Ukuvimbela inzalo ethembekile kubalulekile kwabesifazane abanesifo sikashukela. Ukuhlela ukukhulelwa kuvumela owesimame ukuthi azivikele ezinkingeni ezikhona futhi abelethe ingane enempilo. Ngaphambi kokukhulelwa umntwana, isiguli esinesifo sikashukela sidinga ukuthola isinxephezelo esihle sesifo sikashukela futhi sivimbele ukwanda koshukela wegazi ngaphezulu komkhawulo ophezulu wesilinganiso.
Lapho ukhetha indlela yokuvimbela isifo sikashukela, owesifazane kufanele acabangele izinto ezimbili ezibaluleke kakhulu - lokhu kungukuphepha okuphelele okunamazinga kashukela egazi aphakeme futhi nokuvikelwa okuthembekile kokukhulelwa okungafuneki, okugcwele nemiphumela emibi.
Ngokusho kwabesifazane abaningi, enye yezindlela ezilula, ezinokwethenjelwa nezphephe kunazo zonke zokuvikela ukukhulelwa yindlela yokuvimbela inzalo efana nesisetshenziswa se-intrauterine. Kepha iziguli eziningi zinentshisekelo kulo mbuzo: kungenzeka ukubeka okuvamisile kwabanesifo sikashukela futhi kungaba namiphi imiphumela lokhu?
Ukuze unikeze izimpendulo eziphelele zale mibuzo, kuyadingeka ukuqonda ukuthi idivaysi ye-intrauterine isebenza kanjani nokuthi kukhona yini ukungqubuzana nokusetshenziswa kwayo, futhi futhi icabangele ezinye izindlela ezivunyelwe zokuvikela ukukhulelwa okungafuneki kwisifo sikashukela mellitus.
Ukusetshenziswa kwe-spiral kushukela
Cishe ama-20% abesifazane abanesifo sikashukela bakhetha ukusebenzisa izindlela zokuvimbela inzalo ngaphakathi, okuyi-spiral, njengesivikelo ekukhulelweni okungafuneki. Ukuphefumula okunjalo kuyisakhiwo esincane esenziwe ngo-T, esakhiwa ngocingo oluphephile noma oluyimpulasitiki, olufakwa ngqo esibelethweni.
Amadivayisi we-Intrauterine enziwe ngendlela yokuthi angabandakanyi noma yikuphi ukulimala kwe-mucosa ye-uterine. Banikela ngokuvikelwa ekukhulelweni okungafuneki noma ngabe basebenzise i-wire yethusi enhle kakhulu noma isitsha esincane esine-projinin ye-hormone, ekhishwa kancane lapho isetshenziswa.
Ukuthembeka kokuvimbela inzalo kwe-intrauterine kungama-90%, okuyisilinganiso esiphakeme impela. Ngaphezu kwalokho, ngokungafani namathebulethi okufanele athathwe nsuku zonke, okwindilinga kudinga ukufakwa kanye kuphela futhi akusekho ukukhathazeka ngokuvikelwa kweminyaka engu-2-5 ezayo.
Izinzuzo zokusebenzisa Kuvunguza kushukela:
- I-spiral ayinawo umthelela ushukela wegazi, futhi ngenxa yalokho ayibangeli ukwanda kokuxineka kwe-glucose futhi ayikhulisi isidingo se-insulin;
- Izindlela zokuvimbela inzalo ze-Intrauterine azikukhuthazi ukwakheka kweziqeshana zegazi futhi azibambi iqhaza ekuqhekekeni kwemithambo yegazi, kulandele ukuthuthukiswa kwe-thrombophlebitis.
Okubi ngale ndlela yokuvimbela inzalo:
- Ezigulini ezisebenzisa amadivaysi e-intrauterine, isifo sokujikeleza sitholakala kaningi kakhulu. Izibonakalisa ekukhiqizweni okweqile futhi okuhlala isikhathi eside (ngaphezu kwezinsuku eziyi-7) futhi kuvame ukuhambisana nobuhlungu obukhulu;
- Kuvunguza kukhulisa amathuba okukhulisa ukukhulelwa kwe-ectopic;
- Lolu hlobo lokuvimbela inzalo lungadala izifo ezinzima zokuvuvukala zohlelo lokuzala lowesifazane nezinye izitho zangasese. Amathuba okukhula kokuvuvukala akhula ikakhulu ngesifo sikashukela;
- Imiklamo inconyelwa kakhulu kwabesifazane asebevele benezingane. Emantombazaneni angenalutho, kungadala izinkinga ezinkulu ngomqondo;
- Kwabanye besifazane, i-spiral ibangela ubuhlungu ngesikhathi sokulala;
- Ezimweni ezingavamile, kubangela ukulimala kwezindonga zesibeletho, okungahle kukhiphe ukopha kwe-intrauterine.
