Rikicewar jinin al'ada (jinin haila) da kuma mene ne magani - (Disorders of menstruation)

Gabatarwa:

Yayin da wasu matan ke samun al'ada dai-dai a kowane wata, wasu matan ana barin su a cikin kokwanto. Wasu na iya tsallake wata ɗaya ba tare da yin jinin al'ada ba; wasu kuma suna samun bambancin kwanakin zagayowar al'adar su[¹].

Duk da cewa wannan matsalar tafi shafuwar mata da ke kan gaɓar jinin al'ada, ma'ana, ƙananan yara 'yan mata da basu daɗe da fara yin jinin al'ada ba da kuma manya tsofaffi waɗanda suka kusa daina yin jinin al'ada amma mafi yawancin mata wasu lokuta suna fuskantar rikicewar jinin al'ada. A cikin wannan rubutu zamu fayyace muku abubuwan da ke kawo rikicewar jinin al'ada da kuma yadda ake maganin su[¹].

Mene ne lafiyayyen al'ada?

Kamin mu san mene ne rikicewar jinin al'ada ya kamata mu ɗan yi tsokaci game da mene ne lafiyayyen al'ada. Masana sun ƙayyade cewa lafiyayyen jinin al'ada yakan shafe kwanaki huɗu (4) zuwa kwanaki bakwai (7) yana zuba sannan ya ɗauke, idan ya ɗauke yakan shafe kwanaki ashirin da ɗaya (21) zuwa kwanaki talatin da biyar (35) kamin kuma ya sake dawowa[¹].

Mafi yawancin mata sukan shafe kwanaki ashirin da ɗaya (21) idan jinin ya ɗauke kamin su sake ganin wani jinin yazo, idan yazo sai suyi kwana huɗu (4) zuwa kwana bakwai (7) suna yinsa kamin ya ɗauke. Masu yin haka su ne waɗanda watan al'adan su yake da kwanaki ashirin da takwas (28 days cycle), ma'ana tsakanin farawar jinin al'adan wannan wata zuwa farawar jinin al'adar wani wata akwai kwanaki ashirin da takwas (28). Amma duk da haka wannan ya danganta daga wata mace zuwa wata mace. Bugu da ƙari ko a mace ɗaya wannan adadin zai iya bambanta daga wani wata zuwa wani wata sai dai lafiyayyen wa'adin da mace zata yi idan jinin al'adarta ya ɗauke kamin ya sake dawowa bazai kasa kwanaki ashirin da ɗaya ba (21) haka kuma bazai yi sama da kwanaki talatin da biyar (35) ba. Wani babban bincike da ƙungiyar Flo da Jami'ar Adelaide suka gudanar ya nuna cewa kusan kashi 16 cikin 100 na mahalarta binciken ne kawai ke da zagayowar kwanaki ashirin da takwas (28) cif-cif, duk da cewa ana yawan cewa wannan shi ne lafiyayyen wa'adin watan jinin haila[²].

Yadda mace zata gane lafiyayyen wa'adin ta na al'ada

Lafiyayyen wa'adin al'adan mace shi ne wa'adin da ta saba yi a kowane wata. Domin gane wa'adin da yake shi ne lafiyayyen wa'adin jinin al'ada ga mace, ana so ta fara adana rikodin din lokutan hailarta a kan kalanda.  Ta fara bin diddigin al'adan ta a kowane wata har tsawon watanni dayawa a jere domin gano matsakaicin wa'adin da take yi. 

Ana so ta lura da waɗannan abubuwan kowane wata: 

•  Ranar da ta fara al'ada
•  Kwanaki nawa tayi tana zubar da jini
•  Ranar da al'adarta ta ɗauke
•  Kwanaki nawa tayi kamin ta sake ganin wani al'ada
• Kwanaki nawa ke tsakanin ranar da ta fara al'adan wannan wata zuwa ranar da ta fara al'adan wani wata na gaba.
• Pad nawa take yin amfani dasu kullum
• Matsalolin da take samu lokacin al'ada

Wannan rekodin shi zai taimakawa mace domin tasan lafiyayyen wa'adin ta na al'ada.

