Minyaka yonke, ukwelashwa kwesifo sikashukela kuya ngokuya kusebenza. Lokhu kukuvumela ukuthi uvikele ngokuphelele izinkinga ze-vascular noma ukubambezele isikhathi ukubukeka kwabo. Ngakho-ke, kwabesifazane abanesifo sikashukela, ubude besikhathi sokuzala buyakhula.
Isifo sikashukela singenza kube nzima ukukhetha indlela efanele yokuvimbela inzalo.
Ngasikhathi sinye, bonke abesifazane abanesifo sikashukela badinga ukuhlelwa kokukhulelwa ngokucophelela. Ungaqala ukukhulelwa kuphela lapho amazinga kashukela wakho wegazi esondele kakhulu kokujwayelekile, okungukuthi, isinxephezelo sikashukela esihle kakhulu.
Ukukhulelwa okungakahlelelwa onesifo sikashukela kusongela ngezinkinga ezinkulu kwabesifazane nakwenzalo yakhe ezayo. Lokhu kusho ukuthi udaba lokuvimbela inzalo kwisifo sikashukela lubaluleke kakhulu. Unakwa kakhulu ngabodokotela kanye neziguli zabo ezinesifo sikashukela.
Ukukhetha indlela efanelekayo yokuvimbela inzalo kuwumsebenzi onzima. Le ndaba inqunywa ngokuqondile ngowesifazane ngamunye. Uma enesifo sikashukela, kuvela ama-nuances angeziwe. Ku-athikili yanamuhla, uzofunda konke okudingeka ukwenze, wena nodokotela wakho, ukunquma indlela yokuvimbela isifo sikashukela.
Okulandelayo kuchaza izindlela zanamuhla eziphumelelayo zokuvimbela inzalo. Zilungele abesifazane abanesifo sikashukela, ngokuya ngezinkomba zabo ngazinye. Ngeke sidingide indlela yesigqi, ukuphazamiseka kokuya ocansini, ukukhohlisa nezinye izindlela ezingathembekile.
Ukwemukelwa kwezindlela zokuvimbela inzalo kwabesifazane abanesifo sikashukela
| Isimo | COC | Imijovo | Isikhethi sendandatho | Bye | Izimila | I-Cu-IUD | I-LNG-Navy |
|---|---|---|---|---|---|---|---|
| Kwakukhona isifo sikashukela sokuthambisa umzimba | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
| Azikho izinkinga zemithambo yegazi | 2 | 2 | 2 | 2 | 2 | 1 | 2 |
| Kunezinkinga zesifo sikashukela: i-nephropathy, i-retinopathy, i-neuropathy | 3/4 | 3/4 | 3/4 | 2 | 2 | 1 | 2 |
| Izinkinga ezinkulu ze-vascular noma isikhathi sikashukela iminyaka engaphezu kwengu-20 | 3/4 | 3/4 | 3/4 | 2 | 2 | 1 | 2 |
Kusho ukuthini amanani:
- 1 - ukusetshenziswa kwendlela kuvunyelwe;
- I-2 - ezimweni eziningi akukho okuphikisana nokusetshenziswa kwendlela;
- I-3 - ukusetshenziswa kwendlela ngokuvamile akunconywa, ngaphandle kokuthi ezimeni lapho inzalo efanelekile noma ukusetshenziswa kwayo kungamukeleki;
- 4 - ukusetshenziswa kwendlela kuqinisekiswe ngokuphelele.
Igama:
- Ama-COC - amaphilisi okuvikela inzalo ahlanganisiwe aqukethe ama-hormone asuka ezingxenyeni ezingaphansi zama-estrogens nama-progestin;
- I-PoC - amaphilisi okuvimbela inzalo aqukethe i-progestogen kuphela;
- I-Cu-IUD - insiza ye-intrauterine equkethe ithusi;
- I-LNG-IUD iyithuluzi le-intrauterine eliqukethe i-levonorgestrel (Mirena).
