Njira zakulera za matenda a shuga 1: A mpaka Z

Mbiri ya kulera kwa akazi ndi amuna idayamba zaka masauzande ambiri. Njira zambiri zamakono zakulera zinali ndi machitidwe awo zaka mazana angapo zapitazo. Tikukhala munthawi yomwe kugonana pakati pa mwamuna ndi mkazi ndi kotheka popanda kutenga pakati. Pakadali pano, pali kusankha kwakukulu kwa njira zakulera, kutengera zofuna zanu, moyo wanu ndi kusowa kwa zotsutsana.

Komabe, vuto la kulera pakati pa matenda ashuga 1 sikuti limangophikidwa ndi madokotala omwe amapezekapo, ndipo pali zambiri zambiri zotsutsana pa intaneti. Pali mafunso ambiri omwe simumapeza mayankho nthawi zonse. Kodi njira zakulera ndizothandiza bwanji? Njira iti yothandiza kwambiri? Kodi amaloledwa kukhala ndi matenda ashuga? Kodi zingayambitse kuwonongeka kwa milingo ya shuga, kumayambiriro kapena kukula kwa zovuta za matenda ashuga? Kodi "kuvulaza" ndikugwiritsa ntchito bwanji mankhwala a mahomoni? Momwe mungasankhire njira yoyenera ine? Kodi zitha kunditeteza bwanji? Ndi mafunso ena ambiri. Munkhaniyi tiyesera kuyankha ambiri a iwo.

Kulera (kuchokera ku novolat. "Contraceptio" - makalata. - kupatula) - kuletsa kutenga pakati ndi makina, mankhwala ndi njira zina zakulera.

Kusankha njira yolerera, tiyenera kupeza bwino pakati pa kugwiriridwa kwa njirayo, kuopsa kwake ndi zotsatirapo zake, malingaliro okonzekera kutenga pakati ndi zomwe amakonda.

Amayi onse amisinkhu yokhala ndi matenda a shuga kapena opanda matenda a shuga amawagawa m'magulu awiri: omwe akufuna kukhala ndi pakati komanso omwe safuna kukhala ndi pakati. Kwa amayi omwe akukonzekera kukhala ndi pakati, ndikofunikira kuti akonzekere moyenera pamodzi ndi endocrinologist ndi dokotala wazachipatala. Kumbukirani kuti kutenga pakati kumachitika ndi kuchuluka kwa hemoglobin yayikulu komanso kusowa kwa chipukutiro cha matenda ashuga, kuopsa kwa kusiyana kwa kubereka kwa ana, zovuta za pakati komanso kubereka kumawonjezeka. Chifukwa chake, ndikofunikira kukonzekera pakati ndipo nthawi yakukonzekera gwiritsani ntchito njira yoyenera yolerera kwa inu. Kwa amayi omwe sakukonzekera kutenga pakati, nkhani yoletsa kulera ndiyofunikanso kupewa mimba yosafunikira.

Palibe njira zakulera zomwe zimaphatikizidwa kwathunthu mu shuga. Popeza kuchuluka kowopsa kwa mwana wosabadwayo ndi mayi panthawi yapakati yosakonzekera, njira zomwe zimagwira bwino ntchito kwambiri zimasankhidwa. Chofunikira kwambiri chachipatala chomwe chimasankha kusankha njira zolerera ndi kukhalapo kwa zovuta zamatenda a mtima. Pazifukwa izi, muyenera kuyesedwa ndi dokotala musanasankhe njira yodzitetezera. Palibe chifukwa chomwe mungayambire kutenga njira za kulera nokha.

Mukamasankha njira yodzitetezera, ndikofunika kuti muziiganizira za chitetezo chake komanso chitetezo chake. Kuti muwone kuyendetsera bwino kwake, cholozera chimagwiritsidwa ntchito chomwe chikuwonetsa kuti ndi azimayi angati mwa zana omwe adakhala ndi pakati pogwiritsa ntchito njira imodzi kapena ina yolerera kwa chaka chimodzi. Palibe njira imodzi yomwe ilipo 100% yothandiza. Kumbukirani kuti posatengera kulera mwa amayi 100, opitilira 80 amakhala ndi pakati chaka chimodzi. Kudalirika kwa njira zambiri zotetezera kumatengera kulondola kwa kugwiritsidwa ntchito kwawo.

Muyenera kudzisankhira nokha nthawi yomwe mayi sangathe kukhala ndi pakati - mwezi, chaka, zaka 10, kapena simukonzekera ana konse. Pali njira zakulera zazifupi komanso zazifupi.

Mpaka kulera kwa nthawi yayitali kuphatikiza zida za intrauterine ndi zodulira zam'mimba. Njira zakulera izi sizitanthauza kuti mukhale nawo pachiwonetsero ndipo ndinu otetezeka, kuphatikizapo matenda ashuga amtundu 1. Kukhazikitsa kwawo kumatenga mphindi zingapo, kupereka njira yodalirika yolerera.