Lafiyayyen wa'adin mace shi ne = Matsakaicin (average) kwanakin da take yi tana zubar da jinin al'ada + Matsakaicin kwanakin (average) da take yi idan jinin ya ɗauke kamin ta sake ganin wani jinin al'ada. Ma'ana idan mace tayi rekodin na kwanakin jinin al'adarta kamar yadda muka yi bayani a sama toh zata ɗauki matsakaici (average) na kwanakin da takeyi tana zubar da jini sai ta haɗa da matsakaici (average) na kwanakin da take yi kamin jinin ya sake dawowa.

Misali: idan a kowane wata tana yin kwanaki 6 tana zubar da jini a lokacin al'adarta sannan idan jinin ya ɗauke sai tayi kwanaki 22 kamin jinin ya sake dawowa, toh lafiyayyen wa'adin jinin al'adarta (normal cycle length) = 6+22 wanda ya kama kwanaki 28 kenan (28 days cycle). Ko kuma idan a ko wane wata tana yin kwanaki 4 tana zubar da jinin al'ada, sannan idan ya ɗauke takan kwashe kwanaki 26 kamin ta sake ganin wani jinin al'ada, toh lafiyayyen wa'adin watan jinin al'adarta shi ne 4+26 wanda ya kama kwanaki 30 kenan (30 days cycle).

Mene ne rikicewar jinin al'ada?

Rikicewar jinin al'ada shi ne yin jinin al'ada wanda ya saɓawa lafiyayyen al'adan da mace ta saba yi a kowane wata[²]. Lafiyayyen wa'adi kamar yadda muka tattauna a baya ya danganta daga mace zuwa mace. Amma rikicewar jinin al'ada wanda zai zama gama gari ya ƙunshi waɗannan;

1. Delayed period: Rashin zuwan jinin al'ada lokacin da ya kamata. A ƙa'idance ana cewa jinin al'ada ya makara ne idan mace ta ƙara aƙalla kwanaki biyar (5) tana jiran al'adanta kuma bai zo ba.
2. Oligomenorrhea: Jinin al'adan da yaƙi zuwa har mace ta wuce kwanaki talatin da biyar (35) da yin tsarki amma yazo kamin ta kai kwanaki casa'in (90 days).
3. Amenorrhea: Shi ne jinin al'adan da yaƙi zuwa bayan mace ta shafe tsawon kwanaki casa'in (90) da yin tsarki.
4. Polymenorrhea: Jinin al'adan da yake zuwa kamin mace takai aƙalla kawanaki ashirin da daya (21) da yin tsarki.
5. Menorrhagia: Jinin al'adan da yakai aƙalla kwana takwas yana zuba bai ɗauke ba. Ko kuma zuwan jinin al'ada da ƙarfi sosai yadda zai tilasta wa mace yin amfani da fiye da pad (kaɗar tare jini) ɗaya (1) acikin awa ɗaya (1). Masana sun sabunta sunan menorrhagia zuwa heavy menstrual bleeding (HMB) saboda wasu 'yan dalilai.
6. Intermenstrual bleeding: Shi ne jinin haila mai wasa, shi ne jinin da yake zuwa bayan mace tayi tsarki kamin lokacin zuwan wani  al'ada, haka kuma zai ɗauke kamin cikar kwanakin da take yi tana zubar da jinin al'ada. Mafi yawanci jinin yakan zo ɗan kaɗan kuma baya daɗewa yana zuba, wata rana ma mace zata ga alamunsa ne kawai a wandonta. Amma watarana jinin yakan iya zuwa dayawa[³].

Haka zalika, akwai wani al'amari da ke faruwa da mata a lokacin da suke jinin haila wanda ke haifar musu da matsanancin ciwon mara. Amma wannan maudu'in mun riga munyi rubutu akansa tare dayi masa adalci gwargwadon hali. Saboda haka baza mu taɓo shi a wannan rubutu ba. Idan kuna neman ƙarin bayani sai ku shiga rubutun kamar haka: Bayani game da ciwon mara a lokacin jinin al'ada da kuma yadda ake maganinsa.

