Perimenopause

Perimenopause ka matlab hai menopause ke aas paas. Yeh tab shuru hota hai jab mahwari ka pattern badalne lagta hai, un barson mein chalta hai jab hormone betarteebi se oopar neeche hote hain, aur aakhri mahwari ke aik saal baad khatam hota hai.

Menopause khud aik din hai: aap ki aakhri mahwari. Woh kaun sa din tha, yeh peeche mur kar hi pata chalta hai, jab poora aik saal koi aur mahwari na aaye.

Research karne wale taqreeban isi daur ko menopausal transition kehte hain, yani tabdeeli ka daur. European Society of Endocrinology aur International Menopause Society batati hain ke perimenopause mein aakhri mahwari ke baad ka pehla saal bhi shamil hai. STRAW+10 ke paimane, jinhein Pakistan Menopause Society istemaal karti hai, is ki shuruaat mahwari ki aik tabdeeli se maante hain: aik mahwari aur agli ke darmiyan saat din ya zyada ka farq, jo musalsal rahe. International Menopause Society ki 2026 ki sifarishaat mazeed kehti hain ke alamaat aksar us se pehle shuru ho jati hain jitna STRAW+10 batata hai, aur hot flush ke saath mahwari ke bhaari ya halki hone mein tabdeeli is daur ki shuruaat ki nishani ho sakti hai, is se pehle ke mahwari ka waqfa saat din badle.

Urdu ke jo chand pamphlet perimenopause ka zikr karte hain, woh ya to English lafz le lete hain, پیری مینوپاز, ya ise bayan kar dete hain. Roshara donon karta hai: lafz bhi, aur aik pamphlet ka bayan bhi, mahwari band hone ke aas paas ka waqt.

Pakistan Menopause Society ki August 2026 ki conference mein pesh kiye gaye 40 saal aur us se bari 454 auraton ke aik survey mein 80.8 feesad ne perimenopause ka naam suna hua tha. Survey ne teen aam ghalat fehmiyan jaanchin, aur sirf 6.2 feesad ne teenon ko radd kiya.

Yeh kab shuru hota hai

Women's Health Concern, jo British Menopause Society ka aam auraton ke liye hissa hai, kehta hai ke perimenopause 30 ki dahai ke aakhir ya 40 ki dahai ke shuru mein shuru ho sakta hai. NHS ki website kehti hai ke menopause aam taur par 45 aur 55 ke darmiyan aata hai, lekin Pakistan Menopause Society Pakistan mein is ki ausat umar 45 aur 49 ke darmiyan batati hai, jo safaid faam auraton se kam hai. Menopause ki umar batata hai ke yeh number kahan se aaye.

Hamari raaye: agar aap ki aakhri mahwari 40 ki dahai ke wast ya aakhir mein aane ka imkaan hai, to tabdeeli ke saal 40 ki dahai ke shuru mein hi shuru ho sakte hain. Nishaniyan 40 par pehchanein, 50 par nahin.

Pakistan Menopause Society shuru ke perimenopause ki alamaat ginwati hai, aur kehti hai ke yeh aakhri mahwari se pehle shuru ho sakti hain:

• Mahwari: beqaida mahwari, pehle se bhaari mahwari ya lambe waqfe se aana, kuch mahine aayi hi nahin.
• Garmi: hot flush (achanak garmi lagna), raat ke paseene aur dil ki dharkan tez hona.
• Zehan aur mood: neend ki kami, thakawat, chirchirapan, bechaini, udaasi aur dimaghi dhund.
• Jism: sar dard, joron aur patthon mein dard, chhaati mein dard aur pait phoolna.

Asal zindagi mein yeh woh dupatta hai jo aap baar baar utaarti hain, ya bachchon par jhunjhla jana aur samajh na aana ke kyun. Har aik ko akele taalna aasaan hai. Mil kar yeh aik pattern hain, aur pattern hi woh cheez hai jise doctor pehchan sakta hai.

Women's Health Concern samjhata hai ke bachche paida karne ki umar mein aap ki ande dani estrogen banati hai. Umar ke saath andon ka zakheera kam hota jata hai aur estrogen girta hai, magar raaton raat nahin: is mein saal lagte hain, isi liye alamaat aati jati rehti hain. Us ke mutabiq yehi oopar neeche wala daur aksar woh waqt hota hai jab alamaat sab se zyada mehsoos hoti hain. Aik achha mahina, phir aik bohat bura: yeh aap ka weham nahin.

Doctor ise kaise pehchanta hai

Agar aap ki umar 45 ya us se zyada hai aur sehat waise theek hai, to NICE NG23 kehta hai ke perimenopause aap ki alamaat aur mahwari ki tabdeeli se pehchana jata hai, khoon ke test ki zaroorat nahin (1.3.1). Pakistan Menopause Society bhi yehi kehti hai (Table 3). 40 aur 45 ke darmiyan, NICE kehta hai ke doctor FSH (woh hormone jo ande dani ko kaam par lagata hai) ke khoon ke test par ghaur kar sakta hai (1.3.6). 40 se kam umar mein aisi tabdeeliyon ko mumkina ande dani ka waqt se pehle kaam chhor dena (POI) samajh kar dekha jata hai, yani ande dani ka waqt se pehle kaam chhor dena. Menopause ka pata kaise chalta hai har soorat alag alag batata hai.

