Ukuhlukaniswa kwamaphilisi okulawula ukuzalwa
- Ukuhlanganiswa kokubeletha komlomo (COCs):
- monophasic ( Regulon , Lindineth-30 ). Iqukethe umthamo ohlala njalo we-gestagenic nesici se-estrogenic kuthebulethi ngayinye, ihluke ngohlobo lwe-progestogens, i-estrogens, isilinganiso. Nikeza izinga eliphakeme lokukhulelwa (i-Pearl index 0.06-0.08), uphathe i-endometriosis yesisu ngokuphumelelayo, kuthinteke kahle inkambo nobude besikhathi sokuya esikhathini, ukulinganisela ukuqina kwegazi. Amacala okukhishwa kwamanzi e-interseminal aqoshiwe kakhulu;
- isigaba ezimbili (Adepal, Antotevin). Iqukethe isilinganiso esishintshayo se-gestagen nes estroggen esivamile, kuboniswa abesifazane abanozwela emathunjini, ngezimpawu zomtholampilo ze-hyperandrogenism;
- isigaba sesithathu (Tri-regol, Tri-merci). Efaniswa nokuqukethwe okuguquguqukayo kwe-steroids ngokuhambisana nezigaba zomjikelezo wokuya esikhathini. Banezimpikiswano zomzimba emjikelezweni wokuya esikhathini, banikeze ubuncane bemiphumela emibi, lawula umjikelezo. Baboniswa abesifazane abangaphezu kuka-35 abakhuluphele, ababhemayo.
- Ngomumo wesakhi se-estrogen:
- Izisu zokubeletha zomlomo ze-Gestagenic ("i-mini-drank").
Ezinye izindlela zokusebenzisa ama-COC yizibhebhe eziqukethe ama-progestin ahlanzekile. Umphumela wokukhulelwa we-"mini-second" uhlotshaniswa nezinguquko emgodini we-mucosal uterine, okwenza kube nzima ukufaka iqanda elivundisiwe, futhi ukwandisa i-viscosity ye-mucus yomlomo wesibeletho kuphazamisa ukungena kwe-spermatozoa esibelethweni. Amalungiselelo e-gestagenic abangela ukucindezelwa kokukhiqizwa kwe-lutropin, okuvimbela i-ovulation. I-Minus "i-mini-drank": kwezinye izimo, ukuthatha amaphilisi e-ovulation kwenzeka-lokhu kuchaza okuphansi ekuqhathaniseni ne-COC Pearl Index (0.3-0.6).
Indlela i-COC isebenza ngayo
Izindlela zokuvezwa kwe-OC zenziwa emazingeni ahlukene we-hypothalamus-pituitary-ovary-uterine-uterine tube system. I-steroid ye-synthetic ivimbela ukukhululwa kwe-hormone ye-gonadotropic ye-pituitary nama-hormone we-hypothalamus, okuholela ekususweni kwe-ovulation, inzalo yesikhashana. Ngokudlula, ama-gestagens ezakhiwe kanye ne-ethinyl estradiol evimbela i-folliculogenis, okwenyuka ukwehla ngobukhulu bama-ovari, ukwehla ekusithekeni kwe-estrogens ngesici se-2. I-Undergoes deformations ne-endometrium - kukhona ukuguqulwa komjikelezo kanye nokuguqulwa kokubhala kwangasese ngaphambi kwesikhathi, kunezinguquko ze-atrophic ezinomthelela wokulwa nokufaka impande. I-hormonal contraceptive ivimbela i-peristalsis yamatayipi angama-fallopian, unciphisa ukuhamba kweqanda elivundisiwe, inqamule umqubu womlomo wesibeletho, okwenza kube nzima ukungena kwe-spermatozoa emgodini wesibeletho.