Abubuwan da ke kawo rikicewar al'ada

Mafi yawancin rikicewar jinin al'ada abubuwan da ke kawo sa ba wasu masu tashin hankali bane musamman ga mata masu ƙananan shekaru. Amma rikicewar al'ada ga mata masu yawan shekaru da tsofaffi chan ba'a rasa ba yakan iya samo asali daga wasu cututtuka masu tashin hankali kamar irin su cutar sanƙarar bangon mahaifa na ciki (Endometrial cancer) ko sanƙarar bakin mahaifa (Cervical cancer) ko kuma kumburin fibroid. Waɗansu abubuwa masu kawo rikicewar jinin al'ada sun haɗa da[²][³]:

1. Stress; Yawan gajiya da kuma damuwa sukan iya sa mace ta daina ganin jinin al'adar ta yadda ya kamata.
2. Lifestyle changes: Chanji game da yadda mace ke gudanar da rayuwar ta shima yakan iya kawo chanji game da yadda take jinin ta na al'ada. Misali mace mai ƙiba wadda ta rage ƙiba sosai ko kuma mace ramammiyar da tayi ƙiba cikin ƙanƙanin lokaci, rashin samun motsa jini irin yadda aka saba, ko kuma motsa jini fiye da yadda aka saba, chanjin kalar abincin da mace ke ci, da dai sauransu. Waɗannan sauye-sauyen duk sukan iya rikata jinin al'adar mace.
3. Contraception: Amfani da magungunan bada tazarar iyali, ko allurorin bada tazarar iyali ko kuma robar da ake sakawa a hannu domin bada tazarar iyali duk suna rikita al'adar mace. Idan mace tana amfani da waɗannan to zata iya fuskantar rikicewar al'ada, wannan yana ɗaya daga cikin manyan matsalolin amfani da abubuwan bada tazarar iyali masu ɗauke da sinadarin progesterone kawai. Sannan a lura cewa, koda mace ta daina amfani dasu to ba kai tsaye al'adan ta zai dawo dai-dai ba, yakan iya ɗaukar lokaci har tsawon watanni shida (6) bayan ta daina amfani dasu.
4. Pregnancy and lactation: Samun juna biyu da kuma shayarwa. Samun juna biyu yakan kawo yankewar al'ada baki daya har sai an sauka da aƙalla sati shida (6). Haka ma mace mai ɗanyen jego takan ɗauki lokaci kamin al'adan ta ya dawo.
5. Uterine polyps: Uterine polyps wani ƙurji ne dake fitowa a jikin bangon mahaifa na ciki. Wannan ƙurjin yakan kumbura yasa zubar jini ba bisa tsari ba.
6. Uterine fibroids: Wannan wani kumburi ne dake samo asali daga tsokokin mahaifa (tsokokin mahaifa su ne suka gina bangon mahaifa na tsakiya). Idan aka ƙyale kumburin yakan iya girma sosai ta yanda ana iya tsammanin ciki ne. Wannan kumburin yakan sa zubar jini sosai yayin al'ada da kuma lokacin da ba na al'ada ba. Haka kuma idan ya girma sosai yakan iya taushe mafitsara ya sa mace yawan fitsari.
7. Endometriosis: Wannan shi ne samun ƙwayoyin halittun bangon mahaifa na ciki a wani wuri na daban. Yayin jinin al'ada wannan bangon mahaifa na ciki shi ne ke rushewa ya zubar da jinin al'ada. Samun ƙwayoyin halittun wannan bangon a wani wuri yakan haifar da ƙarin fitar jini yayin al'ada, Haka kuma yakan haifar da mummunan ciwon ciki ko ciwon mara yayin da jinin yake fita.
8. Pelvic inflammatory disease: Cutar sanyin mara ita ma tana haifar da zubar jini ba bisa ƙa'ida ba. Bayanin wannan cutar ya gabata a cikin wannan rubutu "Bayani akan cutar sanyin mara da kuma yadda ake maganin ta"
9. Polycystic ovary syndrome: Wannan wata cuta ce dake sa sinadaran hormones na namiji suyi yawa a cikin jinin mace. Wannan cutar takan haifar da oligomenorrhea (munyi bayanin mene ne oligomenorrhea a sama). Bayan haka wannan cutar ta kan hana mace samun ciki kuma ta kan sa mace ta siffantu da wasu halaye na maza kamar irin su gashin gemu ko gashin baki, ko muryarta ta koma irin ta maza da dai sauran halayen maza.
10. Premature ovarian failure: Wannan cuta ce da ke sanya ovaries ɗin mace su daina aiki gaba ɗaya tun kamin takai shekara arba'in. Ovaries su ne ke da alhakin samar da sinadaran hormones na mata, waɗannan sinadaran kuma su ke sa mace tayi al'ada. Mace mai wannan cutar zata daina al'ada baki ɗaya tun kamin lokacin dainawar ta yayi (aƙalla shekara arba'in da biyar (45) zuwa sama).
11. Endometrial cancer: Wannan ita ce cutar sanƙarar bangon mahaifa na ciki. Tana sa zubar jini sosai
12. Cervical cancer: Wannan itace cutar sanƙarar bakin mahaifa, itama tana sa zubar da jini barkatai.
13. Use of steroids or anticoagulant: Shan wasu magungunan daga zuriyar steroids da kuma anticoagulant shima yana iya kawo zubar jini.
14. Some medical conditions: Wasu cututtuka masu sa zubar da jini daga jikin mutum ba bisa tsari ba kamar irin su Haemophilia A, B and C, Von willebrand disease da dai sauransu. Waɗannan cututtukan sukan iya sa mutum yawan zubar da jini daga hanci (haɓo) ba tare da wani dalili ba.

