DINH DNG CHO PH N GIAI ON TIN MN KINH V MN KINH

BS NG BCH TRN, TTDD/TP.HCM

I.NH NGHA Mn kinh xy ra khi ngi ph n ngng hn hnh kinh do bung trng khng cn kh nng hot ng bnh thng na. y l mt chn on hi cu, ch c khng nh sau khi mt ph n ngng kinh 12 thng lin tc m khng c l do no r rng. Mn kinh l mt chuyn tip gia hai giai on ca cuc i, khng phi l mt bnh l. Mn kinh sm khi hin tng ngng kinh nguyt xut hin di tui mn kinh trung bnh. Tui mn kinh trung bnh ca n ti M l 51. Phn ln ph n mn kinh tui 48-55.. Nu mn kinh trc 40 tui l mn kinh sm. Ph n mn kinh sm cn c nh gi cc vn sc khe. Khong 5% n b mn kinh sm. Tin mn kinh thng bt u khong tui 35-45, ko di t 5-15 nm. Trong giai on ny, ngi ph n vn c chu k kinh u nhng bt u c nhng thay i v lng mu mt v khong thi gian hnh kinh. Tui mn kinh l t dng gi chung khong thi gian ngay trc mn kinh, khi bt u c cc du hiu lm sng v sinh ho ca suy gim chc nng bung trng cho n vi nm u tin sau khi ngng kinh nguyt. Tui mn kinh c th ko di khong 3-5 nm. Trong giai on chuyn tip, thng xut hin cc chu k kinh nguyt khng u. II.NGUYN NHN 1.Mn kinh sm Stress tnh cm m tnh ko di Mt mu nhiu khi sinh U tuyn yn Chy sa ko di Sanh con hay no thai nhiu ln Nhim khun ko di Lao ng th lc qu mc Suy dinh dng Cc bnh ton thn nng 2.Mn kinh nhn to: Ct b bung trng hai bn Tia x 3.Mn kinh sinh l: sau tui 45-55 Rt kh xc nh c tui mn kinh chnh xc ca tng ph n. Cc yu t sc tc, s con v cc yu t a l khng c nh hng. Yu t gia nh khng r nt. Ph n ht thuc l mn kinh sm hn ngi khc t 1-2 nm. Ph n ung ru, khng mang thai ln no hay sng tng lp cao cng c khuynh hng mn kinh hi sm. IV.CC TRIU CHNG LM SNG CA TUI MN KINH Cc triu chng lm sng ca tui mn kinh rt thay i. Mt s ph n khng c triu chng g, mt s gp nhiu triu chng gy kh chu.

CC TRIU CHNG THNG GP CC TRIU CHNG KHC Cn bc ha v m hi m v/hay cn Tiu khng kim sot, tiu nhiu ln Da b nga, rm ran nh c kin b lnh Cm gic chm chch, in git di da Tim p nhanh au c v khp Cu gt, kh chu Nga, bt rt tay chn Ri lon cm xc, d khc Thng nhc u Ri lon gic ng Cng tc v Mt Ri lon tiu ho Lo lng, hong s Bng rt li Cm gic mun cht y hi, kh tiu Kh tp trung Ph t ngt Gim tr nh, l ln Trm cm Ri lon kinh nguyt Tng d ng Mt hng phn tnh dc Tng cn, mt vng eo Kh m o Rng tc, tng lng mt D b nhim trng Long xng Hu qu lu di: cc ri lon thng xy ra lng l, khng triu chng cho n khi xy ra bin chng 1.Xng mt dn cht vi v cc cht khong khc gy ra long xng. 2.Tn sut tai bin tim mch tng ln: nhi mu c tim, suy ng mch vnh 3.Da, cn, t chc lin kt mt tnh n hi nn da nhn, t cung sa ra ngoi m o nht l cc ph n sanh con nhiu ln v c rch tng sinh mn trc 4.ng mch x cng dn gy ra cao huyt p v suy ng mch vnh Xp theo th t thi gian th cc triu chng trn nh sau: Tin mn kinh Estrogen Ri lon kinh nguyt Cn bc nng mt V m hi ban m Mt ng Mn kinh Estrogen Thay i tnh tnh Hay lo lng D cu gt Km tp trung suy ngh t quan tm t chm sc B ngoi Sau mn kinh Estrogen m o kh teo Giao hp au D nhim trng tit niu C th sn tiu Long xng Bnh tim mch tng Bnh Alzheimer