Njengoba kubonakala kusukela ngenhla, ukusetshenziswa kwamadivayisi we-intrauterine akuvunyelwe ku-mellitus yesifo sikashukela. Kodwa-ke, uma owesifazane enezinqubo zokuvuvukala esibelethweni kanye nama-appendages noma izifo zangasese ezingalashwa, ukufakwa komshini we-intrauterine akunconywa ngokuphelele.
Ngaphezu kwalokho, kufanele kuqashelwe ukuthi yi-gynecologist kuphela engabeka Kuvunguza ngokuhambisana nayo yonke imithetho. Noma yimiphi imizamo yokufaka lolu hlobo lokuvimbela inzalo kungaholela emiphumeleni emibi. Uchwepheshe wezokwelapha kufanele futhi asuse ukuvunguza esibelethweni.
Kulabo abangabazayo ukuthi imigudu ilungele abanesifo sikashukela, umuntu kufanele atshele ukuthi le ndlela yokuvimbela inzalo isebenza kanjani nokuthi hlobo luni lomoya olusebenzayo luphumelela kakhulu.
Zonke izinhlobo zamadivayisi we-Intrauterine:
- Ungavumeli amaqanda ukuthi afake odongeni lwesibeletho.
Imiklamo equkethe i-Progestin:
- Ukudlula kwesidoda ngomlomo wesibeletho kuyavinjezelwa;
- Iphula inqubo ye-ovulation.
Imiklamo ye-Copper:
- Chitha isidoda namaqanda.
Imiphemelo equkethe i-progestin equkethe ne-zethusi inokwethenjwa okufanayo, kepha ama-spirals anensimbi yethusi anempilo ende yokusebenza - kuze kube yiminyaka emi-5, ngenkathi imiyingi enomsebenzi weprogestin ingabi ngaphezu kweminyaka emi-3.
Ukubuyekezwa ngokusetshenziswa kwensimbi ye-intrauterine yesifo sikashukela kuxubeke kakhulu. Iningi labesifazane lincome le ndlela yokuvimbela inzalo ngokulula nangendlela esebenza ngayo. Ukusetshenziswa komoya kuvumela abesifazane ukuba bazizwe bekhululekile futhi bangasabi ukuphuthelwa isikhathi sokuthatha iphilisi.
Idivaysi ye-intrauterine ilungele kakhulu iziguli ezinesifo sikashukela esinzima, lapho kwenqatshelwe ngokuphelele ukusebenzisa izithiyo zokuvimbela inzalo ze-hormonal. Kodwa abesifazane abaningi bayabona ukuthi ukusetshenziswa kwayo kungadala imiphumela emibi kakhulu, kufaka phakathi ikhanda kanye nobuhlungu obuphansi emuva, ukuwohloka kwemizwa, kanye nokwehla okumaphakathi kwe-libido.
Ngaphezu kwalokho, ukufunda ukubuyekezwa kweziguli ezinesifo sikashukela, umuntu angeke ehluleke ukuqaphela izikhalazo ngokwanda okukhulu kwesisindo ngemuva kokufakwa komoya, kanye nokuvela kwe-edema, ukwanda kwengcindezi kanye nokuthuthukiswa kwama-comedones ebusweni, emuva namahlombe.
Kodwa-ke, abesifazane abaningi banelisekile ngokusetshenziswa kwensimbi ye-intrauterine futhi bayaqiniseka ukuthi indlela yokuvimbela isifo sikashukela yiyo ephephe kakhulu futhi ephumelela kunazo zonke. Lokhu kufakazelwa ukubuyekezwa okuningi kwababili abanesifo sikashukela nodokotela ababaphathayo.
Uma, ngasizathu simbe, isiguli esinesifo sikashukela sohlobo 1 noma uhlobo 2 singakwazi ukusebenzisa umoya ukuvikela ekukhulelweni okungafuneki, singasebenzisa ezinye izindlela zokuvimbela inzalo.
