Indlela engcono kakhulu ukubonisana nomjozi wezifo zokwelapha ozobeka umlomo wokubeletha ngomlomo ngokusekelwe ekuhlolweni nasekuhlolweni kokubukwa. Uma nganoma yisiphi isizathu akunakwenzeka ukuxhumana nochwepheshe ekukhethweni kwezinzalo zokubeletha kwe-hormone, ungakwenza ngokwakho. Umthetho oyinhloko wokuzikhethela: ikhwalithi yokuya esikhathini, ekhombisa isizinda se-hormonal. Ukusuka esikhathini esiningi nokuhlala isikhathi eside kubonisa umsebenzi ophawulekayo wama-estrogen, omncane futhi omfushane - emsebenzini wezinwele zokugcoba. Imigomo yokhetho olufanele lokukhulelwa komlomo: impilo enhle, akukho ukuphuma kwegazi ngaphakathi, ukunyamalala kwe-PMS.
Ukuvimbela ukubhema
I-Estrogen-equkethe ukukhulelwa nokubhema - imiqondo ayihambisani. Ukuphuza ngokweqile kwe-nikotine ngokwakho kulimaza umzimba wesifazane, futhi kuhlanganiswe nokusetshenziswa kokuhlanganiswa kokubeletha okuhlangene (progestin + estrogen), umphumela omubi we-nicotine uphakama kaningi.
Izingozi nemiphumela:
- I-blood coagulability iyanda;
- kukhona i-vasospasm yesikhathi esifushane;
- ukuhamba kwegazi emithanjeni nasezindlini zegazi kunzima;
- ingozi yezindwangu zegazi iyanda, okuholela ekutheni i-myocardial infarction, i-atherosclerosis, i-stroke.
Amaphilisi okuvimbela ukubhema abesifazane akufanele aqukethe i-estradiol valerate, i-ethinyl estradiol, i-estradiol hemihydrate. Bangathatha izisu zomlomo ngaphandle kwe-estrogen ("i-mini-drank"): Charozetta, Microlut, Laktineth, Eksluton. Inkomba yePearl "mini-saws" yi-0.5-4. Lezi zidakamizwa zivikelekile ngokumelene nokukhulelwa okungahleliwe futhi zibe nomthelela omuhle emzimbeni, kodwa zibhebhethekise kakhulu umjikelezo, okuholela ekuphumeni okungahleliwe kokuphuma ngaphakathi. "I-mini-second" inconywa ukuba ithathwe ngokuqhubekayo epilisi ngosuku kusukela ngosuku lokuqala lokuphuma esikhathini. Ezinye izindlela zokuvikela: ukuvuthwa kwe-hormonal, ukufakelwa kwe-hormonal, isidakamizwa esingekho-hormonal Benatex .
Ukukhulelwa kwe-nulliparous
Amantombazane angewona ama-generic kanye nezintsha ezithandana nabo ngokobulili, izakhi zokubeletha zomlomo zanamuhla zihlelekile. Zihlanganisa i-progestagen ne-ethinyl estradiol, ziphumelela kakhulu ekuvimbeleni ukukhulelwa kanye nemiphumela eminingi yokwelapha - unciphisa izimpawu ze-PMS, ukuyeka ubuhlungu, ukulawula umjikelezo wesimiso. Ezinganeni ezivame ukuthatha izitho zokubeletha ezihlangene, ukubonakaliswa kwe-dysmenorrhea kuyanyamalala, ivolumu yokulahleka kwegazi esikhathini sokuya esikhathini iyancipha, futhi ibhalansi ye-hormone ibuyiselwa.
Izindlela zokubeletha zamantombazane:
- Ama-COC amancane-dose: Lindineth-30, Regulon, Belara , Janine ;
- I-COC encane: Lindineth-20, Clayra, Jess.
Izazi ze-gynecologists aziphakamisi ukubeka i-endometrili kuvunguza kubesifazane ngenxa yengozi enkulu yokucindezeleka: ukuvuvukala (isisu, isisu somlomo wesibeletho), umonakalo emgodini wesibeletho, ukwelapha ngokweqile kwe-uterine, ukunciphisa i-endometrium, egcwele ukuphazamiseka kwezigaba ezihlukahlukene zokukhulelwa, ukungabi nabantwana. Kumantombazane angashadile kanye nentsha kungcono kakhulu ukusebenzisa izindlela ezivikelekile zokuvikelwa: i-suppository engeyona i-hormonal ye- Benatex , amakhondomu, amaphilisi okuvimbela i-hormonal .
