthelela omubi empilweni yokuzala.

Nazi ezinye izimo zezempilo ezivamile ezibangela ubuhlungu ema-ovary:

1. Ama-Ovarian Cysts

Ama-ovarian cysts yizikhwama ezigcwele uketshezi ezakheka phezu noma ngaphakathi kwama-ovary. Angadala ubuhlungu uma ekhula abe makhulu. Ama-ovarian cysts amakhulu angabuye aqhume noma ajijime i-ovary, isimo esibizwa ngokuthi i-ovarian torsion [8]. Izimpawu ze-ovarian cyst zingabandakanya ubuhlungu obubukhali noma obuthambile ohlangothini olulodwa lwesisu esingezansi nokuvuvukala noma umuzwa wokugcwala.

Imibiko ibonisa ukuthi abesifazane abayi-10 kwabayi-100 bathuthukisa ama-ovarian cysts empilweni yabo [9]. Ezinye izimila zama-ovary (ovarian cysts) ziyanyamalala zona zodwa, kanti ezinye zidinga ukuhlinzwa okungahlaseli kakhulu ukuze zisuswe.

2. I-Endometriosis

ubuhlungu be-ovulation obuhlobene ne-endometriosis buvela lapho izicubu ezifana nengqimba yangaphakathi yesibeletho zikhula ngaphandle kwesibeletho. Lezi zicubu zivame ukukhula ema-ovary zibe seziholela ebuhlungwini obukhulu ema-ovary.

I-Endometriosis ingadala ubuhlungu obukhulu besibeletho sangaphansi, ikakhulukazi ngaphambi nangesikhathi sokuya esikhathini. Ezinye izimpawu zifaka phakathi ukuya esikhathini okubuhlungu, ubuhlungu ngesikhathi sokulala ucansi, nokopha kakhulu ngesikhathi sokuya esikhathini.

Imibiko ibonisa ukuthi cishe u-10% wabesifazane emhlabeni jikelele, elinganiselwa kubesifazane abayi-176 million, bahlushwa i-endometriosis eminyakeni yabo yokuzala [10]. Kuyesinye sezimo ezivamile ezibhekwa njengembangela yokungazali kwabesifazane. Ukwelashwa kungenzeka ngokwelashwa ngamahomoni kanye nokuhlinzwa.

3. Isifo Sokuvuvukala Kwezitho Zokuzala (Pelvic Inflammatory Disease)

I-Pelvic inflammatory disease noma i-PID wukutheleleka kwezitho zokuzala kowesifazane. Izifo ezithathelwana ngocansi (STIs) ngokuvamile, kodwa hhayi ngaso sonke isikhathi, yizona zibangela lesi simo. Lokhu kutheleleka kungahlasela ama-ovari, ama-fallopian tubes, isibeletho, kanye nomsila wesibeletho (cervix).

Izimpawu ze-PID zingahlanganisa ubuhlungu emaqandeni esibeletho uma ama-ovari ethelelelekile. Ezinye izimpawu zifaka umkhuhlane, ukudlikiza, nokuphuma koketshezi okungajwayelekile esithweni sangasese sowesifazane okunuka kabi.

Imibiko ikhombisa ukuthi i-PID ithinta izigidi ezi-1 zabesifazane minyaka yonke e-United States kuphela [11]. Umbiko we-Centers of Disease Control and Prevention ubonisa ukuthi kwabesifazane abayi-8 abane-PID, oyedwa uhlangabezana nobunzima bokukhulelwa [12]. Ama-antibiotic angasiza ekwelapheni lesi simo nasekugwemeni izinkinga.

4. Ukugoqeka Kwe-ovari

Ukugoqeka kwe-ovari kwenzeka lapho i-ovari izisonta nxazonke zemigqa eyiyisekelayo. Lokhu kusonta kuholela ekunqunyweni kokugeleza kwegazi kuya kwi-ovari [8]. Uma kwenzeka, ungase uzwe ubuhlungu besisu obukhulu, obuqubuka masinyane futhi udinge ukunakwa kwezokwelapha ngokushesha. Ezinye izimpawu zokugoqeka kwe-ovari zihlanganisa isicanucanu, ukuhlanza, nokuzwela esiswini.

Ukuhlinzwa ukuphela kokwelashwa okusebenzayo kwalesi simo, futhi imibiko ikhombisa ukuthi ukuhlinzwa kokusonta ama-ovari kubaphumelela ku-90% wamacala [13].

Kufanele Ubone Nini Udokotela Ngezibuhlungu Zamaqanda Esibeletho?

Ubuhlungu emaqandeni esibeletho ngezikhathi ezithile buvame ukubangelwa ukuya esikhathini noma ukukhishwa kwamaqanda, okungalimazi. Nokho, kubalulekile ukwazi ukuthi nini okufanele ufune usizo lwezokwelapha. Cabanga ukuxhumana nodokotela uma uhlangabezana nalokhu:

• Ubuhlungu obukhulu noma obuqubuka masinyane obungathuthuki.
• Ubuhlungu obuhambisana nomkhuhlane, isicanucanu, noma ukuhlanza.
• Ukuphuma koketshezi lwesitho sangasese sowesifazane noma ukopha okungajwayelekile.
• Ubuhlungu obungapheli noma obubuya buvame obuphazamisa imisebenzi yansuku zonke.
• Izimpawu zokugoqeka kwe-ovari noma i-cyst eqhume.