Amaphilisi okulawula ukuzalwa kwesifo sikashukela
Mhlawumbe indlela ethandwa kakhulu yokuvikela ukukhulelwa okungafuneki phakathi kwabesifazane emhlabeni wonke amaphilisi okulawula ukuzala. Zingasetshenziselwa isifo sikashukela, kepha lokhu kufanele kwenziwe ngokuqapha, kubhekwe zonke izincomo zikadokotela.
Kuze kube manje, izindlela zokuvimbela inzalo ngomlomo zitholakala ngezinhlobo ezimbili - zihlanganiswe futhi ziqukethe iprogesterone. Ukwakhiwa kwezindlela zokuvimbela inzalo kufaka phakathi ama-hormone amabili ngasikhathi sinye: i-estrogen ne-progesterone, ama-hormone aqukethe laphohesterone afaka kuphela i-progesterone ye-hormone.
Kunzima ukusho ukuthi yiliphi iqembu lezidakamizwa elifanelwa kangcono isifo sikashukela, ngalinye lazo linokuhle nezinzuzo zalo.
Kepha iningi lamaphilisi wesimanje okubeletha angamalungu eqembu lokuvimbela inzalo, ngakho-ke, ukukhetha wona wokuhlelela ukukhulelwa kulula kumuntu wesifazane ukuzikhethela ikhambi elifanele kunazo zonke.
Kuhlanganiswe izindlela zokuvimbela inzalo zomlomo
Izindlela zokuvimbela inzalo zomlomo ezihlanganisiwe (ezifushanisiwe njengama-COC) ngamalungiselelo wamahomoni aqukethe i-estrogen ne-progesterone. IProgesterone ihlinzeka ngokuvikelwa okuthembekile kokukhulelwa okungafuneki, futhi i-estrogen isiza ukuguquguqula umjikelezo wokuya esikhathini futhi ivikele lowesifazane ezinhlungwini nasekukhuculweni kanzima ezinsukwini ezibucayi.
Abesifazane abanesifo sikashukela i-mellitus kumele babonane nodokotela wabo ngaphambi kokusebenzisa ama-COCs futhi bahlolwe igazi ukuze benze umsebenzi we-platelet kanye nokuhlaziywa kwe-hemoglobin ku-mellitus yesifo sikashukela. Uma kutholakala ukuthambekela okuphezulu kwezigaxa zegazi, kufanele uyeke ukusebenzisa la maphilisi okulawula ukuzala.
Uma ukuhlolwa kungazivezi ukuphambuka okubalulekile kokujwayelekile, lapho-ke abanesifo sikashukela bavunyelwe ukusebenzisa lezi zindlela zokubeletha ukuhlela ukukhulelwa. Kodwa-ke, ngeke kube yiphutha ukuqala kokufunda ngazo zonke izithiyo nezinzuzo zama-COC, nangemiphumela emibi engangabakhona kanye ne-contraindication.
Izinzuzo zokusebenzisa izindlela zokuvimbela inzalo ezihlanganisiwe:
- I-KOK ihlinzeka abesifazane ngokuvikelwa okuthembekile kokukhulelwa okungakahlelwanga;
- Ezigulini eziningi ezinesifo sikashukela, ukuthatha lezi zinto zokuvimbela inzalo akubangeli imiphumela emibi neminye imiphumela engemihle;
- Lezi zimali azithinti kakhulu ikhono lokuzala labesifazane. Ngemuva kokwenqaba ukuthatha ama-COCs, ngaphezu kwe-90% yabesifazane bakwazi ukukhulelwa kungakapheli unyaka owodwa;
- Izindlela zokuvimbela inzalo zomlomo ezihlanganisiwe zinomphumela wokwelapha okuthiwa, ngokwesibonelo, zifaka isandla ekuthatheni kabusha ama-cysts ama-ovarian. Ngaphezu kwalokho, zingasetshenziswa njenge-prophylactic emelana nezifo eziningi ze-gynecological.
