Ukugula Okwandulela Ukuya Esikhathini—Inganekwane Noma Iqiniso?

Indlela aziphatha ngayo iyaguquguquka futhi ayiqondakali. Uba nesimo esihle okomzuzwana; ngokungazelele abe nezimpikiswano. Ukhuluma amazwi okuphelelwa ithemba. Naphezu kokumduduza kwenu, usabela ngokweqile kulokho enikushoyo nenikwenzayo. Impikiswano encane ingabhebhetheka ibe inhlansi eyokhela umlilo owubuhanguhangu. Ngemva kwezinsuku ezimbalwa, noma isikhathi esingangesonto, lona “omunye” wesifazane ngokungazelele uyanyamalala, futhi aphinde abe umuntu ojwayelekile . . . okwesikhashana.

KUYAVUNYWA, akubona bonke abesifazane ababhekana nokushintsha kwemizwelo okukhulu ngalendlela. Nokho, ngaphambi kokuya esikhathini, kungenzeka abanye besifazane baye babona kubo lona wesifazane oguquguqukayo. Yini ebangela ukushintsha kwemizwelo okunjalo? Ingabe ukuziphatha okunjalo ngempela kubangelwa izinguquko phakathi nomjikelezo wokuya esikhathini?

Iyini I-PMS?

Ngokwe-American Journal of Psychiatry, abesifazane ababa “nezimpawu zomjikelezo ezivela njalo ezinamandla ngokwanele ukuba ziphazamise izici ezithile zokuphila” futhi ezivela njalo ngaphambi kokuya esikhathini kungenzeka baphethwe i-PMS (premenstrual syndrome [ukugula okwandulela ukuya esikhathini]). Nakuba kungekho ukuhlola kwezemithi okungaxilonga i-PMS, abesifazane abane-PMS kumelwe babe nesikhathi esingenazimpawu esiyisonto elilodwa noma amabili phakathi nomjikelezo ngamunye. Ngalencazelo, odokotela balinganisela ukuthi amaphesenti ayishumi kuphela abesifazane ane-PMS.

Ezinye izisebenzi zezokwelapha zinombono ohlukile nge-PMS. Zibonisa ukuthi inani elikhulu labesifazane, amaphesenti aphakathi kwangu-40 nangu-90, liphethwe i-PMS. Zichaza ukuthi leli gama lihlanganisa nokuba nezikhalazo ezihlukahlukene, njengokukhuluphala, ukukhathala, ukuqaqamba kwamalunga, isilumo, izinhlungu zekhanda, ukucunuka, amabele asheshe azwele, iziqubu zokukhala, ukuhalela ukudla, nokushintshashintsha kwemizwelo. Kunezimpawu ezingaphezu kuka-150 ezihlobene ne-PMS. Abesifazane, kuhlanganise nalabo abangasayi esikhathini, bangase babe nanoma iluphi lwalezi zimpawu noma eziningana zazo. Nokho, ngokuvamile owesifazane uba ne-PMS phakathi neminyaka yakhe yokweva ku-30. Kwabesifazane abaningi, izimpawu ze-PMS zibangela ukucindezeleka kodwa ziyasingatheka. Kulesi sihloko sizogxila kulaba abaphethwe i-PMS engenamandla kakhulu.

UNancy Reame, umcwaningi e-University of Michigan, wabika ukuthi e-United States i-PMS ibhekwa ‘njengenkinga engokwempilo engaqondakali,’ kodwa kwamanye amazwe kunomehluko omkhulu ohlotsheni nasemandleni ezimpawu. Wathi: “Abanye babika izimpawu ezingokomzimba eziphawuleka kakhulu, kanti eminye imiphakathi ibika izimpawu ezingokomzwelo.” UReame, oye wenza ukucwaninga eChina, wabhekisela kumaShayina njengesibonelo. “Emphakathini wamaShayina akwamukeleki ukuba nezimpawu ezingokomzwelo.” Waphawula ukuthi ngenxa yalokho, abesifazane bagxila ebuhlungwini besilumo lapho bebuzwa ngezinkinga zokuya esikhathini.

