Kunezindlela ezahlukene zokuvimbela ukukhulelwa: i-intrauterine ivulela i-Mirena, amakhondomu, amaphilisi, njll, manje sesinqume ukukutshela ngokusungulwa kwe "Mirena" emzimbeni. I-intrauterine yokukhulelwa kwengqondo "iMirena" ilula ukusebenzisa futhi isikhathi eside, futhi le ndlela yokuvimbela ukukhulelwa ishintsha. Idivayisi ye-intrauterine iyisiluleko esiyingqayizivele esivikela ngokuthembekile owesifazane ekukhulelwe iminyaka emihlanu. Ibuye isetshenziswe uma kwenzeka ukwelashwa ngokweqile kokuya esikhathini nasesikhathini sokwelapha esikhundleni se-estrogen ukuvikela i-endometrium kusuka e-hyperplasia.
Izinzuzo zedivayisi ye-intrauterine:
- Le ndlela yokuvimbela ukukhulelwa ishintsha futhi iphumelele kakhulu;
- Kulula kakhulu kulesi sicelo: "beka bese ukhohlwa";
- Kukhona cishe akukho nhlobo ye-hormonal systemic emzimbeni;
- Kuholela ekunciphiseni esikhathini kanye nomthamo wokulahleka kwegazi esikhathini;
- Ukuvama kwezifo ezivuthayo ezithombeni zensiza kunciphisa.
Izakhiwo nesenzo sokukhulelwa "iMirena".
I-Mirena iyisimiso se-intrauterine yokukhulelwa, induku yayo ibukeka njenge-cylinder ebanzi eyenziwe ngepulasitiki futhi iqukethe i-hormone levonorgestrel. Ukuze uhlelo lukwazi kangcono ukuma kwesisu, lwenziwa ngendlela efana ne-T. Ukuze kususwe ngokulula kwesistimu emzimbeni, ekugcineni okuphansi kwesigxathu esiyingqayizivele kuyi-loop, lapho kufakwe khona izintambo ezimbili. I-hormone ye-levonorgestrel equkethwe i-intrauterine evunguza iMirena yi-gestagene efundwa kakhulu kakhulu (i-progesterone engokwemvelo), futhi isetshenziswa ngokuphumelelayo ezinhlobonhlobo zokukhulelwa ezihlukahlukene.
"I-Mirena", enhle ngokuvimbela ukukhulelwa, ilawula ukuthuthukiswa nyangazonke kwegobolondo langaphakathi lesisu, futhi ivimbela ukunyakaza kwesidoda esibelethweni. Lapho i-levonorgestrel ingena emgodini we-uterine, inomthelela wendawo ku-endometrium, ngaleyo ndlela igweme izinguquko ezandayo futhi inciphise umsebenzi wayo wokufaka. Ngakho-ke, i-endometrium ayikwazi ukufinyelela ukuvuthwa okudingekayo, ngenxa yalokho, ukukhulelwa akukwenzeka. I-Levonorgestrel ikhuthaza ukwanda kwe-viscosity ye-mucus yomsele womlomo wesibeletho, ngaleyo ndlela ivikela isisu kusukela ekungeneni kwesidoda futhi ngaleyo ndlela igweme ukukhulelwa kwe-ovum. Kungabuye kuqaphele ukuthi i-levonorgestrel inomphumela omncane wesistimu, obonakala ekucindezelweni kwe-ovulation ngenani elingenamkhawulo lemijikelezo.
Ukuphumelela kwe-contraire "Mirena" kungafaniswa nokuqothulwa kowesifazane. Kuze kube manje, i-"Mirena" ekusebenzeni kwayo akuyona into embi kakhulu kunezingcingo ezithintekayo kakhulu zethusi eziqukethe i-intrauterine kanye nemithi yokubeletha ngomlomo.
Izimpawu zokusetshenziswa kwe-intrauterine ezivulwa nge-Mirena ziyi:
- ukuphuma ngokweqile kokuphuma esikhathini (i-menorrhagia);
- ukuvikelwa ngokumelene ne-hyperplasia ngenkathi kusetshenziselwa ukwelapha esikhundleni se-estrogens.