Ngubani ophoqelelwa ekusebenziseni la maphilisi okulawula ukuzala:
- Ama-COC awalungele abesifazane abanesifo sikashukela esinganciphiswanga kahle, lapho isiguli sinezinga eliphakeme likashukela wegazi;
- Lemithi yokuvimbela inzalo ayikwazi ukusetshenziselwa iziguli ezinomfutho wegazi ophakeme, lapho umfutho wegazi uvama ukukhuphukela ezingeni le-160/11 nangaphezulu;
- Abalungele abesifazane abanesifiso sokukopha kakhulu, kunalokho, ukuphakama kwegazi okungajwayelekile;
- I-COC iphikisana ngokuphelele neziguli ezinezimpawu ze-angiopathy, okungukuthi, ukulimala kwemithambo yegazi ku-mellitus yesifo sikashukela. Ikakhulu, ngokuncipha kokujikeleza kwegazi emikhawulweni ephansi;
- Lawa mathebhulethi awathathwe abesifazane abanezimpawu zokulimazeka okubonakalayo futhi lapho kukhona isifo sikashukela - ukulimala kwemikhumbi ye-retina;
- Izindlela zokuvimbela inzalo ezihlanganisiwe azinconywa kwabesifazane abane-nephropathy esigabeni se-microalbuminuria - ukulimala kwezinso okunesifo sikashukela.
Izici ezifaka isandla ekuthuthukiseni nasekuqiniseni imiphumela emibi ngenkathi kusetshenziswa amaphilisi okulawula ukuzalwa nge-estrogen ye-hormone:
- Ukubhema ugwayi;
- Umfutho wegazi omncane ovezwe kancane;
- Iminyaka yobudala engama-35 noma ngaphezulu;
- Isisindo esikhulu ngokweqile;
- Isandulela sofuzo ezifweni zenhliziyo nemithambo yegazi, okungukuthi, kunezimo zokuhlaselwa yisifo senhliziyo noma imivimbo phakathi kwezihlobo eziseduze, ikakhulukazi ezingabi ngaphezu kweminyaka engama-50;
- Lapho uncelisa ingane ibele.
Kumele kugcizelelwe ukuthi zonke izidakamizwa ze-COC, ngaphandle kokunye, zandisa ukugcwala kwama-triglycerides egazini. Kodwa-ke, lokhu kungaba yingozi kuphela kwiziguli ezinesifo sikashukela esake satholakala nge-hypertriglyceridemia.
Uma owesifazane onesifo sikashukela ephula umthetho we-lipid metabolism, ngokwesibonelo, i-dyslipidemia enesifo sikashukela sohlobo 2, lapho-ke ukuthatha izindlela zokuvimbela inzalo zomlomo ezihlangene ngeke kuwulimaze umzimba wakhe. Kepha akufanele ukhohlwe ukuhlolwa njalo kwenani lama-triglycerides egazini.
Ukugwema imiphumela engaba khona yokuthatha amaphilisi okulawula ukuzala, abesifazane abanesifo sikashukela kufanele bakhethe ama-COCs aphansi kanye nama-micro-dozi amancane. Izinkampani zesimanje zamakhemikhali zinikeza ukukhetha okuningi okubanzi kwale mishanguzo.
Izindlela zokuvimbela inzalo ephansi zifaka izidakamizwa eziqukethe ama-microphs angaphansi kwama-35 e-estrogen hormone kwithebhulethi. Leli qembu lifaka lezi zidakamizwa ezilandelayo:
- Marvelon
- Insikazi;
- I-Regulon;
- Belara;
- UJeanine;
- UYarina;
- UChloe
- I-Tri-Regol;
- Isihe sesithathu;
- I-Triquilar;
- UMilan.
Ama-Microdosed COCs yizindlela zokuvimbela inzalo eziqukethe ngaphezu kwama-20 e-estrogen. Izidakamizwa ezidumile ezivela kuleli qembu yilezi:
- ILindinet;
- Ukuboleka;
- INovinet;
- UMercilon;
- UMirell;
- UJack.
Kepha ukubuyekezwa okuhle kakhulu kutholwe ngomuthi u-Klaira, okuwukuthuthuka kwakamuva emkhakheni wezokuvimbela inzalo futhi udlula kakhulu ikhwalithi yezindlela zokuvimbela inzalo ezindala.
IKlayra yakhelwe ngqo abesifazane abanesifo sikashukela. Lokhu kuhlangana komlomo okuhlanganisiwe kuqukethe i-estradiol valerate ne-dienogest, futhi futhi kunerejimusi yemithamo enamandla.
Ividiyo ekulesi sihloko izokhuluma ngezindlela zokuvimbela isifo sikashukela.
