 Tal-menopawsa
 Zmien tal-menopawsa
Xorta ta’ ]ajja
Ostjoporo\i
Mard tal-qalb
Onkolo[ija
Il-[ilda u l-Organi tal-}ass
Sess u sesswalità
Sintomi psikolo[i`i
Studji li g]adhom g]addejjin
Laqg]at
Asso`jazzjonijiet/G]aqdiet
Kuntatti
Ikkuntatjana
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Il-gilda isservi numru ta' funzjonijiet vitali biex l-organi\mu jadatti ruhu g]all-ambjent.
Sa `ertu punt `ertu theddid ambjentali b]al ]sara fisika, tibdil osmotiku u a`idus, u tibdil
e``essiv ta' temperatura jistg]u ji[u jitnaqqsa biex ixejnu ]sara lejn il-[ilda tal-[isem uman.
L-epidermis jipprovdi ]ajt kontra infezzjoni u d-dermis bir-rita mferrxa tg]ejn biex tikkontrolla
t-temperatura tal-[isem.
Il-menopawsa tidher li g]anda effett importanti fuq il-komponenti ba\i`i
tal -anatomija tal-[ilda. Il-tessut konnettiv, li ]afna minnhu huwa Collagen tip I huwa effettwat
b'mod signfikanti mill-istat estrogeniku tal-mara. Il-collagen tip I bill-ebusija u elasti`ita'
moderata tieghu jaghti `ertu stabilita' lill-[ilda u b'hekk i\omm l-anatomija tag]ha u f'istess
]in i]alli l-[ilda tkompli bil-funzjonijiet tag]ha. Il-“glycoaminoglycans” huma komponent ie]or
tas-tessut konnetiv u bil-karateristi`i idroscopi`I tieg]u ji[bed lejh ilma li jag]ti `ertu
ebbsusija u sa]]a lill-[ilda.
Kemm is-safef epidermi`i u dermi`i tal-[ilda []andhom komponenti `ellulari
u tat-tessut konnetiv li jidhru effettwatti b'mod signifikattiv mill-menopawsa. Il-]xuna
tal-epidermis tidher li tonqos wara l-menopawsa, u l-ikbar tnaqqies fil-]xuna tal-[ilda isse]]
wara l-ewwel sena tal-menopawsa. Dan it-telf fil-]xuna tal-epidermis tidher li ti[I irkupprata
malajr bit-trattament tal-ormoni sesswali. Il-]xuna tas-saf tad-dermis ukoll tonqos wara
l-menopawsa. B]all- epidermis, is-saf tad-dermis jidher li je]xin wara li jitie]du l-ormoni
sesswali.
Minbarra it-tessut konnetiv, hemm ukoll il-komponent `ellulari tal-[ilda
li l-aktar importanti huma il-fibroblasts. Il-fibroblasts []andhom re`ettur estro[eniku fir-rita
`ellulari li jirrespodu g]al l-istimolu tal-ormoni li jirri\ulta fil-produzzjoni ta’ diversi
proteini partikolarment dawk ta’ collagen tip I. l-effett favorevoli tal-estro[eni fuq l-epidermis
u d-dermis qieg]ed ji[i nvestigat sabiex dan ji[i wtili\at fit-trattament ta’ t-tikmiex tal-wi``
u biex i]affef il-fejqan ta' feriti fil-[ilda. L-effett fuq it-tkmiex jidher li hu favorevoli
kemm meta t-trattament tal-ormoni ji[u amministrati bhala pilloli kif ukoll meta l-ormoni ji[u
applikati topikment fuq il-[isem. Studji fuq l-annimali juru ri\ultati kontradittorji fuq l-effett
tal-estro[eni fuq il-fejqan tal-[ilda. Dan jista' jkun min]abba l-metidolo[ija li ntu\at. Pero;
hemm evidenza qawwija li tindika effett posittiv tal-ormoni fuq il-fejqan tal-[ilda.
Studju ta' Ashcroft et al, f’nisa wara il-menopawsa wera effett favorevoli tal-estro[enu fuq
il-fejqan tal-[ilda. Nisa fil-menopawsa li ma' gewx ittrattati bil-ormoni kellhom inqas produzzjoni
ta' collagen 7 u 84 [urnata wara li saret il-ferita. Imma n-nisa fil-menopawsa li ]adu l-ormoni
kellhom I\jed produzzjoni ta' collagen.