Yadda ake gane rikicewar al'ada a asibiti.

 Likita zai yi tambaya game da wa'adin da kike yin haila da kuma tarihin hailar ki baki ɗaya. Za'a duba marar lafiya akan gadon asibiti game da lafiyar ta baki ɗaya. Haka kuma za'a yi mata duban farji da mahaifa (Pelvic examination) da kuma wani lokacin gwajin sanƙarar mahaifa ( Pap smear test)[³].  Likitan kuma na iya yin odar wasu gwaje-gwaje, kamar haka:

1. FBC: Gwajin jini don kawar da anemia ko wasu cututtuka.

 2. Vaginal fluid M/C/S: Awon ruwan dake fita daga farji don neman cututtuka.

 3. Abdominopelvic Uss: Gwajin hoton kayan ciki da na'ura mai amfani da igiyoyin sauti don bincika uterine fibroids, uterine polyps, ko cyst na ovary.

 4. Endometrial biopsy: Gwaji ne wanda a cikinsa ake cire samfurin nama daga bangon mahaifa na ciki a auna don gano cutar endometriosis, rashin daidaituwa na sinadaran hormones, ko wasu ƙwayoyin cuta. 

Hakanan kuma za'a iya gano cutar endometriosis ko wasu yanayin cutar sanyin mara ta hanyar amfani da wani hoton bidiyo da ake kira laparoscopy inda likita zai yi ɗan ƙaramin huduwa a ciki sannan ya sanya wani siririn bututun ɗaukar hoto mai haske don ɗauko hoton bidiyon mahaifa da ovaries da sauran kayan ciki.

Yadda ake maganin rikicewar jinin al'ada

Hanyoyin magance rikicewar jinin al'ada sun danganta da abinda ya kawo matsalar.

1. Yawan zubar jinin al'adan da ya samo asali saboda sauyin yanayin da mace ke gudanar da rayuwarta ana maganin sa ne ta hanyar shan wasu ƙwayoyin magani dake rage zubar jinin al'ada. Waɗannan magungunan sun haɗa da Tranexamic acid da Mefenamic acid. Haka kuma ana amfani da wasu magungunan bada tazarar iyali waɗanda suke ɗauke da sinadarai biyu (Oestrogen da Progesterone) domin rage yawan jinin da ke zuba a lokacin[⁴].

A lura cewa, magungunan bada tazarar iyali waɗanda ke ɗauke da sinadarin progesterone shi kaɗai (Progesterone only pills) da kuma robar sawa a hannu su ke kawo rikicewar al'ada. Amma magungunan bada tazarar iyali waɗanda suke ɗauke da sinadaran oestrogen da progesterones (combined oral contraceptives pills) da kuma robar bada tazarar iyali wadda ake sanyawa a mahaifa (mirena) su ake amfani dasu wajen daidaita al'adar da ta rikice. 

Ɗaukewa ko makarar jinin al'ada da ke faruwa saboda yawan gajiya, yawan motsa jiki ko baƙin ciki, ko wata damuwa ana maganin sa ne ta hanyar rage yin ayyukan da ake yi ba tare da wani shan magani ba.

2. Zubar jinin da uterine polyps yake kawo wa ana maganin sa ne ta hanyar yin tiyata a cire wannan ƙurjin polyps da ya fito. Ana iya amfani na wuccin gadi da ƙwayoyin magani masu rage zubar jini kamar su Mefenamic acid da Tranexamic acid da kuma magungunan tazarar iyali domin rage zubar da jinin[⁴].

