MÃN KINH VÀ NHỮNG ĐIỀU CẦN BIẾT

DANH MỤC CHIA SẼ
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tienmankinh

Trong cuộc đời mỗi người phụ nữ, ai cũng đến lúc phải trải qua giai đoạn tiền mãn kinh và mãn kinh. Đó là khi các nội tiết tố trong cơ thể bắt đầu suy giảm dần gây ra nhiều khó chịu, ảnh hướng tới sức khỏe, tâm sinh lý của chị em. Vậy độ tuổi mãn kinh ở phụ nữ là bao nhiêu và những dấu hiệu nào giúp nhận biết giai đoạn này để cải thiện kịp thời.




1. Mãn kinh là gì ?

  - Mãn kinh là giai đoạn chuyển tiếp lần thứ hai trong đời sống sinh dục của một người phụ nữ, đúng hơn là đánh dấu sự kết thúc thời kỳ sinh sản của họ.

  - Mãn kinh là tình trạng không hành kinh vĩnh viễn và không còn khả năng sinh sản tự nhiên, là một hiện tượng sinh lý bình thường do buồng trứng suy tàn, các hormon sinh dục không còn được chế tiết dẫn đến những biến đổi và rối loạn tạm thời một số chức năng tâm sinh lý.

2. Khi nào được xem là đã mãn kinh ?

  - Mãn kinh được chẩn đoán chủ yếu dựa trên lâm sàng, khi một phụ nữ từ trước vẫn có kinh đều mỗi tháng lại tự nhiên ngừng, không có kinh trong 12 chu kỳ liên tiếp.

  - Khi một phụ nữ còn trẻ (dưới 40 tuổi mà vô kinh liên tiếp 12 tháng) hoặc một phụ nữ đã bị cắt tử cung mà có một số các triệu chứng cơ năng của mãn kinh, muốn chẩn đoán là mãn kinh cần làm các xét nghiệm định lượng nội tiết buồng trứng và tuyến yên, nếu: FSH ≥ 40 mIU/ml, Estradiol thấp; khoảng dưới 50 pg/ml thì có thể xem người phụ nữ ấy đã mãn kinh.

3. Các giai đoạn của mãn kinh

  - Tiền mãn kinh: Bắt đầu khá sớm, khi xuất hiện các triệu chứng đầu tiên của rối loạn quanh mãn kinh, thường vào khoảng 40 tuổi, kéo dài khoảng 2-8 năm và kết thúc bởi chu kỳ kinh sinh lý cuối cùng.

  - Quanh mãn kinh: Quanh mãn kinh là khoảng thời gian từ lúc xuất hiện các triệu chứng đầu tiên của rối loạn mãn kinh cho đến 12 tháng sau của chu kỳ kinh sinh lý cuối cùng.

  - Hậu mãn kinh: Hậu mãn kinh được định nghĩa là thời kỳ diễn ra sau mãn kinh.

4. Những rối loạn chức năng của phụ nữ mãn kinh

Các triệu chứng cơ năng của mãn kinh thay đổi theo từng giai đoạn, về cơ bản có 3 nhóm triệu chứng chính:

4.1 Triệu chứng vận mạch:

  - Bốc hỏa và vã mồ hôi đêm là hai biểu hiện đặc trưng của rối loạn vận mạch, là triệu chứng mãn kinh phổ biến nhất.

  - Chúng được miêu tả là cơn bừng nóng ở mặt hoặc ngực và sau đó lan khắp cơ thể. Cảm giác này tồn tại trong vòng vài phút hay chỉ vài giây nhưng thường kèm theo vã mồ hôi, cảm giác nóng toàn thân, hồi hộp đánh trống ngực, lo lắng và làm cho người phụ nữ rất khó chịu. Hiện tượng này lặp lại nhiều lần trong ngày, số lần nhiều hay ít tùy thuộc từng người. Mỗi cơn kéo dài khoảng 3 phút, dẫn đến giãn mạch trong vòng 5 phút sau đó các triệu chứng này giảm đi.

  - Vã mồ hôi đêm là cơn bốc hỏa xảy ra vào ban đêm và thường can thiệp vào giấc ngủ. Béo phì, hút thuốc lá, phụ nữ đã cắt buồng trứng hay học vấn thấp là những yếu tố có thể làm tăng tần suất và mức độ nghiêm trọng của biểu hiện rối loạn vận mạch.

4.2 Triệu chứng tâm – thần kinh

  - Những rối loạn về tâm lý thời kỳ mãn kinh chủ yếu là mất ngủ, dễ cáu gắt, lo lắng và trầm cảm đặc biệt ở người có tiền sử tâm lý không ổn định trước mãn kinh. Đặc biệt rối loạn dạng trầm cảm chiếm khoảng 20% các phụ nữ trong độ tuổi mãn kinh. Toát mồ hôi đêm gây khó ngủ làm bực dọc và mệt mỏi trong ngày có thể đưa đến những triệu chứng trầm cảm.

