Ukuphuma uketshezi olunamathelayo oluxutshwe negazi ngesikhathi sokuvuthwa kwamaqanda: Ukubuka ngokuningiliziwe impilo yomjikelezo wokuya esikhathini

Ukuvuthwa kweqanda kuwumcimbi omangalisayo emjikelezweni wokuya esikhathini, okuwuphawu lokukhishwa kweqanda elivuthiwe esibelethweni samaqanda. Nakuba abantu abaningi bebanaka kakhulu ukuvuthwa kweqanda uma bezama ukukhulelwa noma nje befuna ukuqonda kangcono imizimba yabo, kulula ukumangala izinguquko ezingalindelekile, ikakhulukazi ukuphuma kwegazi okuncane noma ukuba khona kwamafinyila esibeletho axutshwe negazi. Abanye abantu bayabona inani elincane legazi ekuphunyukeni kwabo phakathi nomjikelezo, elingabonakala njengemigqa epinki noma ensundu. Abanye bangathola ukuthi ukubona ukugeleza okubonakala kakhulu kuyethusa, ikakhulukazi uma kungesilo into abayijwayele njalo. Kwezinye izimo, abantu bangaphinda babone uketshezi olunamafinyila anegazi ngesikhathi sokuvuthwa kweqanda, okungaba uhlobo olujwayelekile kodwa olungadala ukukhathazeka uma kungakavami kubo. Lo mhlahlandlela ophelele uzohlola ukuthi kungani imihuzuko yegazi ingavela eduze nesikhathi sokuvuthwa kweqanda, ukuthi iqhathaniswa kanjani nezinye izinhlobo zokulahlekelwa igazi okuhlobene nokuya esikhathini noma ukukhulelwa, nokuthi nini okufanele ucabange ukufuna usizo lochwepheshe.

Umlando Ngomjikelezo Wokuya Esikhathini

Umjikelezo wokuya esikhathini, ngokwesilinganiso, uthatha cishe izinsuku ezingu-28, kodwa ungaba mfushane noma mude kuye ngomzimba womuntu ngamunye. Ukuya esikhathini kumaka ukuqala komjikelezo omusha, lapho udonga lwesibeletho olwakhiwe ngenyanga edlule luphuma. Ngemva kokuya esikhathini, kuqala isigaba se-follicular, lapho ukwenyuka kwe-estrogen kusekela ukukhula kwe-follicle entsha esibelethweni samaqanda (ovary). Cishe maphakathi nomjikelezo, i-luteinizing hormone (LH) iyanda ukuze ivuse ukukhishwa kweqanda elibusayo, okwaziwa kakhulu ngokuthi ukuvuthwa kweqanda (ovulation).

Lapho iqanda selikhishiwe, lithathwa umsele wamaqanda (fallopian tube) futhi lihlala likwazi ukuchanyuselwa cishe amahora ayi-12 kuya kwangama-24. Phakathi nalesi sikhathi, amazinga ama-hormone ayashintsha, kanti i-estrogen ingehla ngaphambi kokubuya kancane. Ngesikhathi esifanayo, izinga le-progesterone liqala ukunyuka, lisiza udonga lwesibeletho ukuba lulungiselele uma kwenzeka kukhona uchanyushelo. Lezi zinguquko kwesinye isikhathi zingaholela ekuphumenini kwegazi okuncane, okuthiwa imihuzuko ephakathi nomjikelezo (mid-cycle spotting). [1].

Indlela Ama-Hormone Athelela Ngayo Amafinyila Esibeletho

Enye into ebalulekile engashintsha uketshezi oluvamile wukudansa kwama-hormone okwenzeka njalo ngenyanga. Ngaphambi kokuvuthwa kweqanda, izinga le-estrogen lenyuka kakhulu, okwenza amafinyila esibeletho abe maningi, ashelele, futhi anwebeke—avame ukuqhathaniswa neqanda elingakaphekwa. Lokhu kuqina kusiza isidoda ukuba sihambe sidlule esibelethweni sifinyelele eqandeni.