Ukukhetha indlela ethile yokuvimbela isifo sikashukela
| Isimo sempilo sowesifazane onesifo sikashukela | Indlela yokuvimbela inzalo | |
|---|---|---|
| Amaphilisi | Mechanical, wendawo, ukuhlinzwa | |
| Thayipha iziguli zikashukela ezi-1 ezinokulawula kahle ushukela wegazi, ngaphandle kwezinkinga ezibangelwa ukumelana nemithambo yegazi |
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| Thayipha iziguli ezinesifo sikashukela ezi-2 ezifeze izinhloso zazo ngazinye ngokuya ngoshukela wegazi, i.e., zilawula kahle lesi sifo |
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| Thayipha iziguli ezinesifo sikashukela esingu-2 ezine-triglycerides ephakeme kanye nomsebenzi wesibindi okhubazekile | Akukhonjisiwe |
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| Thayipha iziguli zikashukela ezi-1 ezingalawulwa kahle ushukela wegazi kanye / noma abanenkinga enkulu yemisipha | Akukhonjisiwe |
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| Thayipha iziguli zikashukela ezi-1 ezigula kakhulu futhi / noma osuvele unezingane ezi-2 noma ngaphezulu | Akukhonjisiwe |
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Umthombo wolwazi: imihlahlandlela yemitholampilo "Ama-algorithms wokunakekelwa kwezokwelapha okukhethekile kweziguli ezinesifo sikashukela", ihlelwe yi-II. I-Dedova, M.V. Shestakova, 6th edition, 2013.
Uma owesifazane onesifo sikashukela enokuphambana okuphelele kwezokwelapha kokukhulelwa, bese ucabanga ukwenziwa inzalo yokuhlinzwa ngokuzithandela. Into efanayo uma usuvele "uxazulule imisebenzi yakho yokuzala."
Kuhlanganiswe izindlela zokuvimbela inzalo zomlomo
Ama-contraceplication womlomo ahlanganisiwe (i-COCs) ngamaphilisi okulawula ukuzala aqukethe izinhlobo ezimbili zama-hormone: ama-estrogens nama-progestin. I-estrogen njengengxenye yamaphilisi okuvimbela inzalo igcwalisa ukusweleka kwe-estradiol, okuvela ngokwemvelo okucindezelwe emzimbeni. Ngakho-ke, kulawulwa umjikelezo wokuya esikhathini. Futhi i-progestin (progestogen) inikela ngomthelela wokuvimbela inzalo kwama-COCs.
Ngaphambi kokuthatha izindlela zokuvimbela inzalo ze-hormonal, thintana nodokotela wakho bese ubheka ukuhlolwa kwe-heestasiological. Lezi zivivinyo zegazi zomsebenzi we-platelet, i-AT III, i-factor VII nezinye. Uma izivivinyo ziba zimbi - le ndlela yokuvimbela inzalo ayikulungele, ngoba kunengozi ekhuphukayo ye-venous thrombosis.
Njengamanje, izindlela zokuvimbela inzalo zomlomo ezihlangene zithandwa kakhulu emhlabeni wonke, naphakathi kwalabo besifazane abanesifo sikashukela. Izizathu zalokhu:
- Ama-COC avikela ngokuthembekile ekukhulelweni okungafuneki;
- ngokuvamile babekezelelwa kahle ngabesifazane;
- ngemuva kokumisa iphilisi, iningi labesifazane likhulelwa kungakapheli izinyanga eziyi-1 ukuya ku-12;
- ukuphuza amaphilisi kulula kunokufaka i-spiral, ukwenza imijovo, njll.
- le ndlela yokuvimbela inzalo inemiphumela eyengeziwe yokwelapha kanye ne-prophylactic.