Umhlinzeki wezempilo uzokuhlola, akubuza ngezimpawu, enze nezivivinyo, njengama-ultrasound noma ukuhlolwa kwegazi, ukuze anqume imbangela yobuhlungu emaqandeni esibeletho.

Okubalulekile Ekugcineni

Ubuhlungu emaqandeni esibeletho ngaphambi kokuya esikhathini buwuphawu oluvamile abaningi besifazane abaluzwa ngesikhathi sabo sokuzala. Akuyona into okufanele ukhathazeke ngayo ngoba izimbangela ezivame kakhulu zobuhlungu emaqandeni esibeletho ukuya esikhathini nokukhishwa kwamaqanda.

Ungakwazi ukwehlukanisa lobu buhlungu bobabili ngokuluqonda kahle isikhathi okuvela ngaso nezimpawu ezihamba nabo. Isibonelo, umehluko ocacile wukuthi ubuhlungu bokuvuthwa kweqanda buvela phakathi kwezinsuku ezingu-10 kuya kwezi-14 ngaphambi kokuya esikhathini kanti ubuhlungu bokuya esikhathini buvela phakathi kwezinsuku ezingu-1 kuya kwezi-3 ngaphambi kokuya esikhathini.

Ezinye izimo zezempilo nazo zingabangela ubuhlungu ema-ovarini, kodwa iphethini nobude besikhathi sobuhlungu kuzohluka kakhulu kunobuhlungu bokuvuthwa kweqanda nobobuhlungu bokuya esikhathini. Uma uhlangabezana nobuhlungu obungapheli noma obukhulu ema-ovarini, sincoma ukuthi uthintane nodokotela wakho ukuze uthole ukuqondiswa.

Imithombo Esetshenzisiwe

1. Franco, P., García-Baizán, A., Aymerich, M., Maino, C., Frade-Santos, S., Ippolito, D., & Otero-García, M. (2023). Izimbangela zezifo zabesifazane zobuhlungu obukhulu besifundeni se-pelvis: okutholakala okuvamile nokungavamile emifanekisweni yokuhlolwa. Life, 13(10), 2025. https://doi.org/10.3390/life13102025 
2. Brott, N. R., & Le, J. K. (2023c, May 1). Mittelschmerz. StatPearls - NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK549822/ 
3. Monis, C. N., & Tetrokalashvili, M. (2022, September 12). Isigaba sokwanda nese-follicular somjikelezo wokuya esikhathini. StatPearls - NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK542229/ 
4. Emori, M. M., & Drapkin, R. (2014). Ukwakheka kwama-hormone kuketshezi lwefollicle nemiphumela yakho ekuthuthukisweni komdlavuza we-ovari. Reproductive Biology and Endocrinology, 12(1), 60. https://doi.org/10.1186/1477-7827-12-60 
5. Cable, J. K., & Grider, M. H. (2023, May 1). Ifizioloji, i-progesterone. StatPearls - NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK558960/ 
6. Ukubaba kwesisu ngesikhathi sokuya esikhathini - Izimpawu nezimbangela - Mayo Clinic. (2022, April 30). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/menstrual-cramps/symptoms-causes/syc-20374938 
7. Umthelela wezimpawu zokuya esikhathini empilweni yansuku zonke: ucwaningo phakathi kwabantu besifazane abangu-42,879. Schoep, Mark E. et al. American Journal of Obstetrics & Gynecology, Volume 220, Issue 6, 569.e1 - 569.e7 https://www.ajog.org/article/S0002-9378(19)30427-2/abstract 

8. Guile, S. L., & Mathai, J. K. (2023, July 17). Ukuphenduka kwe-ovari. StatPearls - NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK560675/ 
9. InformedHealth.org. (2006–). Uhlolojikelele: Ama-cyst e-ovari. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG). Kubuyekezwe ngo-April 21, 2022. Kuthathwe ku https://www.ncbi.nlm.nih.gov/books/NBK539572/ 
10. Pettersson, A., & Berterö, C. M. (2020). Indlela Abesifazane Abane-endometriosis Abahlangabezana Ngayo Nokunakekelwa Kwezempilo. Women S Health Reports, 1(1), 529–542. https://doi.org/10.1089/whr.2020.0099 
11. Yini Isifo Sokuvuvukala Kwezitho Zokuzala noma i-PID? (n.d.). https://www.health.ny.gov/publications/3804/ 
12. Mayelana Nesifo Sokuvuvukala Kwezitho Zokuzala (PID). (2023, December 13). Isifo Sokuvuvukala Kwezitho Zokuzala (PID). https://www.cdc.gov/pid/about/index.html 
13. Hyttel, T. E. W., Bak, G. S., Larsen, S. B., & Løkkegaard, E. C. L. (2014). Ukuphenduka kabusha kwama-ovari. Acta Obstetricia Et Gynecologica Scandinavica, 94(3), 236–244. https://doi.org/10.1111/aogs.12542