Indlela Yokukhetha Amaphilisi Okulawula Ukuzalwa
Isimiso esiyinhloko sokukhetha i-OP ukusebenzisa i-dose encane engaba khona ye-steroids, okuzohlinzeka ngokuvikelwa okuphumelelayo ekukhulelweni okungahlelelwe. Uhlobo lwesisu lwe-estrogenic yizidakamizwa eziphakanyiswayo ezivezwe yi-component eqinile ye-gestagenic (i-Ovidon, i-Rigevidone). Ukulungiswa komugqa wokuqala wabesifazane abanama-gestagens - Regulon, Logest. Uma ukhetha Kulungile, udinga ukucabangela usayizi wesibeletho kanye nekhwalithi yokuya esikhathini, ngoba lezi zimingcele zibonisa isizinda se-hormonal kangcono kakhulu kunokuhlola izibonakaliso zangaphandle: ukuhamba esikhathini esifanele kubonisa umsebenzi owandayo we-progesterone, isikhathi eside nokuningi - mayelana nomsebenzi we-estrogen. Qala ukuthatha imithi yokuvimbela imithi ye-hormone kufanele ivela ezidakamizweni ezihlanganisiwe ezinomthamo osencane wezingxenye ezingenayo. Amaphilisi amancane amathathu nesigaba esincane aphikisana - ngokusetshenziswa okulinganayo kuphephile futhi kusebenza ngokulinganayo. Isimiso sokukhetha okulungile kwe-OK kungukuthi akukho ukuphuma kwegazi ngaphakathi, ukuphuma kwegazi "ukuphumelela". Ulwazi oluthe xaxa mayelana nokukhethwa kwe-OK ungathola lapha .
Indlela yokuphuza amaphilisi okulawula ukubeletha:
- Izisu zokubeletha ngomlomo zithathwa izinsuku ezingu-1-5 emva kokuphuma kokuphuma esikhathini. Ama-COC aseMonophasic aqala ukuphuza amaphilisi ngosuku oluhambisana nalo lwesonto, ama-multiphase - ngethebhulethi ebhalwe phansi "ekuqaleni kokuthola";
- Ama-OP asathathwa nsuku zonke, ngesikhathi esithile, ngezinsuku ezingu-21;
- emva kokuthatha iphilisi lokugcina ephaketheni lilandela ukuphumula kweviki elilodwa, lapho kutholakala khona ukusabela kokuya esikhathini. Iphakheji elilandelayo lesidakamizwa iqalwa ngosuku lwesishiyagalombili lwenqamu;
- uma kungekho "impendulo yokuhoxiswa", amaphilisi aqhubeka nokuphathwa ngokulandela uhlelo lwendabuko lapho kukhishwa ukukhulelwa. Ngaphandle kwalokho, umuthi umisiwe;
- imibuzo yokuphathwa ngokufanayo kwe-COC kanye nemithi (i-anticonvulsants, antibiotics) iqondiswa ngabanye;
- kubalulekile ukwazi ukuthi emva kokuyeka i-COC, ukukhulelwa kungenzeka kakade kumjikelezo wokuqala wokukhansela.
Ukusetshenziswa kwamaphilisi okulawula ukuzalwa:
- ukusebenza ngokushesha, cishe ukuthembeka kokubeletha okungu-100%;
- ukubuyela emuva kwendlela, ukutadisha ngokucophelela;
- ithuba lokuziqaphelisa lokuzala;
- imvamisa ephansi yemiphumela emibi;
- ukulula kwesicelo, ukungenakwenzeka kokudlula ngokweqile;
- ukunciphisa izingozi zokukhulelwa kwe-ectopic;
- ukwehla ngeziqephu zezifo ezivuthayo ezithombeni zomzimba;
- ukuvimbela ukuthuthukiswa kwezicubu ezinobungozi zesisu kanye namaqanda;
- ukukhululeka kwezibonakaliso ze-dysmenorrhea, i-PMS;
- umphumela omuhle endometriosis;
- umphumela wokwelashwa esikhunjeni se-seborrhea, ama-pimples angcolile.