Contraindication ukusetshenziswa kwezindlela zomlomo ezihlanganisiwe zabesifazane abanesifo sikashukela:
- isifo sikashukela asinxephezelwe, i.e., ushukela wegazi uhlala uphakeme impela;
- umfutho wegazi ngaphezulu kwe-160/100 mm RT. st.;
- uhlelo lwe-heestatic luyaphulwa (ukopha okushubile noma ukukhuphuka kwegazi okwandayo);
- izinkinga ezinzima zesifo sikashukela sezivele sezithuthukisiwe - i-proliferative retinopathy (2 iziqu), i-nephropathy yesifo sikashukela esiteji se-microalbuminuria;
- isiguli sinamakhono anganele okuzibamba.
Ukuxhumana kokuthathwa kokudliwayo kwe-estrogen njengengxenye yokuvimbela inzalo yomlomo okuhlangene:
- ingozi eyengeziwe yokuqhekeka kwegazi nokuqhekeka kwemithambo yegazi (thatha izivivinyo uphinde uhlole!);
- kwatholakala ingozi ye-cerebrovascular, i-migraine;
- izifo zesibindi (i-hepatitis, iRotor, i-Dabin-Johnson, ama-Gilnd syndromes, i-cirrhosis, ezinye izifo ezihambisana nokuhluleka kwesibindi);
- ukopha okuvela esithweni sangasese, izimbangela zazo ezingacacisiwe;
- ama-tumors ancike kuma-hormone.
Izici ezikhulisa ubungozi bemiphumela emibi ye-estrogen:
- ukubhema
- isilinganiso se-arterial hypertension;
- iminyaka engaphezu kwengu-35;
- ukukhuluphala okungaphezulu kwama-2 degrees;
- ifa elibi ezifweni zenhliziyo, isb., kuye kwaba nezimo zesifo senhliziyo noma isifo sohlangothi emndenini, ikakhulukazi ngaphambi kweminyaka engama-50;
- i-lactation (ukuncelisa ibele).
Kwabesifazane abanesifo sikashukela, izindlela zokuvimbela inzalo zomlomo eziphansi kufanelekile.
Ama-COC aphansi-aqukethe ngaphansi kwe-35 μg yengxenye ye-estrogen. Lokhu kufaka phakathi:
- monophasic: "Marvelon", "Femoden", "Regulon", "Belara", "Jeanine", "Yarina", "Chloe";
- isigaba sesithathu: "Tri-Regol", "Three-Merci", "Trikvilar", "Milan".
Ama-Microdosed COCs - aqukethe ama-20 mcg noma ngaphansi kwengxenye ye-estrogen. Lokhu kufaka phakathi amalungiselelo amakhulu we-monophasic "Lindinet", "Logest", "Novinet", "Mercilon", "Mirell", "Jacks" nabanye.
Kwabesifazane abanesifo sikashukela, ingqophamlando entsha ekuvimbeleni inzalo kwaba ukukhula kwe-KOK, equkethe i-estradiol valerate kanye ne-dienogest, ene-regimen dosing regimen (Klayra) enamandla.
Zonke izindlela zokuvimbela inzalo zomlomo ezihlanganisiwe zandisa amazinga e-triglyceride egazini. Kepha lokhu kuyinto engathandeki ebeka engcupheni kuphela kulabo besifazane ababesevele benesifo se-hypertriglyceridemia ngaphambi kokuthatha amaphilisi. Uma owesifazane ene-dyslipidemia elinganiselayo (umzimba okhubazekile we-metabolism), ama-COC aphephile. Kepha phakathi kokudla kwabo, udinga ukuhlolwa kwegazi njalo nge-triglycerides.
I-vaginal Horonal ring NovaRing
Indlela yesitho sangasese sowesifazane osebenzisa ama-steroid ama-hormone wokuvimbela inzalo, ngezizathu eziningi, ingcono kunokuthatha amaphilisi. Ukuqunjelwa kwama-hormone egazini kugcinwa kuzinze ngokwengeziwe. Izinto ezisebenzayo azivezwa endimeni eyinhloko ngokusebenzisa isibindi, njengokufakwa kwezibhebhe. Ngakho-ke, lapho usebenzisa izithiyo zokuvimbela inzalo yowesifazane, umthamo wansuku zonke wama-hormone ungancishiswa.