Umsuka We-PMS

I-PMS yadingidwa okokuqala uDkt. Robert T. Frank waseNew York ngo-1931 embikweni wakhe othi “The Hormonal Causes of Premenstrual Tension [Izimbangela Eziphathelene Nama-hormone Zokucindezeleka Okwandulela Ukuya Esikhathini].” Waphawula abesifazane ababehlushwa ukukhathala, ukuhluleka ukugxilisa ingqondo, nokucindezeleka kwezinzwa ngaphambi kokuya esikhathini.

Kwakuseminyakeni engu-22 kamuva lapho uKatharina Dalton noRaymond Greene, odokotela baseNgilandi, benyathelisa umbiko ephephabhukwini lezokwelapha abaqamba kuwo igama elithi “ukugula okwandulela ukuya esikhathini.” UDkt. Dalton wabhekisela kuyi-PMS ngokuthi “isifo esivame kakhulu, futhi ngokunokwenzeka esidala kunazo zonke emhlabeni.” Akuthola ngomphumela i-PMS engaba nawo ekuziphatheni kowesifazane kwavela obala ngo-1980. Yena nabanye odokotela babizelwa ukuzoxilonga abesifazane ababili baseBrithani ababemangalelwe ngokubulala. Baveza inkolelo-mbono yokuthi ukuziphatha kowesifazane kungathonywa ukushintshashintsha kwama-hormone phakathi nomjikelezo wakhe wokuya esikhathini. Ngokusekelwe ekuxilongeni kwabo i-PMS, izigwebo zokubulala kuwo womabili amacala zancishiswa. Kwesinye isinqumo ummangalelwa wathola isigwebo esincane sokubulala ngenxa “yokushabalala komuzwa womthwalo wemfanelo.”

Izenzakalo zokuziphatha okubhubhisayo kwabesifazane, njengasesimweni esingenhla, kubonakala kuyizenzakalo ezingavamile. Imbangela yokuziphatha okunjalo nezimpawu ezincane ezibangela ukucindezeleka ezihlupha abesifazane abaningi ngenkathi yokuya esikhathini kusadingidwa ezincwadini zezokwelapha nezivamile.

Ingabe ukuziphatha okunjalo ngempela kubangelwa ukushintshashintsha kwama-hormone ngesikhathi somjikelezo emzimbeni womuntu wesifazane? Noma ingabe umbono wama-hormone angalawuleki nomzimba wesifazane ongaqondakali umane uyinganekwane? Kunemibono ehlukene ngokuthi ukushintshashintsha kwama-hormone kunamuphi umphumela, uma ukhona, ekuziphatheni kowesifazane. Abacwaningi nodokotela abaningi bayavuma ukuthi ukukuqonda kangcono ukusebenzelana kobuchopho nama-hormone asesizalweni phakathi nomjikelezo wokuya esikhathini kuyisihluthulelo sokwazi ukuthi kungani abanye besifazane behlushwa i-PMS.

Umjikelezo Wokuya Esikhathini

Cishe kanye njalo emasontweni amane, umzimba womuntu wesifazane ungena emjikelezweni oyinkimbinkimbi kakhulu wokushintshashintsha kwama-hormone. Njengoba abaningi bebhekisela kulo ngokuthi “isiqalekiso,” igama elithi “menstruation (ukuya esikhathini)” livela kwelesiLatini elithi mensis, elisho “inyanga.”

Ukuze iqale lomjikelezo, i-hypothalamus yobuchopho ithumela isigijimi endlaleni yegilo. Lapho lesi sigijimi samukelwa, indlala yegilo ikhiqiza i-FSH (follicle-stimulating hormone [i-hormone eshukumisa isizalo]). I-FSH ihamba egazini iye esizalweni futhi ishukumise ukukhiqizwa kwe-estrogen. Njengoba i-estrogen yanda, indlala yegilo isabela ngokukhiqiza i-LH (luteinizing hormone). I-LH inciphisa ukukhiqizwa kwe-FSH. Iqanda elilodwa liyavuthwa bese lehlela esibelethweni. Ngemva kokuba leli qanda selikhishiwe, kukhiqizwa i-hormone i-progesterone. Uma leli qanda lingavundiswa, amazinga e-progesterone ne-estrogen ehla ngokushesha.

Njengoba engekho ama-hormone okulusekela, ulwelwesi lwesibeletho luyawohloka, bese kuphuma igazi, uketshezi, nezicutshana esithweni sangasese sowesifazane. Kuthatha cishe izinsuku ezintathu kuya kweziyisikhombisa ukuba isibeletho sowesifazane silukhiphe ngokuphelele lolu lwelwesi, kuphele umjikelezo owodwa wokuya esikhathini. Njengoba omunye umjikelezo uphela, ubuchopho buphinde bukhiqize ama-hormone, ayaleza ukuba kuqale umjikelezo omusha.