Kungozi:
- ingozi yomdlavuza wesibeletho kwabesifazane abasebenzisa i-OC isikhathi eside (iminyaka engaphezu kwengu-10) yanda.
Amaphilisi okukhulelwa: ukuphikisana
- I-neoplasms enonya yezitho zangasese / isifuba;
- ukukhulelwa / okusolakala ukuthi ukukhulelwa;
- ukukhubazeka okukhulu kwenhliziyo;
- ukucindezeleka okukhulu kwemisebenzi, izifo ezimbi, izicubu zesibindi;
- i-thrombosis, i-thrombophlebitis, i-thromboembolism;
- ukuphuma kwe-genesis engacacisiwe.
Izici zengozi:
- ukuphuza ngokweqile kwe-nicotine;
- ukukhuluphala, i-porphyria, ukuchithwa kwempahla;
- isifo sofuba, ukungenela okuzayo okuzayo;
- isithuthwane, ukucindezeleka isikhathi eside, uterine fibroids;
- i-jaundice, i-migraine, i-hypercalcemia, i-hyperlipidemia.
Izinto ezinciphisa ukuthembeka kokulungile:
isifo sohudo, ukuhlanza, ukungena kanyekanye kwe-laxatives, i-anticonvulsant, i-antibacterial.
Imiphumela emibi:
- i-estrogen-kuxhomeke: ukuhlanza, isicanucanu, ukucindezeleka kwegazi, ukukhanda ikhanda, isizungu, isisindo somzimba, isisindo somzimba;
- I-progestogen-ixhomeke ekunciphiseni i-libido, ukucindezeleka, i-acne, eyomile ye-vaginal mucosa, ikhanda, ukukhathala;
- umphumela we-estrogenic owanele: ukwehla kwesayizi webele, ukunciphisa i-libido, ukuhamba esikhathini esibi, ukuphuma kwegazi ngaphakathi;
- Impumelelo ye-progestogenic: ukubambezeleka kokuya esikhathini, ukufihla okuphakathi phakathi kwengxenye yesibili yomjikelezo, ukuhamba esikhathini esiningi.
Umphumela wangemuva ngemuva kokuthatha izisu zomlomo kungase kube ngenxa yokungaboni ngaso sonke isikhathi noma isenzo samathebulethi. Umthelela ohlangothini ungahle ungabi nengozi noma uyingozi emzimbeni, kungakhathaliseki imbangela yokuqala. Ukuqedwa kwesidakamizwa kuvame ukuholela ekushabalaleni kwesenzo esinjalo ngaphansi kwethonya lokwelapha noma ngokuzimela.
Amaphilisi okulawula ukuzalwa okuhle kakhulu
Ngokwemvume efanele, ukwethenjelwa kwezibeletho zomlomo kuzama ukuba ngu-100%, isilinganiso sokuthi "ukuphepha / ukwethenjelwa" amaphilisi e-hormone akuphelelanga amakhondomu. Ungafunda kabanzi ngamakhondomu lapha . Ama-COC wesizukulwane sakamuva aqukethe ama-hormone emazingeni aphansi, ngaphandle komphumela we-androgenic. Gwema ukusabela okungahle kwenzeke kungenzeka ngokuhlolwa kwezokwelapha, okunconywe ngaphambi kokuqala ukuthatha amaphilisi. Ukukhulelwa kwe-hormonal kuvuselelwa, izinga lokuvuselelwa komjikelezo lixhomeke esikhathini sokudla kwezidakamizwa kanye nesizinda sangempela se-hormonal. Isidakamizwa esihle asikho. Okusha - akusho okungcono kakhulu. Umthetho oyinhloko: ukwelashwa kwe-hormonal ukhethwe, okulawulwa yi-gynecologist yokwelapha ngokuhambisana nezici zomzimba wesifazane.