Ngemva kokuba iqanda likhululiwe, isimo samahomoni siyashintsha. Njengoba i-progesterone ikhuphuka, umswakama uba mubi, ube mnyama futhi ungasacaci. Ngezinye izikhathi, kungavela inani elincane legazi kulezi zifihlo njengoba izinga lamahomoni lilungiseka. Lapho lo mkhuba wenzeka ngaso leso sikhathi sokuvuthwa kwamaqanda, abanye abantu bakuthatha njengophawu lokuthi umzimba wabo usesesigabeni sayo esikhulelisa kakhulu. Nokho, indlela okubukeka ngayo kanye nesikhathi sokwenzeka kungahluka kakhulu phakathi kwabantu ngabanye. [2].

Kulabo abafuna ukusekela ibhalansi yamahomoni nokuthuthukisa impilo yokuvuthwa kwamaqanda, Conceive Plus Women's Ovulation Support inikeza amaminerali abalulekile afana ne-Myo-Inositol ne-D-chiro Inositol, asiza ukulungisa ukuvuthwa kwamaqanda futhi akhuthaze inhlalakahle yokuzala.

Ukuchitheka Okuncane Okuvamile Maphakathi Nomjikelezo Nezinhlobonhlobo Kwakho

Abantu abaningi bayazibuza ukuthi ukopha okuncane maphakathi nomjikelezo wabo kuyinkomba yezinkinga zezempilo yini. Eqinisweni, ukukhishwa okumpunga okupinki noma onsundu kungaba yingxenye evamile yezinguquko zomjikelezo womzimba. Ngokujwayelekile, kwenzeka ngobuningi obuncane futhi kuyaphela ngokushesha. Nakuba kungase kusabise ukubona igazi ngesikhathi umuntu angakulindele ukuba nesikhathi sokuya esikhathini, ngokuvamile akuyona inkinga enkulu.

Abanye bangase babone umehluko ocacile phakathi kokuchitheka kwegazi okumpunga okupinki nokufinyela okubomvu okugqamile. Ezimeni lapho ukopha kuhlala kukhanyayo futhi kungadluli ezinsukwini ezimbalwa, kungase kube nje ukushintsha okuvamile kwamahomoni. Abanye bayehlangabezana nokuchitheka okushubile noma okuthatha isikhathi eside okungabangela imibuzo yokuthi lokhu kungaba yini enye into ngaphandle koketshezi oluhambisana nokuvuthwa kwamaqanda. Ukuqonda ububanzi bokuhlangenwe nakho okujwayelekile kusiza ukubeka le mihluko esimeni esifanele.

Lapho Amaphethini Okopha Eseba Yinkinga

Nakuba ukukhukhuleka kwegazi okuncane ngemva kokuvuthwa kwamaqanda kungase kungabi yingozi, akuzona zonke izigameko ezingaphansi kobubanzi bokuchitheka okuncane okuvamile maphakathi nomjikelezo. Ikakhulukazi, umuntu angase abone ukugeleza okukhulu noma isikhathi sokopha eside. Uma kukhona ukopha okukhulu ezinsukwini ezingu-3 ngemva kokuvuthwa kwamaqanda, lokhu kungase kube inkomba yesimo esingaphansi okufanele sihlolwe uchwepheshe. Ngokufanayo, iziqephu eziphindaphindayo zokopha okungachazwanga ngaphandle kwezikhathi ezivamile zomjikelezo zingase zidinge ukuhlolwa kwezokwelapha.

Ama-fibroid, ama-ovarian cysts, noma ukungalingani kwamahomoni kwesinye isikhathi kubangela ukopha okungajwayelekile. Izifo noma ukulimala komlomo wesibeletho nakho kungaba yimbangela. Ngakho-ke, kubalulekile ukwazi isimo somzimba ojwayelekile bese uqaphela uma kukhona okweqa kakhulu kulokho okuvamile. Uma ukugeleza kwegazi kuningi kuhambisana nobuhlungu, umkhuhlane, noma uketshezi olunuka kabi, kufanele kubonwe umhlinzeki wezempilo masinyane kunokulinda isikhathi eside. [3].

