Kukonzekera komwe kumakhala ndi mahomoni opatsirana pogonana ndi imodzi mwa njira zothandiza komanso zothandiza pakulera kwa amayi. Kugwiritsa ntchito ndalama kuchokera mimba yosafuna, ngati kugwiritsidwa ntchito bwino, kumafika 99-100%. Kupindulitsa kwa mankhwala otero kumadalira kulondola kwa kusankha kwawo.
Zokambirana zapakati pa amayi - mapiritsi
Pali mitundu iwiri ya mankhwala omwe akugwiritsidwa ntchito, omwe ali ndi zodziwika. Mitundu ya kulera kwakamwa:
- Progestin (mini-kumwa). Kugwira ntchito - pafupifupi 95-96%, amadziwika ndipamwamba zotetezera.
- Kuphatikizidwa (COC). Zogwira ntchito - mpaka 100%, zotsutsana, nthawizina zimayambitsa zotsatira zoipa.
Masituni aang'ono
Mapiritsi oletsa kugonana omwe ali m'gululi ali ndi mlingo wochepa wa pure progestin (progesagen), omwe ndi mafanidwe a ma prostgesone a progesterone (opangidwa m'mimba mwake). Kulandira pakhomo pamimba ndipiritsi kumaperekedwa kwa amayi omwe saloledwa kutenga COCs. Mankhwala opatsirana amachititsa thupi kukhala lolimba, koma chitetezeni ku mimba yosafunika kwambiri.
Kuphatikizapo kulera kwakamwa
Mtundu wa mankhwala ofotokozedwawo umaphatikizansopo progesterone yokha ndi mafanidwe a estrogen. Mankhwalawa amatha kukhala osakwatira, awiri ndi atatu, malinga ndi mlingo wa mahomoni. COCs amagwira ntchito bwino kwambiri, kufika 100%, koma si abwino kwa akazi onse. Ndizowasankha kuti azisankha okha, kulera kovomerezeka kwa gulu logwirizanitsidwa ndi mmodzi mwa amayiwo.
Kodi mapiritsi oletsa kubereka amagwira ntchito bwanji?
Njira yothandizira kutenga mimba kwa mini-pili ndi COC ndi yosiyana. Mfundo zoyenera kufotokoza momwe piritsi yothandizira pulogalamu yaprogestin imathandizira:
- Kusungunuka kwa ntchentche pamimba. Izi zimalepheretsanso kuti umuna ukhale ndi dzira.
- Kusintha mucosa (kuponderezana kwamtendere) kumayika chiberekero. Ngakhale spermatozoon inatha "kudutsa" ndi kudzala dzira, silingathe kudziphatika.
- Kuchepetsedwa kwa mazira a fallopian. Kawirikawiri, dzira limamwalira musanamwe umuna, lisanalowe mu mucosa.
Mapiritsi opatsirana pogonana a mtundu wofanana amabweretsa zofanana, koma amakhalanso ndi zotsatira zina:
- Pewani kumasulidwa kwa mahomoni osakanikirana ndi olota amtundu wa mankhwala m'kamwa;
- kuletsa ntchito za mazira oimba;
- kupewa kutsegula kwa ovulation .
Mapiritsi opatsirana pogonana - ndiyenera kusankha ndani?
Kusankhidwa kwa njira zothandizira kulera kumayendetsedwa ndi gynecologist woyenera. Dokotala wodziwa bwino yekha angapereke mankhwala oletsa kubereka - omwe ali abwino kwa mkazi wina, atsimikizika pa maziko a zifukwa:
- zaka;
- mzimayi;
- mtundu wa chikhalidwe (chikhalidwe, kukula kwa msambo, kukula kwa makhalidwe achiwerewere ndi zina);
- zizoloŵezi zoipa;
- kubereka kapena kubereka mimba;
- shuga wambiri m'magazi;
- kukhalapo kwa matenda a chiberekero ndi endocrine pathologies;
- mlingo wa magazi;
- kulemera kwa thupi;
- chikopa cha khungu;
- chiwonetsero;
- chiwindi;
- Magazi ogwiritsira ntchito magazi;
- Kukhalapo kwa ziphuphu mu ziwalo zazing'ono za pelvic ndi mazira a mammary;
- zogonana.
Amayi ambiri ndi oyenera kuphatikizapo mapiritsi oletsa kubereka. Ngati zotsutsana ndi ntchito zawo zimapezeka, dokotalayo amalangiza kuti asankhe njira ina yoberezera, monga, makina (makondomu, chipangizo cha intrauterine), kapena ntchito yachiwiri:
- Chodabwitsa;
- Charozette;
- Ovret;
- Dziko;
- Organometr ndi zofanana.