V.CC XT NGHIM CN THIT V CHN ON 1.nh gi thiu mu: cng thc mu, Hemoglobin, dung tch hng cu 2.nh lng Cholesterole mu. Nu bnh thng c th lp li mi 3-5 nm 3.Chp Xquang tuyn v (nh nh) mi 3 nm. Nu nghi ng c khi u th lm siu m v. Khi cn thit c th sinh thit hay phu thut ly ton b khi u 4.o mt xng 5.Pht t bo m o mi nm pht hin sm ung th c t cung 6.Nu mt ph n cn tr b tt kinh trn 12 thng, cn lm xt nghim ni tit chn on xc nh mn kinh: FSH, LH, Estrogen, Progesteron trong mu 7.Xt nghim nc tiu

Ngoi ra, khi khm nu c pht hin thm bnh l no khc, c th lm thm xt nghim chn on. Cn pht hin sm cc ung th thng gp ph n ln tui: Pht t bo m o mi nm Nu c rong huyt th no sinh thit bung t cung Chp Xquang tuyn v (nh nh) mi 3 nm (c bit ch trng n nhng ngi c nguy c cao nh ph n khng c gia nh, khng c con hay khng cho con b, gia nh c ngi b ung th v, ph n trn 45 tui). Nu nghi ng c khi u th lm siu m v. Khi cn thit c th sinh thit hay phu thut ly ton b khi u Khm m o v siu m (tt nht qua u d m o) pht him sm cc bt thng ca c quan sinh dc nh khi u bung trng, khi u t cung. Chn on mn kinh: Lm sng: + V kinh trn 12 thng + Triu chng mn kinh: Ri lon vn mch: cn bc ha Teo sinh dc Cn lm sng: FSH 40 n v/lt Chn on phn bit: Cc cn bc nng v v m hi: cn phn bit cng gip, u ty thng thn, carcinoid Ph n di 40 tui c hin tng tt kinh cn phn bit gia mn kinh sm vi hi chng bung trng khng p ng bng ni soi bng, sinh thit bung trng xem c cn nang non s cp hay khng VI.IU TR A.Ch nh iu tr trong mn kinh C 3 l do chnh cn ch nh iu tr trong mn kinh: iu tr cc ri lon vn mch, triu chng ng tit niu sinh dc do thiu ht Estrogen D phng, iu tr long xng nu c D phng tai bin hay t vong do cc loi bnh tim mch B.iu tr ni tit (khi cn): dng Estrogen thin nhin. Khong 2-3 thng sau khi x dng ni tit, cn ti khm bc s xem tc dng, hiu qu, liu lng, tc dng ph, c cn thay i thuc hay khng cng nh pht hin sm cc loi ung th sinh dc n. Sau phi ti khm t nht mi 6-12 thng. C.Cc iu tr khc: Clonidin, Propanolol: iu tr cn bc ha iu tr cc bnh l km theo nu c: nhim trng tiu, tng lipid mu, long xng, cc bnh l tim mch.v.v VII.DINH DNG Duy tr cn nng thch hp: BMI 20-22 kg/m2 m bo nhu cu nng lng: ty theo tui, gii tnh, loi hnh vn ng v mc hot ng th lc trnh tnh trng suy dinh dng hay tha cn, bo ph. m bo cc cht dinh dng cn thit: Hn ch cht bo (trung bnh 20g hay 4 mung c ph/ngy), c bit l cc loi m bo ho (tht b, tht heo, v thm ch tht g). Nn x dng cc acid bo cn thit nh omega-3 v omega-6 c th gip ci thin mt s triu chng ca mn kinh: trm cm, gim m trong mu, ci thin cc triu chng ca vim khp v gim nguy c ung th v. Omega-3 c trong b ng c ht, du ci, c bit EPA (eicosapentaenoic) v DHA (docosahexaenoic) cha trong c hi, c thu, c trch, c mi, c trng, to, rong bin, trng. Nn n c bin t nht 3 ln/tun. Omega-6 c trong bp, ht hng dng, m, c bit GLA (gammalinolenic acid) c trong hoa anh tho, to lc lam v AA (arachidonic acid) c trong tht cc sn phm sa, trng, mc.