Ukukhulelwa emva kokukhipha isisu nokukhulelwa kwesisu
Ukuvimbela ukukhulelwa ngokweqile emva kokukhipha isisu noma ukukhulelwa kwesisu kudla indima ebalulekile - kusiza ukujwayelekile kwesizinda se-hormonal, kuvimbela ukuqhuma kwezinqubo zokuvuvukala ezithweni zangasese, kuvimbela ukuguguleka kwesisu somlomo wesibeletho, kuvikela ekugcineni kwe-endometriosis, kunciphisa ukuqina kwegazi. Ngemuva kokukhipha isisu, i-mucosa yesibeletho sesibeletho yalimala, ukukhulelwa okuphindaphindiwe kuyaphikisana ngokuqondile, kodwa ikhono lokukhulelwa libuyiselwe kakade ngosuku lwesishiyagalombili kuya kweyisishiyagalolunye, ngakho-ke, ukukhetha amaphilisi okubeletha ngomlomo kufanele kutholakale ngokuziphendulela.
Ukwelashwa emva kokukhipha isisu nokukhulelwa kwesisu
Izakhi zokubeletha ezihlanganisiwe. Zihlanganisa imithi ephansi ye-estrogen ne-progestogens yanamuhla. Kuboniswe ukwamukelwa ngosuku olu-1-2 emva kokukhipha isisu. Nciphisa ubude bokubheka, ukunciphisa ubukhulu bezinyosi zomzimba, ukulawula ukushisa komzimba, ukuvimbela ukuvuvukala kwezitho zomzimba, ukunciphisa inani lezinkinga zakuqala:
- monophasic (Regulon, Yarina, Lindineth-30, Belara);
- isigaba sesithathu (Triziston, Trinovium, Trikvilar).
I-Gestagennye yokukhulelwa ("i-mini-drank"): Charozetta, Microlut, Laktineth, Eksluton. Zihluke ekusebenzeni okuhle kokukhulelwa, musa ukwandisa umfutho wegazi, ungabi nengozi yokuthwala i-thrombosis, ungashintshi imingcele yokusebenza yesibindi.
Ukukhulelwa emva kokukhulelwa kanye nesigaba sokudla
Ukwelashwa kwe-hormonal kwesizukulwane sakamuva kuqinisekisa ukuvikeleka okungamaphesenti angu-99 ngokumelene nokukhulelwa okungadingeki, kodwa u-1% uhlala lapho isidakamizwa sithathwa uma uthatha isidakamizwa. Ukuvimbela ukukhulelwa ngesikhathi sokukhulelwa, i-fetus ayilimazi, odokotela abanalo ulwazi olunokwethenjelwa mayelana nobuhlobo obukhona phakathi kokusetshenziswa kokukhulelwa kanye nokukhubazeka kosana, uma owesifazane ethatha iphilisi isikhathi esingaphezu kwenyanga eyodwa yokukhulelwa. Kusukela ngeviki le-6, umntfwana uqala ukwakha uhlelo lwezocansi, uzwela ekusebenzeni kwamahomoni, ngakho ukuthatha imithi ekhulelwe yaleli qembu kungabangela ukuphazamiseka kokusebenza kwengane. Ngemuva kokuthi ufunde ngokukhulelwa komfazi, udinga ukuxhumana nomjozi wezifo zogciwane ozosikisela indlela engcono kakhulu yokuxazulula inkinga.
Izindlela zokuvimbela ukukhulelwa emva kokubeletha kanye ne-cearean:
Spermicides (Benatex, Pharmatex, Contraceptin). Isetshenziswe lapho iqala kabusha ubuhlobo bobulili ngokusuka kwesizinda se-lactation noma inhlanganisela nezinye izindlela zokuvikela. Ukuthembeka kwalendlela kungu-90-92%, umphumela wokukhulelwa kwenzeka emva kwemizuzu emihlanu kuya kwemihlanu emva kokuphatha, ihlala amahora angu-2-6.
