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მენოპაუზა - ბუნებრივი ეტაპი ქალის ცხოვრებაში

თარიღი: 19 სექტემბერი, 2025

მენოპაუზა — ცვლილებების ფიზიოლოგია და რა უნდა იცოდეს ყველა ქალბატონმა, ამ თემაზე გვესაუბრება კლინიკური ონკოლოგიის ინსტიტუტის გინეკოლოგი თამარ ჩირგაძე.

რა არის მენოპაუზა და როდის იწყება?
მენოპაუზა არის ბუნებრივი ფიზიოლოგიური პროცესი, რომლის დროსაც წყდება მენსტრუალური ციკლი. ეს ხდება იმ დროს, როცა საკვერცხეები პრაქტიკულად წყვეტს ესტროგენის და პროგესტერონის — ქალის ჰორმონების — გამოყოფას. საშუალოდ, მენოპაუზა დგება 45-დან 55 წლამდე ასაკში, თუმცა ეს პროცესი ინდივიდუალურია. მენოპაუზის ითვლება ის ეტაპი, როცა ქალს მენსტრუაცია ერთი წლის განმავლობაში აღარ აქვს, თუმცა ამ პერიოდს წინ უძღვის გარდამავალი ფაზა პერიმენოპაუზა, რომელიც რამდენიმე წლით ადრე იწყება.

 

რომელი სიმპტომებია ყველაზე ხშირად ასოცირებული მენოპაუზასთან?
ყველაზე გავრცელებული სიმპტომებია სიცხის მოულოდნელი შეგრძნებები (ალები),რომლებიც ასევე ცნობილია, როგორც ვაზომოტორული სიმპტომები,  ღამის ოფლიანობა, განწყობის ცვალებადობა, უძილობა, საშოს სიმშრალე, სექსუალური ლიბიდოს შემცირება, გახშირებული  შარდვა,გულისცემის აჩქარება და ზოგადი დაღლილობა, ვაზომოტორული ცვლილებები. ასევე ხშირია მეხსიერების დროებითი დაქვეითება ან კონცენტრაციის გაძნელება, რაც ზოგჯერ ქალებში შფოთვას იწვევს, მაგრამ ეს დროებითი მდგომარეობაა.

როგორია მენოპაუზის მართვა?
თანამედროვე მედიცინაში მენოპაუზის მართვის საკმაოდ ეფექტური და გამოცდილი მეთოდები არსებობს:

 

ის რამდენიმე ჯგუფად შეიძლება დაიყოს:

არამედიკამენტოზური - ცხოვრების სტილის შეცვლა, ვარჯიში, სწორი კვება და  ა. შ.

მცენარეული წარმოშობის ბიოლოგიურად აქტიური დანამატები - ფიტოესტროგენები

არაჰორმონალური პრეპარატებით მკურნლობა

ჰორმონალური ანუ ჰორმონ ჩანაცვლებითი თერაპია (HRT)

პაციენტის მკურნალობას წყვეტს ექიმი გინეკოლოგი, ინდივიდუალურად, მისი ზოგადი მდოგმარების და ანამნეზის გათვალისწინებით. მკურნალობა შეიძლება მოიცავდეს ზემოთხსენებული მედიკამენტების ჯგუფის ერთ ან რამდენიმე დასახელების კომბინაციას.

 

რა არის ჰორმონ ჩანაცვლებითი თერაპია (HRT)?

ჰორმონ ჩანაცვლებითი თერაპია (HRT) არის სამედიცინო მკურნალობა, რომელიც მოიცავს ჰორმონების გამოყენებას სხეულის ბუნებრივი ჰორმონების ესტროგენისა და პროგესტერონის დონის შესავსებად ან მისი ჩანაცვლებისთვის.მისი მიზანია ჰორმონის დეფიციტით გამოწვეული სიმპტომების შემსუბუქება. ის ასევე ახდენს ოსტეოპოროზის რისკის შემცირებას პოსტმენოპაუზურ ქალებში. არსებობს ჰორმონ ჩანაცვლებითი თერაპიის სხვადასხვა ტიპები. მხოლოდ ესტროგენის შემცველი და ასევე კომბინირებული ესტროგენ-პროგესტერონის შემცველი მედიკამენტები. მათი შერჩევა ხდება ექიმი სპეციალისტის მიერ პაციენტის მდგომარეობის გათვალისწინებით.

 

ჰორმონჩანაცვლებითი თერაპია შეიძლება ჩატარდეს სხვადასხვა ფორმით;

 

პერორალური აბები

ტრანსდერმული პაჩები

ადგილობრივი კრემები ან გელები

ვაგინალური მედიკამენტები (მაგ:კრემები, ტაბლეტები )

 

პირველ რიგში, მნიშვნელოვანია  ექიმთან დროული კონსულტაცია. უმეტეს შემთხვევაში საჭიროა ჰორმონალური ფონის შეფასება, ზოგჯერ — სისხლის ანალიზები. ცხოვრების ჯანსაღი წესი ძალიან ეხმარება ქალს ამ პერიოდის უკეთ გადატანაში: სწორი კვება, რეგულარული ფიზიკური აქტივობა, ძილის ჰიგიენა და სტრესის მართვა.

 

ჰორმონოთერაპია ბევრს აშინებს — რა შემთხვევაში არის იგი მიზანშეწონილი?

ჰორმონალური ჩანაცვლებითი თერაპია (HRT) არ ნიშნავს “მავნე წამალს”. ის გამოიყენება მხოლოდ ინდივიდუალური ჩვენებით და მონიტორინგით. თუ ქალს გამოხატული სიმპტომები აქვს და სხვა სამედიცინო შეზღუდვები არ არსებობს, HRT შეიძლება მნიშვნელოვნად გააუმჯობესოს ცხოვრების ხარისხი. თუმცა ამ გადაწყვეტილებას მხოლოდ ექიმთან ერთად ვიღებთ — თითოეული შემთხვევა ინდივიდუალურია.

 

მენოპაუზა ხშირად ფსიქოლოგიურ სირთულეებთანაა  დაკავშირებული. როგორია თქვენი მიდგომა ამ მხრივ?
დიახ, მენოპაუზა მხოლოდ ფიზიოლოგიური პროცესია, თუმცა ის ხშირად აისახება ხოლმე  ფსიქოემოციურ პროცესებზე. ზოგ ქალს ეწყება თვითშეფასების დაქვეითება, მოულოდნელი შფოთვა, ზოგჯერ — დეპრესიული სიმპტომებიც. აქ მნიშვნელოვანია ფსიქოემოციური მხარდაჭერა — ოჯახის წევრების, მეგობრების და საჭიროების შემთხვევაში, ფსიქოლოგის.