Mapiritsi oletsa kubereka pambuyo pake
Gulu ili la mankhwala limaperekedwa ku milandu yodzipatula, pamene kuli kofunikira kusokoneza mimba yomwe ikuyembekezeka mwamsanga. Mankhwala awa amachotsedwa pambuyo pa ubwenzi (nthawi yomweyo). Poyambirira ntchito yogwiritsira ntchito njira za kulera zamwambo yayamba, ntchito yawo ndi yogwira mtima kwambiri. Amayambitsa imfa ya dzira laubwamuna (mankhwala "ochotsa mimba").
Pulogalamuyo isanalandire patapita masiku awiri mutatha kupewa kugonana mosadzitetezera, komanso bwino - m'maola oyambirira ochepa. Mankhwala amasiku ano amathandiza kwambiri komanso otetezeka, koma ogwira mtima kwambiri. Ndikoyenera kumwa mapiritsi oterowo pambuyo pochitika mkati masiku 3-4:
- Mzimayi;
- NorLevo;
- Tithawa;
- Mzimayi;
- ElEva ndi zofanana.
COPs za Monophase
Mankhwalawa amathandiza kuti mapiritsi azikhala ndi nthawi yowerengeka ya progestogen ndi estrogen piritsi lililonse. Mlingo wa mahomoni omwe sutengedwa samasintha malinga ndi nthawi ya kusamba. Ubwino wa mtundu wa kulera mu funso ndi:
- mtengo wokwera mtengo;
- chiwonongeko;
- pamaziko a zaka zambiri zachitikira.
Mapiritsi abwino kwambiri obadwira omwe amachokera ku gulu la magawo osakanizidwa nthawi zambiri amatchulidwa kuti athe kuchiza matenda aakulu a amai:
- uterine fibroids ;
- polycystic ovaries ;
- endometriosis ndi matenda ena.
Mapiritsi oletsa kubadwa omwe ali ndi gawo limodzi - maudindo:
- Zovuta;
- Janine;
- Silhouette;
- Chodabwitsa;
- Anova ndi analogues.
COCs magawo awiri
Mtundu uwu wamagulu opanga mankhwala anapangidwa kuti afanizire kuchuluka kwa mahomoni opangidwa omwe amachokera ku kusintha kwa thupi kwa thupi lachikazi pa nthawi ya kusamba. Mu mapiritsi opatsirana omwe amavomerezedwa, matenda a estrogen ndi osasintha. Mlingo wa progesterone ndi wosiyana kwa theka ndi theka lachizunguliro.
Kodi ndi mapiritsi otani omwe ali ndi magawo awiri omwe amalembedwa ndi amayi amuna:
- Femoston;
- Sequilar;
- Neo-Eunomine;
- Adepal;
- Bifazil ndi ena.
COCs magawo atatu
Mu phukusi lililonse la kukonzekera koteroko ndi mapiritsi atatu omwe ali ndi mazira osiyanasiyana. Miyambo itatu ya mibadwo yatsopano imapangidwa ndi mlingo wa progesterone ndi estrogen yomwe ikugwirizana ndi kusintha kwachilengedwe pakapita nthawi (follicular, luteal, ovulation). Njira yowonjezeretsa kulera siingaganizidwe mogwira mtima kusiyana ndi matembenuzidwe akale. Azimayi ena ndi ofunika kwambiri ku ma-agent kapena biphasic agents.
Ndi mapiritsi ati omwe ayenera kutengedwa (kuchokera mu gulu lofotokozedwa):
- Milvanes;
- Mitundu itatu;
- Atatu-regol;
- Marvelon;
- Trisilete ndi zofanana.
Kodi kumwa mapiritsi oletsa kubereka?
Mankhwala onse ogwiritsira ntchito pakamwa amagwiritsidwa ntchito mofanana. Ndikofunika kuti kudya kwa mapiritsi oletsa kubereka kumawatsatira kwambiri ndi malangizo kwa amayiwa. Malamulo oyambirira:
- Piritsi loyamba limatengedwa tsiku loyamba la kuyamba msambo.
- Mankhwala opatsirana pogonana ayenera kumwa mowa tsiku lililonse. Kuti musaiwale za izo, ndi bwino kusunga paketi pamalo pomwe mayi amatha kuyang'ana - thumba la zodzoladzola, kabati mu bafa, pafupi ndi kalilole.
- Tsiku lina tenga mapiritsi 1, makamaka nthawi zonse.
- Pamene mapiritsi otsekedwa atatha (chiwerengero chawo ndi zidutswa 21-28), pumulani masiku asanu ndi awiri. Mu sabata ino, padzakhala kusowa magazi, monga kusamba. Zosiyana ndizozigawo ziwiri, ayenera kumwa mowa popanda kusokonezeka.
