{"id":28294,"date":"2017-05-23T08:39:52","date_gmt":"2017-05-23T06:39:52","guid":{"rendered":"http:\/\/www.invarena.cz\/?p=28294"},"modified":"2017-05-23T08:39:52","modified_gmt":"2017-05-23T06:39:52","slug":"jakou-lecbu-klimakterickych-potizi-hradi-pojistovna","status":"publish","type":"post","link":"https:\/\/www.invarena.cz\/?p=28294","title":{"rendered":"Jakou l\u00e9\u010dbu klimakterick\u00fdch pot\u00ed\u017e\u00ed hrad\u00ed poji\u0161\u0165ovna?"},"content":{"rendered":"

OT\u00c1ZKA : Jak\u00e9 jsou mo\u017enosti l\u00e9\u010dby klimakterick\u00fdch pot\u00ed\u017e\u00ed a co z toho hrad\u00ed poji\u0161\u0165ovna?<\/strong><\/p>\n

ODPOV\u011a\u010e:<\/p>\n

Klimakterium je p\u0159irozen\u00fd proces v \u017eivot\u011b \u017eeny, obdob\u00ed vyhas\u00edn\u00e1n\u00ed pohlavn\u00edho cyklu. Z\u00e1kladn\u00ed p\u0159\u00ed\u010dinou rozvoje n\u00ed\u017ee popisovan\u00fdch zm\u011bn je pokles hladiny \u017eensk\u00e9ho pohlavn\u00edho hormonu estrogenu, kter\u00fd je produkov\u00e1n vaje\u010dn\u00edky.<\/p>\n

Akutn\u00ed p\u0159\u00edznaky klimakteria se dostavuj\u00ed u v\u011bt\u0161iny \u017een a mohou v\u00fdznamn\u011b sn\u00ed\u017eit kvalitu \u017eivota. Jde p\u0159edev\u0161\u00edm o psychick\u00e9 pot\u00ed\u017ee (nespavost, podr\u00e1\u017ed\u011bnost, pla\u010dtivost, prudk\u00e9 zm\u011bny n\u00e1lad, ztr\u00e1ta libida atd.) a vazomotorick\u00e9 zm\u011bny (n\u00e1valy horka, pocen\u00ed, bu\u0161en\u00ed srdce). Tyto p\u0159\u00edznaky m\u016f\u017ee \u017eena do jist\u00e9 m\u00edry ovlivnit sama. P\u0159isp\u00edv\u00e1 k tomu zv\u00fd\u0161en\u00ed pohybov\u00e9 aktivity (cvi\u010den\u00ed \u010di rychl\u00e1 ch\u016fze alespo\u0148 3x t\u00fddn\u011b po 30 min.), co\u017e nav\u00edc pom\u00e1h\u00e1 k udr\u017eov\u00e1n\u00ed kostn\u00ed hmoty a optim\u00e1ln\u00ed t\u011blesn\u00e9 hmotnosti. D\u016fle\u017eit\u00e1 je tak\u00e9 \u00faprava j\u00eddeln\u00ed\u010dku \u2013 omezen\u00ed k\u00e1vy, ko\u0159en\u011bn\u00fdch j\u00eddel, alkoholu, dostate\u010dn\u00fd pitn\u00fd re\u017eim. Lu\u0161t\u011bniny, s\u00f3ja, rostlinn\u00e9 oleje, \u010derstv\u00e1 zelenina a ovoce zvy\u0161uj\u00ed p\u0159\u00edjem fytoestrogen\u016f v optim\u00e1ln\u00ed kombinaci s pot\u0159ebn\u00fdmi vitaminy a miner\u00e1ly. P\u0159\u00edpadn\u00e9 u\u017e\u00edv\u00e1n\u00ed voln\u011b prodejn\u00fdch l\u00e9\u010div a dopl\u0148k\u016f stravy s obsahem isoflavonoid\u016f a fytoestrogen\u016f je ale t\u0159eba v\u017edy konzultovat s l\u00e9ka\u0159em. Tyto dopl\u0148ky stravy nejsou hrazeny z ve\u0159ejn\u00e9ho zdravotn\u00edho poji\u0161t\u011bn\u00ed.<\/p>\n

V ur\u010dit\u00e9m \u010dasov\u00e9m odstupu se pak vyvinou chronick\u00e9 p\u0159\u00edznaky klimakteria. Mezi n\u011b \u0159ad\u00edme urogenit\u00e1ln\u00ed atrofie (porucha r\u016fstu sliznice pochvy a mo\u010dov\u00fdch cest), zv\u00fd\u0161en\u00e9 riziko vzniku osteopor\u00f3zy, ateroskler\u00f3zy, infarktu myokardu a centr\u00e1ln\u00ed mozkov\u00e9 p\u0159\u00edhody. Nedostatkem estrogen\u016f je ovlivn\u011bn i metabolismus lipid\u016f a karbohydr\u00e1t\u016f, tak\u017ee se nap\u0159\u00edklad zvy\u0161uje inzul\u00ednov\u00e1 rezistence, tedy riziko obezity a cukrovky. Rovn\u011b\u017e doch\u00e1z\u00ed ke zvy\u0161ov\u00e1n\u00ed hladiny cholesterolu.<\/p>\n

V\u011bt\u0161in\u011b t\u011bchto probl\u00e9m\u016f dok\u00e1\u017ee bu\u010f zcela p\u0159edej\u00edt, nebo je alespo\u0148 v\u00fdznamn\u011b zm\u00edrnit hormon\u00e1ln\u00ed substitu\u010dn\u00ed l\u00e9\u010dba.<\/p>\n