Izizathu Ezingaba Khona Zokopha Okuncane Ezinsukwini Ezimbalwa Ngemva Kokuvula Iqanda

Abanye abantu babona ukopha okuncane ezinsukwini ezi-2 ngemuva kokuvula iqanda noma ukopha okuncane ezinsukwini ezi-2 kuya kwezi-3 ngemuva kokuvula iqanda, bazibuze ukuthi ngabe lokho kuseyikopha okuqhubekayo kokuvula iqanda noma inqubo ehluke ngokuphelele. Umzimba womuntu ngamunye uhlukile, kodwa kukhona izincazelo ezimbalwa okufanele zicatshangelwe:

1. Izinguquko Zamazinga Ehomoni: Njengoba i-estrogen yehla kancane bese i-progesterone ikhuphuka, kungavela ukopha okuncane [4].
2. Ukuqhuma Kwe-Follicle: Ukukhishwa kweqanda ngokwalo kungadala ukuqhuma okuncane, okuholele ekophweni okuthambile kakhulu.
3. Umsebenzi Womzimba Noma Ukwabelana Ucansi: Ukuzivocavoca okunzima noma ukwabelana ucansi kungesinye isikhathi kukhathaze umlomo wesibeletho, kuholele ekopheni okuncane.

Noma yikuphi kwalokhu kungase kube negalelo ekushintsheni kombala okwesikhashana koketshezi lomlomo wesibeletho. Uma ukopha kuncane futhi kuphele masinyane, kungaba nje impendulo evamile ezifundeni ezijikeleza njalo.

Ukuhlukanisa Phakathi Kokopha Kokuvula Iqanda Nokopha Kokutshalwa Kombungu

Enye ingxenye yokudideka ivela uma kuqhathaniswa ukopha ngesikhathi sokuvula iqanda nokopha ngesikhathi sokutshalwa kombungu. Ngokujwayelekile, ukopha okuncane maphakathi nomjikelezo ohambisana nokukhishwa kweqanda kuhlotshaniswa nezinguquko ku-follicle noma emazingeni amahomoni. Ukopha kokutshalwa kombungu, ngakolunye uhlangothi, kwenzeka cishe phakathi kwesonto elilodwa kuya kwamabili ngemuva kokufakelwa kombungu, lapho iqanda elichumile lizifaka emgodleni wasesibelethweni.

Isikhathi siyisici esiyinhloko sokuhlukanisa. Ukuphuma koketshezi okuhlobene nokuvula iqanda kuvame ukuvela cisuka ngosuku lwe-14 kumjikelezo wezinsuku ezingama-28. Ngokuphambene nalokho, uma umbungu ukhona, ukopha okuncane kungase kuqhamuke cishe isonto ngemuva kokuba ukuvulwa kweqanda sekwedlulile. Nokho, imijikelezo yangempela ayivamile ukuba iphelele “encwadini”, ngakho ukudideka kuyaqondakala uma umuntu enomjikelezo ongajwayelekile. Uma kukhona ukusola ukukhulelwa, ukuhlolwa noma ukubonana nochwepheshe kwezempilo kungasiza ukucacisa isimo. [5].

Ukopha Okuncane Uma Kuqhathaniswa Nezimpawu Zokutshalwa Kombungu

Ngokufanayo, abanye bahlola ukopha ngesikhathi sokuvula iqanda uma kuqhathaniswa nokopha kokutshalwa kombungu ukuze bahlukanise umehluko ngobuningi begazi, umbala, noma isikhathi. Ukubonakala kokopha kwesikhathi sokuvula iqanda kuvame ukuba kuncane, kube mpofu ngokubomvana noma kube nsundu kancane. Ukopha okuxhumene nokutshalwa kombungu kungase kubonakale kukhanya ngendlela efanayo, kodwa lokhu kuvame ukwenzeka cishe phakathi kwezinsuku eziyisikhombisa kuya kweziyishumi nambili ngemuva kokwabelana ucansi okungenzeka kuholele ekukhulelweni.