I-Gestagennye yokukhulelwa komlomo (Charozetta, Microlut, Laktionet, Eksluton). Ukulungiswa kwaleli qembu kuqala ukuthatha amasonto ayi-6-6.5 emva kokubeletha. Ngokusetshenziswa okuvamile futhi okufanele kwamaphilisi amancane, ukusebenza kwabo kokubeletha kufinyelela ku-97-98%.
Kulungile kuhlangene . Ukwamukelwa kwe-gestagen estrogens kungenzeka kuphela uma ukuncelisa isisu kuphelile, ngoba i-estrogen inomthelela omubi ekwenzeni ikhwalithi / ubuningi besibisi sesifuba, kunciphisa ubude bendawo. Amathebulethi kufanele athathwe esimisweni esithile, ngaphandle kokushiywa. Ukuthembeka kokubeletha kwe-COC ku-99-100%.
Ukwelashwa emva kwesigaba se-caesarean kufana nokuvikeleka emva kokulethwa kwemvelo, umehluko munye - iphilisi kufanele iqalwe ithatha amasonto angu-8-9 emva kokuzalwa.
Ukukhulelwa kwemivimbo ye-varicose nama-cysts ovarian
Isifo sama-Varicose asibhekisele kuma-contraindications okuphelele ekusetshenzisweni kokukhulelwa kwe-hormonal, kepha-ke, ama-progestins afakiwe emalungiselelo ama-gestagens kanye nama-estrogens angadala uketshezi kwegazi kanye nesimo semikhumbi enamandla. Ukukhipha ingozi yokukhubazeka okujulile - ukucindezeleka okujulile kwe-vein, kunconywa ukuthi uma kuthathwa isisu somlomo oqhubekayo, bheka i-phlebologist. Ukubonakala kokuvuvukala kwemiphakathi engezansi, ubuhlungu, ukungakhululeki, ukukhulula ngokumelene nesizinda sokuthatha amaphilisi e-hormone - ithuba lokuphulukiswa ngokushesha kumchwepheshe.
Ukwelashwa kwe-hormonal e-cyst ovarian ye-genesis esebenzayo isetshenziswa njengendlela yokuqala yokwelashwa. I-cysts yesikhashana (ukusebenza) iyenzeka kwabesifazane abaneminyaka yobudala yokubeletha, okwelashwa okukhethwe kahle, ngemva kwezinyanga ezingu-2-3. Nge-cysts engavunyelwe, izisu zokubeletha zomlomo ezimbili nezigaba zomzimba ziboniswa ngokubambisana ne-acupuncture and vitamin therapy.
Ukwelashwa kokubeletha
Ukuvimbela ukukhulelwa kwe-myoma ne-uterine
Ukuhlanganiswa kokubeletha komlomo ngokubambisana kuyindlela yokukhetha yokukhulelwa. Kulabo besifazane abathatha i-COC isikhathi eside, isimo sithuthuka kakhulu, umjikelezo wokuya esikhathini uyancipha, ukukhathazeka kwezigulane zamathambo kuyanyamalala, futhi ukwehla okuqhubekayo kumvuthwandaba wokubamba iqhaza kwenzeka. Imithi yokuzikhethela: COC monophasic (Lindineth-20, Yarina , Janine , Regulon ), COC nge-androgenic ephansi (uJeanine, Jess).
I-COC nge-myoma ye-uterine-isifo esibuhlungu se-myometrium, silungisa isizinda se-hormonal, esibangele ukunciphisa inqubo yokukhula / ephindaphindiwe ye-fibroids. Imithi yokuzikhethela: UJeanine, Regulon, Lindineth-20/30.
Ukukhulelwa kwe-endometriosis
Ukuvimbela ukuvimbela i-monophasic e-endometriosis kunomphumela wokwelapha kwi-myometrium ne-endometrium, ukuphumelela kokwelashwa kwesifo ngezidakamizwa zaleli qembu kungu-57-59%. Izidakamizwa zokuzikhethela: uJeanine , Regulon , u- Yarina .