Indandatho ye-HorvaRing yowesifazane wesitho sowesifazane sangasese iyindlela evimbela inzalo ngokuthi ibe yindandatho evele obala, ububanzi bube ngu-54 mm ububanzi no-4 mm ubukhulu esigabeni sesiphambano. Kuyo, kukhiqizwa ama-microgs ayi-15 e-ethinyl estradiol nama-microphs ayi-120 e-vagono nsuku zonke, lokhu kuyi-metabolite esebenzayo ye-desogestrel.
Owesifazane ngokuzimela ufaka indandatho yokuvimbela inzalo esithweni sangasese, ngaphandle kokubamba iqhaza kwabasebenzi bezokwelapha. Kufanele igqokwe izinsuku ezingama-21, bese ithatha ikhefu izinsuku ezingama-7. Le ndlela yokuvimbela inzalo inethonya elincane emgudwini wama-carbohydrate namafutha, acishe afane nezindlela zokuvimbela inzalo zomlomo ezihlanganisiwe.
Indandatho ye-HorvaRing ye-vaginal femin ikhonjiswa ikakhulukazi ukusetshenziswa kwabesifazane lapho isifo sikashukela sihlanganiswa nokukhuluphala, ukuphakama kwegazi triglycerides noma ukungasebenzi kahle kwesibindi. Ngokusho kocwaningo lwakwamanye amazwe, izinkomba zempilo sowesifazane aziguquki kulokhu.
Kuzoba wusizo lapha ukukhumbula ukuthi abesifazane abanokukhuluphala ngokweqile kanye / noma ushukela wegazi ophakeme ngenxa yesifo sikashukela bathambekele kakhulu kwi-veral vevovaginitis. Lokhu kusho ukuthi uma une-thrush, khona-ke kungenzeka ukuthi akuyona imiphumela emibi yokusebenzisa inzalo yokuvimbela inzalo yowesifazane ongumfazi we-NovaRing, kodwa ivele ngenxa yezinye izizathu.
Izindlela zokuvimbela inzalo ze-Intrauterine
Izindlela zokuvimbela inzalo ze-Intrauterine zisetshenziswa abesifazane abangafika kuma-20% abanesifo sikashukela. Ngoba le ndlela yokuvimbela inzalo ngokuthembekile futhi ngasikhathi sinye ivikela ngokumelene nokukhulelwa okungafuneki. Abesifazane bakhululekile kakhulu ukuthi abadingi ukubhekwa ngokucophelela nsuku zonke, njengalapho bethatha amaphilisi okulawula ukuzala.
Izinzuzo ezingeziwe zokuvimbela inzalo yesifo sikashukela:
- azilimazi i-carbohydrate kanye nama-metabolism wamafutha;
- musa ukwandisa amathuba okuqhekeka kwegazi nokuvalwa kwemithambo yegazi.
Okubi kwalolu hlobo lokuvimbela inzalo:
- Abesifazane bavame ukuvela ngokungahambi kahle kokuya esikhathini (i-hyperpolymenorrhea ne-dysmenorrhea)
- ingozi eyandayo yokukhulelwa kwe-ectopic
- izifo ezivuvukala zivame ukwenzeka, ikakhulukazi uma unesifo sikashukela ushukela wegazi uhlala uphakeme.
Abesifazane abangazalanga abazaleliswanga ukuthi basebenzise izindlela zokuvimbela inzalo ngaphakathi.
Ngakho-ke, uthole ukuthi yiziphi izizathu zokukhetha indlela eyodwa noma enye yokuvimbela isifo sikashukela. Owesifazane oneminyaka yobudala bokuzala uzokwazi ukuzikhethela indlela efanelekile, uqiniseke ukuthi usebenza nodokotela. Ngasikhathi sinye, zilungiselele ukuthi kuzofanela uzame izindlela ezahlukahlukene ezihlukene kuze kube yilapho unquma ukuthi iyiphi evumelana kakhulu nawe.