Okokucabangela kwesibili wukuthi ukopha kokufakelwa kungahambisana nezimpawu zokuqala kakhulu zokukhulelwa, njengokubanjwa yisisu okuncane, ukukhathala, noma ukuvuvukala kwamabele, nakuba lezi zimpawu ziphinde zifane nesigaba sangaphambi kokuya esikhathini. Lokhu kufana kugcizelela ukuthi kungaba nzima kangakanani ukuxilonga imbangela yamabala egazi ngaphandle komongo owengeziwe, njengamaphethini okushisa komzimba okuyisisekelo noma imiphumela yokuhlolwa kokukhulelwa.

Kwenzekani Uma Amabala Egazi Evela Ngemva Kwesonto?

Kulabo abaqaphela amabala egazi ngesonto ngemuva kokuvuthwa kwamaqanda, amathuba ayanda. Lesi sikhathi singahambisana nefasitela lapho umbungu unamathiselwa khona elinini lesibeletho. Ngokunye, lokhu kungase kungabi namphumela nokukhulelwa kodwa kubonise izinguquko ezijwayelekile zama-hormone noma enye into yangaphandle efana nokucindezeleka noma imithi.

Amazinga e-estrogen angabuya aguquguquke futhi esigabeni sokugcina se-luteal, kwesinye isikhathi kubangele ukopha okuphunyukayo (breakthrough bleeding). Kwezinye izimo, ama-polyps amancane noma ama-fibroid angabangela amabala egazi ajikijelwayo ngomjikelezo. Ukuthola imbangela eqondile kuvame ukufuna umlando ogcwele wezempilo yalowo muntu futhi, uma kuqhubeka noma kukhathaza, ukubonana nochwepheshe bezempilo ukuze kwenziwe ukuhlolwa kokuxilonga.

Ukuqaphela Ukopha Okuncane Noma Okukhulu Ezikhathini Ezibalulekile

Kubantu abaningi, ukopha okuncane ngemuva kokuvuthwa kwamaqanda kwenzeka ngezikhathi ezithile kuphela, futhi kuvela njengemigqa emincane yegazi. Nokho, abambalwa bangase babike ukopha okukhulu okungafana nokuya esikhathini okuncane. Yize kungavamile, kwenzeka futhi kungadida. Ukuhlonza ukuthi lezi zigameko ziyaphindwa noma kwenzeka kanye kuphela kusiza ukunciphisa imbangela.

Uma umuntu ebhekana nokopha okukhulu ezinsukwini ezingu-3 ngemuva kokuvuthwa kwamaqanda izikhathi ezingaphezu koyedwa, kunconywa ukuthi akhulume nochwepheshe bezempilo. Ukuhlolwa kwegazi, i-ultrasound, noma ukuhlolwa kwamahomoni kungaveza ukungalingani noma izinkinga ezingaphansi ezidinga ukunakwa. Ohlelweni olunempilo, ukugeleza okukhulu maphakathi nesikhathi somjikelezo akuvamile, ngakho izigameko eziphindaphindayo zivame ukufuna ukuhlolwa okwengeziwe. [6].

Nini Amabala Egazi Angaba Uphawu Lokukhulelwa Kokuqala

Ukuhlanganisa nalokho okungenzeka kube amabala okubangelwa ukufakelwa (implantation), abambalwa kuphela abantu abasuke beqaphele ukuthi bangase babe nokukhulelwa lapho sebebona ukopha okungalindelekile. Njengoba amabala egazi ezinsukwini ezingu-2 kuya kwezi-3 ngemuva kokuvuthwa kwamaqanda esesondelene nesikhathi sokukhishwa kweqanda, mancane amathuba kodwa akusikho okungenzeki ukuthi kube uphawu lokukhulelwa kokuqala. Inqubo yokufakwa kwesidoda eqandeni kanye nohambo olulandelayo lokuya esibelethweni kuthatha izinsuku ezimbalwa.