Family planning

Hamal ab bhi ho sakta hai. Family planning kab tak jaari rakhein, is par zaraye mukhtalif baatein kehte hain, is liye apne doctor se poochein ke aap par kaun si baat laagu hoti hai. World Health Organization kehta hai ke lagataar 12 mahine mahwari ke baghair guzarne tak family planning jaari rakhein. Women's Health Concern kehta hai ke agar aap 50 se kam hain to do saal mahwari na aane tak jaari rakhein, aur 50 se zyada hain to aik saal. NHS ki website 40 se 49 saal ki umar mein aakhri mahwari ke baad do saal, aur 50 ya us se zyada par aik saal batati hai. Woh yeh bhi kehti hai ke hormone wali family planning mahwari ko chhupa sakti hai, jis se yeh jaanna mushkil ho jata hai ke aap kis marhale par hain, aur yeh ke HRT family planning ka tareeqa nahin hai.

Roshara par shuru karne ki do jagahein

• Main kahan hoon? aap ki umar, mahwari aur jo kuch aap ne mehsoos kiya, us par chhe sawal poochta hai, aur STRAW+10 ka woh mor batata hai jis ki taraf aap ke jawab ishara karte hain. Yeh andaza hai, tashkhees nahin.
• Alamaat ka score 27 alamaat ko number deta hai, taake appointment par aap "main theek hoon" ki bajaye aik record le kar jayen.

Hidayat alamaat ka ilaaj batati hain. NICE NG23 aur Pakistan Menopause Society donon hot flush aur raat ke paseenon ke liye HRT (hormone ki dawa) ko pehle darje ka ilaaj kehte hain, un auraton ke liye jo ise le sakein (NICE 1.5.1; PMS 7.1.1). Yeh aap ke liye theek hai ya nahin, yeh aap ka doctor aap ki medical history dekh kar tay kare ga. Har alamat ka safha apne ilaaj khud batata hai.

Jab tak mahwari aa rahi hai, International Menopause Society ki 2026 ki sifarishaat kehti hain ke HRT aam taur par baari baari wale (sequential) tareeqe se di jati hai, jis mein har mahine khoon aata hai, aur yeh ke perimenopause mein aap ki apni ande dani ki wajah se is dauran bhi beqaida khoon aa sakta hai. Woh yeh bhi kehti hain ke hormone wali coil aik saath family planning bhi karti hai aur HRT ka progestogen wala hissa bhi banti hai, aur yeh ke 50 se kam umar ki sehatmand auratein, jin ke liye yeh theek ho, hot flush ke liye HRT ki jagah mushtarka goli (combined pill) le sakti hain. Dekhein HRT aur progesterone ki qismein.

American College of Physicians ki hot flush ki dawaon par 2026 ki hidayat kehti hain ke un ke zyada tar saboot un auraton se aaye jin ka menopause ho chuka tha, aur perimenopause wali auraton ke baare mein saboot kam the.

Agar yeh tabdeeliyan aap ki neend, kaam ya ghar walon ke saath zindagi mein aare aa rahi hain, to appointment lene ke liye yehi kaafi wajah hai.

Kuch cheezon ko intezar nahin karna chahiye. Pakistan Menopause Society jinsi taalluq ke baad khoon aane, do mahwariyon ke darmiyan bila wajah khoon aane, aur achanak bohat bhaari ya lambi mahwari ko khatre ki nishaniyan kehti hai, aur doctoron se kehti hai ke inhein menopause ke khaate mein daalne ki bajaye in ki jaanch karein. Is fehrist mein 40 se pehle ki woh alamaat bhi hain jo premature ovarian insufficiency ki taraf ishara kar sakti hain, aur shadeed depression ya khudkushi ke khayalat bhi. Agar aap ka mood itna gir gaya hai to fauran doctor ko dikhayen.

Jab mahwari ka koi bharosa na rahe, to namaz aur roze ki woh tarteeb bhi badal jati hai jo is ke saath chalti hai. Auratein poochti hain ke mahwari aur dhabbon mein farq kaise karein, aur namaz ya roze ke liye is ka kya matlab hai. Yeh sawal kisi mustanad aalim se poochne ke hain. Yeh khoon tibbi taur par kya hai, yeh sawal aap ke doctor ka hai.

Ghar mein aksar sab se mushkil baat yeh hoti hai ke kehne ko koi lafz hi nahin. Mahwari band hone ke aas paas ka waqt, yeh perimenopause se zyada seedhi baat hai, aur is se aap ke aas paas ke logon ko samajhne ke liye kuch mil jata hai.