3. Maganin yawan zubar jinin da uterine fibroids ke kawo wa shima ya ƙunshi yin tiyatar da ake cema myomectomy domin cire fibroids ɗin ko kuma idan mace bata da buƙatar sake haihuwa baki ɗaya za'a iya cire mahaifar baki ɗaya (hysterectomy). Haka kuma idan fibroid ɗin ƙarami ne akwai ƙwayoyin magani da ake amfani dasu domin rage masa girma da miyagun alamomin da yake kawowa. Waɗannan magungunan sun haɗa da ƙwayoyin busereline, leuprolide, triptorelin da goserelin. Haka kuma ana iya amfani da allurar Depo provera da sauran magungunan bada tazarar iyali na dangin progestin only pills[⁴].

5. Ko da yake babu takamaiman magani ga cutar endometriosis, amma akan yi amfani da maganin rage raɗadin ciwo domin rage ciwon da wannan cutar ke kawo wa.  Magungunan da ke ɗauke da sinadaran hormones irin su maganin hana haihuwa na iya taimakawa wajen hana girman endometriosis daga cikin mahaifa da kuma rage yawan asarar jini a lokacin haila.  Idan har abin yayi tsanani sosai ana iya amfani da ƙwayoyin goserelin da leuprolide domin tsayar da jinin al'ada.  Haka kuma idan abin ya faskara ana iya yin tiyata domin cire waɗannan ƙwayoyin halittun bangon mahaifa da suka fito ba bagiren su ba

6. Pelvic inflammatory disease: Bayanin yadda ake maganin wannan cutar yazo dalla dallah a cikin wannan rubutu "Bayani game da ciwon sanyin mara".

7. Polycystic ovaries syndrome: Hanyoyin maganin wannan cutar sun haɗa da kwayoyin hana haihuwa don daidaita lokutan al'ada, maganin da ake kira metformin don hana ciwon sukari, magungunan statins don rage man kitsen da ke cikin jini, hormones don ƙara bada damar haihuwa da kuma yawan aske gashi akai-akai[³][⁴].

 

8. Premature ovarian failure: Maganin wannan cutar shi ne samar da sinadaran hormones irin waɗanda ovaries suke samarwa.

9. Magungunan sanƙarar bangon mahaifa da kuma bakin mahaifa suna da sarƙaƙiya sosai, don haka wannan rubutu yayi kaɗan ayi bayanin su.

Kammalawa

A cikin wannan rubutu munyi tsokaci game da rikicin jinin al'ada, abubuwan da ke kawo shi da kuma yadda ake maganin su.

Idan kuna da tambaya sai kuyi a cikin akwatin sharhi dake ƙasa, Insha Allah zamu karba ba tare da jinkiri ba. Haka kuma zaku iya shiga group dinmu na WhatsApp domin kasancewa damu damu a koda yaushe da kuma samun ingantattun bayanan mu a cikin sauki. Ku danna wannan domin shiga: Lafiyata Group 3. 

Nassoshi

1. Tazim Dowlut-McElroy, Karen B. Williams, Shannon L. Carpenter, Julie L. Strickland, Menstrual Patterns and Treatment of Heavy Menstrual Bleeding in Adolescents with Bleeding Disorders, Journal of Pediatric and Adolescent Gynecology, Volume 28, Issue 6, 2015, Pages 499-501, ISSN 1083-3188.

2. Sonya S. Dasharathy, Sunni L. Mumford, Anna Z. Pollack, Neil J. Perkins, Donald R. Mattison, Jean Wactawski-Wende, Enrique F. Schisterman, Menstrual Bleeding Patterns Among Regularly Menstruating Women, American Journal of Epidemiology, Volume 175, Issue 6, 15 March 2012, Pages 536–545, https://doi.org/10.1093/aje/kwr356

3. S.Cansun Demir, T.Oktay Kadayýfçý, M.Ali Vardar, Yilmaz Atay, Dysfunctional Uterine Bleeding and Other Menstrual Problems of Secondary School Students in Adana, Turkey, Journal of Pediatric and Adolescent Gynecology, Volume 13, Issue 4, 2000, Pages 171-175, ISSN 1083-3188.

4. Abnormal Uterine Bleeding: A Management Algorithm John W. Ely, Colleen M. Kennedy, Elizabeth C. Clark and Noelle C. Bowdler The Journal of the American Board of Family Medicine November 2006, 19 (6) 590-602; DOI: https://doi.org/10.3122/jabfm.19.6.590

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