Kulabo abalandela isikhathi sokuvuthwa kwamaqanda, ushintsho olungazelelwe kuketshezi lomlomo wesibeletho lungavusa imibuzo enjengokuthi akukho uketshezi ngesikhathi sokuvuthwa kwamaqanda ngikhulelwe na, ngoba ukwehluka ebusweni boketshezi kungabonisa izinguquko zama-hormone noma ukukhulelwa kokuqala.

Uma amabala egazi amancane evela cishe isonto noma ngaphezulu ngemuva kokuvuthwa kweqanda futhi ehambisana nezinye izinguquko ezincane njengobuhlungu obuncane kwamabele noma isicanucanu esincane, kungase kucatshangwe ukwenza ukuhlolwa kokukhulelwa. Naphezu kokubikezela okubandakanyekayo, lezi zimpawu zinganikeza imikhondo yokuqala, kudala ngaphambi kokuthi uphuthelwe isikhathi sokuya esikhathini. Kodwa-ke, azihlangene ngokuphelele—zinye izici zivame ukufana nezimpawu zokuqala zokukhulelwa.

Okufingqiwe

Uma uhlangabezana nokuphuma koketshezi okunamafinyila okuxutshaniswe negazi ngesikhathi sokuvuthwa kweqanda, ukuqonda ukuthi amabala amancane egazi angaba yingxenye evamile yezinguquko ezisemaphakathi nomjikelezo kunganciphisa ukukhathazeka, yize ukwelulekwa ngokwezokwelapha kubalulekile uma kuba nokopha okuningi noma okuqhubekayo. Ekugcineni, ukunaka umzimba wakho kungaveza ulwazi olubalulekile ngomjikelezo wokuya esikhathini nezikhathi zokuvundeleka. Noma kungaba amabala egazi ezinsukwini ezingu-2 ngemuva kokuvuthwa kweqanda, ukuqaphela amabala evikini elilodwa ngemuva kokuvuthwa kweqanda, noma ukuzama ukuhlukanisa phakathi kokopha kokuvuthwa kweqanda nokopha kokufakwa kwembryo, ulwazi lukhuthaza ukuzethemba ekuchazeni lezi zimpawu. Ngokulinganisela ukuqonda kwakho umzimba siqu kanye nomnikelo wochwepheshe, abantu bangazuza ukuqonda okujulile ngomgqigqo womzimba wabo futhi balungele kangcono ukubhekana nanoma yikuphi okuthuthuka okungalindelekile.

Izinkomba

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3. Hasan R, Baird DD, Herring AH, Olshan AF, Jonsson Funk ML, Hartmann KE. Amaphethini nezinto ezibikezelayo zokopha kwelungu langasese lesifazane esigabeni sokuqala sokukhulelwa. Ann Epidemiol. 2010 Jul;20(7):524-31. doi: 10.1016/j.annepidem.2010.02.006. PMID: 20538195; PMCID: PMC2884141.
4. Nagy B, Szekeres-Barthó J, Kovács GL, Sulyok E, Farkas B, Várnagy Á, Vértes V, Kovács K, Bódis J. Ukhiye Wokuphila: Indima ye-fizioloji nemiphumela kwezokwelapha ye-progesterone. Int J Mol Sci. 2021 Oct 13;22(20):11039. doi: 10.3390/ijms222011039. PMID: 34681696; PMCID: PMC8538505.
5. Harville EW, Wilcox AJ, Baird DD, Weinberg CR. Ukopha kwelungu langasese lesifazane ekuqaleni kakhulu kokukhulelwa. Hum Reprod. Available at: https://pubmed.ncbi.nlm.nih.gov/12923154/
6. McKennett M, Fullerton JT. Ukopha kwelungu langasese lesifazane ngesikhathi sokukhulelwa. Am Fam Physician. 1995 Feb 15;51(3):639-46. PMID: 7863960