Impi Yama-hormone?

Abanye baphikisa ngokuthi ukungalingani kwe-estrogen ne-progesterone yikhona okubangela izimpawu ezandulela ukuya esikhathini kowesifazane. Bagomela ngokuthi ngokuvamile lama-hormone asebenza ndawonye ukuze afinyelele ukulingana okufanele. Lapho kukhiqizwa enye ngaphezu kwenye, kuqubuka impi, futhi izinkubela zisala emzimbeni womuntu wesifazane.

Amazinga aphakeme e-estrogen angase enze abesifazane bacunuke. Kwabanye, i-progesterone iba ningi, okubenza bazizwe becindezelekile futhi bekhathele.

Abanye abacwaningi abavumelani nenkolelo-mbono yokuthi ukungalingani kwama-hormone kubangela i-PMS. Bathi izici ezingokwengqondo nezingokwenhlalo zinezindima eziyinhloko ekubangeleni izimpawu ezandulela ukuya esikhathini kwabanye besifazane. Ibika ngezimbangela ze-PMS, i-Patient Care ithi “awukho umehluko ocacile oye watholwa ekwakhekeni, ezilinganisweni, emazingeni, noma esikhathini sokusebenza kwama-hormone ezakhi zobulili kwabesifazane abane-PMS enamandla noma abangenayo.”

Ngokwesibonelo, ukucindezeleka kungase kusheshise, kubambezele, noma kukhulise izimpawu ze-PMS. Incwadi ethi PMS—Premenstrual Syndrome and You: Next Month Can Be Different iyaphawula: “Ukucindezeleka kuthiya ukukhiqizwa kwama-hormone futhi ukungeneli kwama-hormone kungabangela ukungalingani kwawo okwenza izimpawu ze-PMS zibe zimbi nakakhulu.” Izinkinga zezokwelapha, zezimali, noma zomkhaya zingase zibonakale zizinkulu futhi zingasingatheki ngaphambi kokuya esikhathini.

Ukusaba Ihlazo

Abanye abacwaningi baphikisa ngokuthi owesifazane angase abhekwe njengesisebenzi noma umenzi wezinqumo ongenakwethenjelwa uma ebonisa izimpawu ezihlobene nokuya kwakhe esikhathini. “Yindlela umphakathi ogcina ngayo abesifazane endaweni yabo. Uma uphazamiseka kanye ngenyanga, lokho-ke kusho ukuthi akufanele wenze imisebenzi emikhulu, nenethonya,” kusho uBarbara Sommer, isazi sokusebenza kwengqondo.

Abanye abacwaningi bathi abesifazane baye bayamukela i-PMS ngoba ibavumela ukuba basebenzise lesi simo njengezaba zendlela abaziphatha ngayo. Lapho exoxa nomagazini i-Redbook, uDkt. Carol Tavris, umlobi wethi The Mismeasure of Woman, uthi i-PMS “ivumela abesifazane ukuba bathi, ‘Yini engalungile ngami ngokwezokwelapha?’ hhayi ukuthi, ‘Yini engalungile ekuphileni kwami engenza ngibe lusizi?’”

Ngo-1985, odokotela besifazane bezifo zengqondo ku-Committee on Women ye-APA (American Psychiatric Association) bamelana nokufakwa kwe-PMS kuyi-Diagnostic and Statistical Manual ye-APA. Nakuba esithasiselweni sephephabhuku elisetshenziswa manje (lika-1987) ibizwa ngokuthi “ukuphazamiseka kwenjabulo okubangelwa ukuya esikhathini sekwephuzile,” iqembu elithile lezisebenzi ze-APA liye laveza isiphakamiso sokufaka ohlwini i-“premenstrual dysphoric disorder [ukuphazamiseka kwenjabulo okwandulela ukuya esikhathini]” (PMDD) ohlwini oluyinhloko lwephephabhuku elilandelayo. Ukuyifaka kuleli phephabhuku bekungayenza ibhekwe njengokuphazamiseka okungokwengqondo okungokomthetho.