Dg]jufija tal-[ilda hi mag]rufa li sse]] wara trattament bil kortikosterojds. Il-]xuna tal-[ilda
ta' nisa wara l-menopawsa li qeghdin fuq kortikosterojds kellhom \iedet wara trattament bil-ormoni
sesswali. Jidher li t-tben[il u riti ta' vini wara t-trattament bil-kortikosterojds jistg]u
jirrespondu favoralment g]al kura bl-ormoni sesswali.
Il-patolo[ija li tikkaw\a it-tikmiex fill-wi`` mhix maghrufa. Pero' trattament bl-ormoni jnaqqas
in-numru tat-tikmiex kif ukoll kemm ikunu fondi. Feriti min]abba “atrophic acne” jidher li
jirrespondi g]al trattement bl-ormoni sesswali. “Estriol iontophoresis” jindika fejqan ta' feriti
tal-akne. Dan jidher kemm fotografikament kif ukoll klinikament.
Ir-ri`erka fil-[ejjieni tidher li qeda f’l-u\u tal-estro[enu fit-trattament ta' feriti kron`i
tal-[ilda. Hemm l-possibilita' ta’ trattament ta' ul`eri “decubitus” tal-vini u ul`eri djabetici
bil estro[en sabiex il-pro`ess ta' fejqan jit]affef
L-Ghajn
Numru ta' problemi tal-vista [ew assocjati man-nuqqas tal- estro[enu fi\- \mien tal-menopawsa.
Fil-fatt ir-re`ettur estro[eniku jinsab fil-komponent ma[[uri tal-g]ajn. Problemi tal-vista' li
jidhru effettwati min-nuqqas tal estro[enu matul il-menopawsa huma de[enerazzjoni tal-makula
marbuta mal-eta’, glaukoma, kataretti u “dry-eye syndrome”.
De[enerazzjoni tal-makula marbuta mal-eta’
De[enerazzjoni tal-makula marbuta mal-eta’ hija l-iktar kawsa kommuni tat telf tal-vista fil
pajji\i tal-punent.Ir-re``etur estrogeniku alpha (65Da) instab fir-retina ta' nisa zg]ar pero' ma instabx f'dak tal-irgiel u fin-nisa li g]addew mill-menopawsa. De[enerazzjoni tal-makula marbuta mal-eta’ hija iktar kommuni fin nisa li g]addew mill-menopawsa. Nisa li kellhom menopawsa kmieni jew inkella kellhom nuqqas ta' snin bi`-`iklu menstuwali (bejn il menarkija u l-menopawsa) g]andhom riskju g]al de[enerazzjoni tal-makula tar-retina. Toqob fil- makula u “precipitates” fir-retina, huma iktar komuni f' nisa fil-menopawsa li ma ]adux ormoni u l kuntrarju [ara fin-nisa li g]addew mil-menopawsa imma li gew ittrattati bil-ormoni. Id-de[enerazzjoni tal-mkula hi mahsuba li ti[i kkawsata minn patolo[ija vaskulari. Fil-fatt mard vaskolari b]all-pressjoni g]olja, t-tipjip u ]afna xa]am fid-demm huma asso``jati ma' de[enerazzjoni tal-makula marbuta mal-eta’. Studji bid-doppler jindikaw nuqqas ta' “end-diastolic flow” u \ieda fil- “Pourcelot resistance index” fi`-`irkulazjoni ta’wara l-g]ajn fin-nisa wara il-menopawsa. Nisa li wara il-menopawsa instabu li g]andhom inqas resistensa vaskulari fir-re[un tal-arterja pri`ipali tal-g]ajn
Il-Kataretta
Il-kataretta hija l-iktar kaw\a ta' telf tad-dawl f'Ewropa and fil-Istati Uniti. Fin-nisa li kellhom nuqqas ta' estrogen b]al menarkija fit-tard jew f'nisa li kellhom nuqqas ta' snin reproduttivi, r-riskju g]al kataretta hija ikbar. Nisa li ]adu trattament bil-hormoni jidhru li g]andhom ftit prottezzjoni mill-kataretta. Fin-nisa li hadu l-ormoni instab nuqqas ta' 49% fi`-`par fil-lenti tal-g]ajn. Il- letteratura fuq l’is-studji tal-g]ajnejn juru riduzjoni fi`-`par tal-lenti kemm fuq barra kif ukoll fuq gewwa fin-nisa wara il-menopawsa u gew ikkurati bil-ormoni sesswali. L- “epithelium” tal-lenti tal-g]ajn g]anha re`etturi estro[eni`i li meta ji[i stimulati jista' jinfluenzaw kemm il-funzjoni kif ukoll l-anatomija tal -komponenti tal-lenti.