  - Phụ nữ bước vào giai đoạn tiền mãn kinh thường đã đến tuổi nghỉ công tác, phải rời xa tập thể. Khi đó, con cái của họ cũng đã đến tuổi trưởng thành, một phần trong số đó sống xa gia đình để học tập hoặc làm việc. Vì vậy, trong suy nghĩ của người phụ nữ thường xuất hiện cảm giác cô độc do thể lực sút giảm, giảm các hoạt động xã hội. Họ ngộ nhận là mình đã già, không còn có ích gì cho xã hội và con cái nữa; thấy cuộc sống tẻ nhạt, hoài nghi về giá trị tồn tại của mình, từ đó mà sinh ra trạng thái bi quan, tiêu cực, lo lắng, u uất, dễ kích động.

  - Một số ít phụ nữ thời kỳ tiền mãn kinh có những thay đổi về tính cách hoặc hành vi. Bình thường vốn rất hòa nhã, khoan dung, độ lượng, bỗng trở nên nóng tính, nổi cáu bất thường, hoặc suy nghĩ hẹp hòi, hay đa nghi, đố kỵ, lãnh cảm…

  - Nghiên cứu tại Việt Nam của tác giả Nguyễn Thị Mỹ Hạnh đã chỉ ra rằng các trường hợp như phụ nữ quanh tuổi mãn kinh không có nhà riêng, không có con, sang chấn tâm lý liên quan đến hạnh phúc, công việc, bệnh tật, có triệu chứng tiền mãn kinh sẽ có nguy cơ trầm cảm cao hơn những phụ nữ bình thường.

4.3 Triệu chứng ở mô đích:

  - Teo niêm mạc niệu dục, thay đổi môi trường âm đạo, khô hay đau khi giao hợp, cảm giác nóng rát hay ngứa âm hộ.

  - Những thay đổi ở đường sinh dục bắt đầu vào tuổi mãn kinh, thường tiến triển dần trong vài năm. Khi nồng độ Estrogen giảm, âm hộ dần mất hầu hết collagen, mô mỡ và khả năng giữ nước, trở nên phẳng, mỏng, nhợt nhạt. Âm đạo khô, ngắn và hẹp, vách trở nên mỏng hơn, kém đàn hồi hơn. Âm đạo tiết chất nhờn ít hơn và chậm hơn khi kích thích tình dục, dẫn đến đau khi giao hợp và giảm ham muốn tình dục.

4.4 Các biểu hiện khác

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5. Điều trị và phòng ngừa các rối loạn mãn kinh

  - Với mục đích nâng cao chất lượng cuộc sống của phụ nữ mãn kinh, các nghiên cứu về mãn kinh và xu hướng điều trị các rối loạn tuổi mãn kinh không ngừng phát triển.

  - Liệu pháp hormone thay thế (Hormone Replacement Therapy – HRT) đã được nhiều tổ chức uy tín trên thế giới nghiên cứu và công nhận là liệu pháp:

    + Điều trị tốt các triệu chứng cơ năng của mãn kinh đặc biệt là rối loạn vận mạch và viêm teo niệu dục.

    + Bảo vệ tim mạch và giảm tỉ lệ gãy xương do loãng xương.

    + Giảm và làm chậm phát triển bệnh Alzheimer.

  - Tuy nhiên, việc sử dụng HRT cũng tiềm ẩn một số nguy cơ như tăng cân, đau đầu, đau vú, huyết khối và ảnh hưởng lên nội mạc tử cung nên cần phải tham khảo ý kiến của bác sĩ chuyên nghành trước khi bắt đầu điều trị.

Bên cạnh đó, cũng cần phải duy trì lối sống lành mạnh, khoa học và tinh thần luôn vui khỏe.

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  - Bản thân người phụ nữ và những người thân trong gia đình cần có những hiểu biết đúng đắn về giai đoạn này và có cách thích nghi phù hợp để giúp người phụ nữ mà chúng ta yêu quý an tâm vượt qua những khó khăn và phòng ngừa tốt những vấn đề sức khỏe của lứa tuổi.

BS Nguyễn Thị Ngọc Huyền – Khoa Phụ

Tài liệu tham khảo

1. Nguyễn Thị Ngọc Phượng, “ Những vấn đề của tuổi mãn kinh”.
2. Nguyễn Đình Phương Thảo (2017), “ Nghiên cứu các rối loạn chức năng ở phụ nữ mãn kinh tại TP huế và hiệu quả của một số biện pháp điều trị”, luận văn tiến sĩ, đại học Y Dược Huế.
3. Bệnh viện Mỹ Đức, “ Mãn kinh”.
4. Nguồn Internet

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