“Akufanele ingene noma ikuphi kulencwadi ngoba ayikhona ukuphazamiseka kwengqondo,” kuphawula uDkt. Paula Kaplan, owayengumeluleki waleli qembu. Wathi: “Ngokuzayo lapho owesifazane ekhethwa njengommeli omkhulu, uyobuzwa: ‘Wake waphathwa i-PMDD?’”

Ukufuna Ikhambi

Ochwepheshe bezokwelapha basaqhubeka bephikisana ngendaba ye-PMS. Kuvela izinkolelo-mbono eziningi ngembangela enembile nokwelashwa kwe-PMS. Abanye odokotela banomuzwa wokuthi kungase kube nezinhlobo ze-PMS ezingu-18, ngayinye enezimpawu ezihlukile. Ukuhlola okuthile kwamuva nje kubike ukuthi i-zinc ingase ibe nendima ekubangeleni izimpawu ze-PMS. Okunye ukuhlola kwabonisa ukuthi ukuntuleka kuka-vithamini-B₆ kungase kube umnyombo walenkinga, okubangela ukucindezeleka okuncane kwabanye.

Ukwelapha okunjenge-light therapy, ukushintsha imikhuba yokulala, inqubo yokuphumula, izidakamizwa ezinqanda ukucindezeleka, nemithi yokunezela i-progesterone kuzanywa abesifazane abafuna ikhambi lezimpawu eziphikelelayo ze-PMS. Kuze kube manje, alikho ikhambi eliphumelela njalo eliye latholakala.

Abesifazane abahlushwa izimpawu ezingalawuleki ngaphambi kokuya esikhathini kufanele bathintane nodokotela. Umuntu ngamunye ophethwe i-PMS uhlukile, futhi owesifazane ngamunye kufanele athole iseluleko sezokwelapha esinengqondo nokunakekelwa okufanele. Ngenxa yokuthi i-PMS ingase ifane nezinye izimo ezingathi sína, njengesifo se-thyroid, i-endometriosis, nokucindezeleka, ukuhlolwa komzimba kubalulekile.

Kutuswa ukuba ngaphambi kokuya kudokotela okokuqala ngqá, owesifazane agcine umbhalo oningiliziwe noma izinsuku okuvela ngazo izimpawu ezingokomzimba nezingokomzwelo ezandulela ukuya esikhathini. Ukwazi izinsuku lapho angase abe nemizwa eguquguqukayo, acunuke, noma acindezeleke kungamsiza ukuba ahlele isikhathi sakhe ngendlela efanele. Kungamsiza futhi ukuba abone noma uphethwe i-PMS yini.

Odokotela bangase basikisele ukuba anciphise izici ezibangela ukucindezeleka ekuphileni kwakhe. Ukudla okunomsoco nokuvivinya umzimba njalo nakho kungalwa ne-PMS. Ukuhlola okuthile kwaseyunivesithi kwathi ukudla okunezakhi zomzimba eziningi namaprotheni amancane kwathuthukisa imizwelo yabanye besifazane abacindezelekayo ngaphambi kokuya esikhathini. Ukuvivinya umzimba njalo noma ukuhamba ngamandla phakathi nosuku nakho kungase kusize ekunqandeni ukukhathala nokuphatheka kabi.

Yiqiniso, amalungu omkhaya, ikakhulukazi indoda, angasiza. Kumelwe alwele ukuba nomusa, ukucabangela, nokuqonda okukhulu lapho umjikelezo womuntu wesifazane wazinyanga zonke umbangela ubunzima.

Impikiswano Iyaqhubeka

Abanye bathi akufanele ukubiza ushintsho oluvamile olungokomzwelo nolungokomzimba owesifazane abhekana nalo phakathi nomjikelezo wakhe wokuya esikhathini ngokuthi “ukugula.” Futhi abanye basola i-PMS, bathi ihlazisa abesifazane.

Nokho, kwabesifazane abaningi, i-PMS ingokoqobo. Nyanga zonke, kuba nezimpawu ezenza ukubhekana nomkhaya nomsebenzi kube nzima. Ukufuna ikhambi nokuqonda kungase kudumaze njengoba abaningi emkhakheni wezokwelapha nabantu abavamile beqhubeka bephika ukuthi i-PMS ingokoqobo.

[Isithombe ekhasini 15]

Amalungu omkhaya angasiza ngokuba nomusa nokucabangela okukhulu