Hn ch cht bt ng s gip kim sot c cn nng, gim trm cm v thay i kh cht. Nn n cc loi ng phc (c trong cc loi tri cy, rau c, ng cc) trnh cc ng n (ng < 20g/ngy) c nhiu trong cc loi bnh ko ngt, nc ngt. n thc n giu m. Mi ngy nn n trung bnh 50g tht, 100g tu h, 50-100g c, 30g u . Trng 3-4 qu/tun. Nu m mu cao hay c bnh si mt: n 1-2 qu/tun n nhiu rau qu (300g/ngy) v tri cy (200g/ngy) s cung cp nhiu cht x, cc vitamin B, C, D, E v khong cht gip bo v bnh tim mch, xng khp, mt s bnh ung th. Cc cht x gip gim m mu, trnh to bn. Cung cp nhu cu Canxi: 1000-1200 mg/ngy (lng Calci nn di 2000 mg/ngy). Sa v cc ch phm t sa l ngun cung cp Canxi tt v s lng v cht lng (d hp thu). Nn dng khong 60g u nnh hay 2 cc sa u nnh mi ngy. Cung cp vitamin D: 200-400 n v/ngy. Phi nng sng 30 pht/ngy C th x dng thm mt s cc vitamin v khong cht cn thit nu ch n khng m bo cung cp , c bit l cc cht chng oxy ho nh: vitamin C, E, carotene, selen, km, lycopene... Hn ch n mn: mui < 10g/ngy (nu c bnh thn, tim mch, tiu ng: < 6g/ngy). Hn ch mui trong khu phn n bng cch: nm lt, khng chm thm nc mm, mui, nc tng, chao, bt dng bt ngt, gim cc thc n mn nh mm, tng, da c, da mui, trnh cc thc n ch bin sn (m n lin, gi ch, lp xng, hp..). Ung 8-10 ly nc mi ngy. Trnh s dng cc cht kch thch nh: c ph, thuc l, ru, chocolate. Tp th dc u n mi ngy (t nht 5 gi/tun) gip duy tr cn nng, gim vng eo, gim huyt p, duy tr v tng cng sc c, phng nga gy xng do long xng. To mt mi trng sng lnh mnh, hnh phc. VIII.KT LUN Mn kinh xy ra khi n ngng hn hnh kinh 12 thng lin tc. Mn kinh l mt chuyn tip gia hai giai on ca cuc i, khng phi l mt bnh l. Cn khm nh k pht hin sm cc bnh l: long xng, bnh tim mch, cc loi ung th n. Duy tr cn nng thch hp. Hn ch cht bo, cht bt ng. Tng rau v tri cy trong ch n. Ung 2 ly sa/ngy. Hn ch c ph, thuc l, ru. Tp th dc mi ngy IX.TI LIU THAM KHO 1. Cac van e ve sc khoe sinh san cua phu n tuoi man kinh. Nguyen th Ngoc Phng. Tai lieu sinh hoat Hoi Dinh Dng 25/8/2000 2. Dinh dng trong benh ly xng khp. Nguyen th Anh Van. Tai lieu sinh hoat Hoi Dinh Dng 29/7/2005 3. Dinh dng cho phu n tien man kinh va man kinh. Nguyen th Anh Van. Tai lieu sinh hoat chng trnh Dinh dng va sc khoe 4. Dinh dng va mot so yeu to can thiet cho ngi lao ong tr oc. Nguyen Thanh Danh. Tai lieu sinh hoat chng trnh Dinh dng va sc khoe 5. Good nutrition and menopause. http://google.com 6. Hormone references. http://google.com 7. Menopause. http://google.com 8. Menopause treatment. http://google.com 9. Perimenopause. http://healthopedia.com 10. Soy isoflavones. Diagnose me treatment. http://google.com 11. Sign of menopause. http://google.com