Glaukoma
Il-pressjoni fil-g]ajn tidher li tivarja mal-istat estro[enku tal-mara. Fil-fatt rapport fuq ka\i wera “open angle glaucoma” wara li l-mara soffriet minn sintomi tipi`i tal-menopawsa. Il-glaukoma tirrispondi g]al trattament topiku kombinat mal-HRT. Ormoni moghtija lil nisa fil-menopawsa ming]ajr mard tal-g]ajnen naqqsu il-pressjoni sinjifikament. Studji bid-“Doppler” urew bdil vaskulari li jista' jkun responsabli g]al bidu ta' glaukoma. HRT jidher li jeffettwa s-sistema vaskolari wara g]ajn b'mod posittiv.
Sindromu ta’ g]ajn xotta (Dry eye syndrome)
Kemm il-glandola tad-dmug] u il-conjunctiva g]andhom re``etturi li jirrispondu g]al ormoni sesswali. Studji f'annimali jindikaw kon`entrazzjoni ta' re`etturi tal-esteo[enu fil-glandola tad-dmug]. Tibdil morfolo[iku mhux mixtieq fil-konjunktiva instabu skond it-tul tal-menopawsa. Kondizzjoni tal-g]ajn msejha “Keratoconjunctivities sicca” ta' wara l-menopawsa giet asso`jata mal-menopawsa u tirri\ulta f’tibdil morfolo[iku ]a\in fil -kornea. Dan it-tibdil morfolo[iku jidhru li jirrispondi g]alkura bl-HRT. Irridu insemmu li xi studji wrew effett ]a\in fuq id-dmug] f'nisa li ]adu l-HRT.
Il-Widna
Il-Bilan`
Studji jindikaw li l-bilan` huwa effettwat ]a\in fin-nisa li wara il-menopawsa. Il-bilan` huwa importanti sabiex ji[u eviti waqat u possibilment ksur. Dawn l-effetti fuq il-bilan` jidher l-ag]ar fin-nisa b'sintomi tal-menopawsa. In-nisa wara il-menopawsa li ma jkollhomx sintomi ma' jdhrux li jsoffru minn problemi tal-bilan`. Letteratura re`enti tindika li fil ka\ ta' nisa b' sintomi wara il-menopawsa il-problemi ta' bilan` ma jirrispondux g]al HRT.
Is-Smig]
Ir-re`etturi tal-estro[enu alpha u beta nstabu li g]andhom distribuzzjoni unika fil-“auditory pathways” u oqsma li jirregulaw l-ilma u l-eletroliti`i. Tradizjonalment il-pillola kontra`etiva u t-tqala [ew asso`jati mat-telf tas-smig] u nisa b'otosklero\i jidhru li jmorru g]all-ag]ar matul it-tqala. Studji fuq l-annimali b]al “Turner's mouse model” jindikaw nuqqas tas-smig] asso`jat man-nuqqas tal-estro[enu min]abba “ovarian dysgenesis”. Nisa bit-“Turner's syndrome” g]andhom nuqqas ta' smig]. Kura b'HRT moghti lin-nisa b' “Turner's syndrome” wera li f’ 40% tal-ka\i ma kienx hemm telf tas-smig]. fil-letteratura [ie kwotat ka\ wie]ed ta’ telf ta' smig] u “tinnitus” wara l-amministrajoni ta' HRT. Effetti vaskolari mill-ormoni sesswali jinfluen\aw positivament i`-`irkolazzjoni tad-demm fil-koklea u g]alhekk jeffettwaw is-smig].
Il-}alq
It-toma
Wara il-menopawsa jkun hemm tibdid fil-funzjoni tat-“taste buds” u r-rita ta' nervituri tal-]alq. Dan l-effett fuq it-toma u r-rita tan-nervituri j[ib bidla fis-sens tat-toma. Studji fuq l-annimali juru li grieden b'g]anqud tal-bajd mne]]i []andhom it-toma differenti minn [rieden ittratati b'estro[eni. Il-bidla fit-toma marret g]al ag]ar wara l-menopawsa minn]abba nuqqas fil-produzzjoni tal-b\ieq, “dysesthesia” u [in[ivite atrofika. Barra minnhekk is-sens tat-toma huwa kumplikat iktar minn]abba l- ostejoporo\i tax-xedaq , t]assir fis-snin u peridontite.
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The Eye
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Cataract formation
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Glaucoma
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The Ear
Postural balance
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Hearing
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Mouth
Taste
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