- Ukuvimbela ukukhulelwa (ukukhulelwa);
Ukuqhathaniswa nokusetshenziswa kwe "Mirena" yi:
- ukukhulelwa noma ukukhulelwa okuqinile;
- umdlavuza wesibeletho noma isisu (ukusola kwalo);
- ukungajwayelekile kwesibeletho noma umlomo wesibeletho, kuhlanganise nalabo abangelwa yi-fibroids eholele ekuthuthukiseni umkhuhlane wesibeletho;
- i-dysplasia yomlomo wesibeletho ne-atypia;
- ukuphuma kwegciwane lesisu esingenakuqondakala;
- ukutheleleka kwesibeletho emva kokukhipha isisu phakathi nezinyanga ezintathu zokugcina;
- ukutheleleka kohlobo lwe-genitourinary ephansi;
- izifo zokuvuvukala ezithombeni zomzimba
- ukutheleleka komlomo wesibeletho;
- ukutheleleka kokubeletha kwesibeletho;
- izifo ezinzima noma izicubu zesibindi;
- izifo ezihambisana nokuzwela kwezifo;
- ukungaboni ngaso sonke isikhathi izingxenye ze-Navy Mirena;
- umdlavuza webele.
Sebenzisa ngesikhathi sokukhulelwa kanye ne-lactation.
Ekukhulelweni, ukusebenzisa i-intrauterine ukuvunguza iMirena kuyaphikisana. Kodwa uma ukhulelwe ngokuzumayo ngenkathi isetshenziswa, uhlelo kumele lususwe ngokushesha. Ngoba, lapho kwenzeka ukuthi "i-Mirena" isale esibelethweni ngesikhathi sokukhulelwa, kunengozi enkulu yokubeletha ngaphambi kwesikhathi noma isisu sokubeletha kwesisu. Ngesikhathi se-lactation, ukusetshenziswa kwe-Mirena kunokwenzeka - ama-gestagens, asetshenziselwa ukuvimbela ukukhulelwa, angathinti izinga nobuningi besibisi sebele.
Imiphumela emibi ye-VSM Mirena
Ezinyangeni zokuqala emva kokufakwa kwe-Mirena IUD, ezinye imiphumela emibi ingase ivele, okuyinto, njengombuso, inyamalale phakathi nezinyanga ezimbalwa futhi ayidingi ukwelashwa okwengeziwe. Omunye wemiphumela emibi engase yenzeke inguquko ekuphumeni kokuya esikhathini, okukhombisa ukuphendula komzimba kwisenzo seMirena yokuvunguza. Ngokuvamile kunezikhathi ezingavamile phakathi kokuphuma kwegazi, ukubona indawo, ukuphuma ngokweqile noma ubuhlungu ngesikhathi sokuya esikhathini, ukuqeda ngokuphelele ukuya esikhathini, noma ukwandisa isikhathi sokuya esikhathini. Siphinde sibone ukuthi abesifazane abangu-12% babe nama-cysts ama-ovari ngesikhathi sokusebenzisa i-Mirena.
Uma ukwandisa ubukhulu be-follicles (ama-ovari), ngezinye izikhathi ukungenelela kwezokwelapha kuyadingeka. Indlela yokuvimbela ukukhulelwa nokusetshenziswa kwe "Mirena" kwabanye besifazane ingabangela isikhumba ukubhekana nokugula. Uma ukukhulelwa okunjalo kwakungasebenzi, khona-ke kukhona amathuba okuthuthukisa ukukhulelwa kwe-ectopic. Idivayisi ye-intrauterine "i-Mirena" ingaba yingozi kakhulu, ngenxa yokuthi uma usebenzisa, kungenzeka ukuthi kunezifo zezitho zomzimba, mhlawumbe ngisho nezibi kakhulu. Ngaphezu kwalokho, ukusetshenziswa kwe-Navy Mirena kungakwazi ukuguqula udonga lwesibeletho.
Ukubonwa kwabonisa ukuthi emva kokusetshenziswa kwe-spiral, ku-1-10% yabesifazane babangelwa: ubuhlungu besisu, isifo sokukhwabanisa, ubuhlungu besisu noma ubuhlungu emuva, inhlamba, inzuzo yesisindo, ukugcinwa komzimba, ukugcinwa kwesisu, ubuhlungu besisu, ukukhathazeka, ukungazinzi kwemizwelo, ukucindezeleka , ukwabiwa kwe-leucorrhoea kusuka kwesifazane, ukuvuvukala komsele womlomo wesibeletho. Ngaphansi kwephesenti eyodwa yabesifazane, kwakukhona: ukutheleleka kwezitho zangasese, ukulahlekelwa izinwele noma ukukhula ngokweqile, ukwehlisa isifiso sobulili, isikhumba esibucayi. Futhi abesifazane abangaphansi kuka-0.1% babonwe: i-migraine, i-urticaria, ukukhuphuka kwesikhumba, ukuvuvukala, i-eczema. Imiphumela emibi efanayo nayo yenzeke ezimweni zokusebenzisa i- "Mirena" ye-hormone yokwelapha esikhundleni sokuguqula inhlanganisela nama-estrogens.