- Pamapeto a masiku asanu ndi awiri, yambani kugwiritsa ntchito njira za kulera.
- Ngati mwamsanga mutatha kumwa mapiritsi, kusanza kumachitika, mumayenera kumwa chimodzi. Pakutha maola makumi awiri ndi awiri, ndizofunika kuwonjezera kutetezedwa ndi kondomu .
- Ngati mukusowa mapiritsi, ndibwino kuti mutenge piritsi lotsatira kale. Kukayikira mlingo umenewo muzosatheka, ndizowonjezera zowonjezereka zowonongeka.
- Mukamagwiritsira ntchito mankhwala ena owonongeke, onetsetsani kuti mufunsane ndi katswiri.
Mankhwala opatsirana pogonana - zotsatira
Zopweteka zonse zomwe zikuphatikizana ndizokhazikitsidwa mwachikhalidwe m'magulu awiri - ang'onoang'ono komanso ovuta. Mapiritsi oletsa kubereka amachititsa zotsatirazi zotsatirazi:
- chisokonezo;
- kuwonongeka kwa chilakolako;
- mutu;
- kuchepetsa chilakolako chogonana;
- Kutuluka m'mimba kuchokera kumaliseche pakati pa msambo;
- kupindula;
- chizungulire;
- kutukumula kumapeto kwenikweni;
- kukondwa;
- chloasma;
- phulusa pakhungu;
- kunyada ndi chifundo cha mabere;
- kuthetsa kupezeka kwa msambo mokwanira;
- kuwonjezeka kwa tsitsi pa thupi;
- thrush ;
- photosensitivity.
Nthawi zina mapiritsi oletsa kubereka amachititsa mavuto aakulu:
- hemicranium;
- migraine;
- kukomoka;
- kugwa kwa malo kuchokera kumalo owonera, kuwonongeka kwa kuwongolera kwake;
- glaucoma;
- urticaria;
- chovuta kulankhula;
- mavuto omwe amapezeka ndi kupuma (chifuwa cha mvula, kuthamanga kwa nkhwangwa zakuda, kupuma);
- kupweteka kwambiri m'chifuwa;
- kuthamanga kwa magazi kudumpha;
- chithandizo;
- mitsempha ya varicose;
- matenda osokonekera;
- myalgia;
- mliri;
- kukula kwa cysts pa thumba losunga mazira;
- Kutupa kwa miyendo m'mimba mwa ng'ombe.
Mankhwala opatsirana pogonana - osagwirizana
Azimayi ena amaletsedwa kugwiritsa ntchito njira zothandizira pakamwa. Pankhani ya COCs, sizingatheke kumwa mapiritsi oletsa kubereka ndi HB (lactation), panthawi yoyembekezera komanso kwa miyezi 1.5 atabadwa. Zina zotsutsana ndi mankhwala osakaniza:
- matenda osokoneza bongo;
- matenda a chiwindi;
- herpes;
- Kusuta, makamaka ali ndi zaka 35 ndi kupitirira;
- migraine ya chidziwitso;
- matenda a mtima;
- kutuluka m'magazi;
- kupweteka kwa impso;
- kuthamanga kwa madigiri 2-3;
- kutuluka kwa nthawi yaitali;
- khansara;
- kunenepa kwambiri (kupitirira 30% mwachizolowezi);
- shuga;
- matenda a magazi coagulation dongosolo;
- nyamakazi ya nyamakazi;
- chonchi;
- mphutsi yamoto;
- Matenda a Gilbert;
- pigment retinitis ndi ena.
Akafunsidwa ngati n'zotheka kumwa mapiritsi oletsa kubereka ndi progesin yoyenera patsiku, madokotala amayankha bwino. Mapiritsi ochepa samakhudza mkaka ndipo kawirikawiri amakhala ndi zochepa zosiyana:
- ectopic pregnancy in anamnesis;
- oncology;
- matenda aakulu a chiwindi;
- matenda a mtima ndi mitsempha ya magazi;
- magazi a m'mimba.
Kuchetsa mapiritsi oletsa kubereka
Madokotala opititsa patsogolo angathe kupereka njira zothandizira kulera kwachindunji kwa nthawi yayitali, owerengedwa zaka ndi makumi khumi. Kwa nthawi yaitali, chiberekero chimatengera kusintha kwa mahomoni kuchokera kunja, choncho atatha kufotokozedwa, pangakhale kusinthasintha kwa thupi, kuthamanga kwapakati, kuchepa kwa m'mimba ndi zizindikiro zina. Sizimayambitsidwa ndi mapiritsi othandizira amayi, koma kubwerera kwa thupi kumagwira ntchito zachilengedwe komanso kukonzekera umuna. Pamene mahomoni amatha kukhazikika, zizindikiro zoterezi zidzatha pokhapokha.