Hormon\u00e1ln\u00ed substitu\u010dn\u00ed terapie (HRT) je skupina prepar\u00e1t\u016f s pohlavn\u00edmi hormony ur\u010den\u00e1 k pod\u00e1v\u00e1n\u00ed p\u0159i nedostatku estrogen\u016f. Pokud obsahuje pouze estrogeny, je ozna\u010dov\u00e1na jako estrogenn\u00ed substitu\u010dn\u00ed terapie (ERT). N\u011bkter\u00e9 \u017eeny zat\u00edm st\u00e1le je\u0161t\u011b pova\u017euj\u00ed hormon\u00e1ln\u00ed substituci za cosi \u201enep\u0159irozen\u00e9ho“. Av\u0161ak obavy z mo\u017en\u00fdch komplikac\u00ed nejsou nam\u00edst\u011b, proto\u017ee jej\u00ed nasazen\u00ed v\u017edy p\u0159edch\u00e1z\u00ed pe\u010dliv\u00e9 vy\u0161et\u0159en\u00ed gynekologick\u00e9, ultrazvukov\u00e9, laboratorn\u00ed vy\u0161et\u0159en\u00ed krve a mamografick\u00e9 vy\u0161et\u0159en\u00ed. V pr\u016fb\u011bhu l\u00e9\u010dby se tato vy\u0161et\u0159en\u00ed pravideln\u011b opakuj\u00ed. Hormon\u00e1ln\u00ed substitu\u010dn\u00ed terapie je dnes ka\u017edodenn\u00ed z\u00e1le\u017eitost\u00ed t\u00e9m\u011b\u0159 v\u0161ech gynekologick\u00fdch ambulanc\u00ed a nab\u00eddka r\u016fzn\u00fdch prepar\u00e1t\u016f a l\u00e9kov\u00fdch forem se v posledn\u00ed dob\u011b zna\u010dn\u011b roz\u0161\u00ed\u0159ila. M\u016f\u017ee b\u00fdt pod\u00e1v\u00e1na v tablet\u00e1ch, formou n\u00e1plast\u00ed nebo injek\u010dn\u011b. V\u00e1\u0161 gynekolog m\u00e1 tedy k dispozici rozs\u00e1hl\u00fd sortiment p\u0159\u00edpravk\u016f k hormon\u00e1ln\u00ed substituci, kter\u00e9 poji\u0161\u0165ovna v indikovan\u00fdch p\u0159\u00edpadech \u010d\u00e1ste\u010dn\u011b \u010di dokonce pln\u011b hrad\u00ed.<\/p>\n

Lok\u00e1ln\u00ed estrogenn\u00ed l\u00e9\u010dba m\u016f\u017ee b\u00fdt vhodnou formou l\u00e9\u010dby i pro \u017eeny, kter\u00e9 nemohou u\u017e\u00edvat syst\u00e9movou hormon\u00e1ln\u00ed terapii. M\u016f\u017ee pozitivn\u011b ovlivnit atrofii po\u0161evn\u00ed sliznice, odstranit opakovan\u00e9 v\u00fdtoky, nep\u0159\u00edjemn\u00e9 pocity, bolest p\u0159i pohlavn\u00edm styku a pomoci l\u00e9\u010dit pot\u00ed\u017ee spojen\u00e9 s \u00fanikem mo\u010di. Tuto l\u00e9\u010dba m\u016f\u017ee b\u00fdt zah\u00e1jena i s v\u011bt\u0161\u00edm odstupem od p\u0159echodu a v l\u00e9\u010db\u011b lze pokra\u010dovat dlouhodob\u011b. I tyto lok\u00e1ln\u00ed p\u0159\u00edpravky jsou v indikovan\u00fdch p\u0159\u00edpadech \u010d\u00e1ste\u010dn\u011b hrazeny poji\u0161\u0165ovnou.<\/p>\n

P\u0159ipom\u00edn\u00e1me, \u017ee pr\u00e1v\u011b v obdob\u00ed klimakteria za\u010d\u00ednaj\u00ed b\u00fdt velmi d\u016fle\u017eit\u00e9 n\u011bkter\u00e9 preventivn\u00ed prohl\u00eddky a screeningov\u00e1 vy\u0161et\u0159en\u00ed. \u017deny by rozhodn\u011b nem\u011bly zapom\u00ednat na preventivn\u00ed mamografick\u00e1 vy\u0161et\u0159en\u00ed jednou za dva roky a na screening karcinomu d\u011blo\u017en\u00edho hrdla v r\u00e1mci ka\u017edoro\u010dn\u00ed preventivn\u00ed gynekologick\u00e9 prohl\u00eddky.<\/p>\n

Mgr. Old\u0159ich Tich\u00fd vedouc\u00ed tiskov\u00e9ho odd\u011blen\u00ed a tiskov\u00fd mluv\u010d\u00ed <\/p>\n","protected":false},"excerpt":{"rendered":"

OT\u00c1ZKA : Jak\u00e9 jsou mo\u017enosti l\u00e9\u010dby klimakterick\u00fdch pot\u00ed\u017e\u00ed a co z toho hrad\u00ed poji\u0161\u0165ovna?<\/p>\n<\/div>","protected":false},"author":1,"featured_media":19377,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[18,11],"tags":[],"class_list":["post-28294","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-poradna","category-zdravi"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/28294","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=28294"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/28294\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/19377"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=28294"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=28294"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=28294"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}