Makina a intrauterine.

Chipangizo cha intrauterine (IUD) ndi pulogalamu ya intrauterine, yomwe ndi chipangizo chaching'ono chopangidwa ndi pulasitiki chokhala ndi mkuwa chomwe chimalepheretsa umuna kulowa muchiberekero, kuletsa dzira ndi umuna kuti usakumane, komanso kupewa mazira okhathamira kuti asamatenge kukhoma kwa chiberekero. Malinga ndi ziwerengero, azimayi amodzi mwa 100 aliwonse omwe ali ndi njira yolerera imeneyi amakhala ndi pakati. Proteerone ya mahormoni kuchokera munthawiyi imatulutsidwa pang'onopang'ono, koma mosalekeza, kumathandizira kuchepa kwa gawo logwira ntchito mkati mwa khoma la chiberekero (endometrium), lomwe limalepheretsa dzira losauthira kuti lisamatike kukhoma la uterine, ndikupanganso khomo lachiberekero cha chiberekero (izi zimapangitsa kuti zikhale zovuta kulowa kwa umuna ikhoza kukumana ndi dzira). Ubwino wa njirayi ndi njira zabwino zakulera, osafunikira pakudya pafupipafupi, monga momwe zilili ndi mapiritsi. Kuzungulira kumakhala kwa zaka 5. Zowopsa ndizoyipa zamavuto monga matenda, komanso nthawi zochulukirapo komanso zopweteka. Ma IUD nthawi zambiri amakhazikitsidwa kwa amayi omwe abereka. Zomwe zilipo zikuwonetsa zisonyezo zofanizira kukhazikitsa chipangizo cha intrauterine monga momwe ziliri ndi amayi opanda shuga. Njirayi imachepetsa chiwongolero cha matenda ashuga.

Zoletsa za kulera.

Zomwe zimayikidwa zimayikidwa pang'onopang'ono, ndipo zotulukapo zake zimatheka ndikupondereza ovulation (kutuluka kwa dzira kuchokera ku thumba losunga mazira). Mukamagwiritsa ntchito, mayi m'modzi mwa 100 aliwonse amatha kukhala ndi pakati. Imayikidwa pogwiritsa ntchito mankhwala oletsa ululu kwa zaka zitatu. Ubwino wake ndiwodziwikiratu - kukwera kwambiri, kukhazikitsa kamodzi kwa zaka zitatu. Zoyipa ndizovuta zakuwonera komanso zazing'onoting'ono zomwe zimachitika nthawi zambiri m'miyezi yoyambirira.

Zingwe za subcutaneous ndizotetezanso kwa anthu omwe ali ndi matenda ashuga. Malinga ndi kafukufuku, mankhwalawa sanakhudze kuchuluka kwa hemoglobin wa glycated ndipo sanathandizire kukula kwa zovuta za matenda ashuga. Chifukwa chofutira kwambiri chowasiya iwo chinali kuwonera kwakanthawi.

Mpaka kulera kwakanthawi kochepa phatikizani njira zakulera za pakamwa komanso ziwongola dzanja. Izi ndi njira zofala kwambiri zakulera. Komabe, chaka chimodzi chitatha kugwiritsa ntchito njirayi, azimayi 68% okha ndi omwe amapitiliza kudya, chifukwa mapiritsi amayenera kumwedwa tsiku lililonse, zigamba zimasinthidwa sabata iliyonse, ndipo zimakhazikika pamwezi. Pamaso pa mtundu 1 wa shuga wopanda vuto la mtima, phindu la mankhwalawa limaposa zowopsa zake.

Pakamwa (pakamwa) njira zakulera kapena mapiritsi otithandizira.

Iyi ndi imodzi mwazofala kwambiri njira zakulera. Pali magulu angapo a mapiritsi a kulera: kuphatikiza mankhwala (yokhala ndi mahomoni awiri - estrogen ndi progesterone) komanso kokha progesterone - yokhala mankhwala. Choyambirira, mahomoni awa amachita ngati mazira, kutsekereza kutuluka kwa dzira (ovval). Kuphatikiza apo, mahomoni awa amapangitsa kuti khomo lachiberekero libere, ndikupanga endometrium kuonda, zomwe zimalepheretsa dzira lolumikizidwa kukhoma la chiberekero. Timakambirana pagulu lililonse.

Kafukufuku wa Epidemiological awonetsa kuti kutenga kuphatikiza kulera kwamlomo mogwirizana ndi chiwopsezo chachikulu cha matenda a mtima. Inde, kumwa mankhwalawa kumatha kutenga nawo gawo mu zovuta za matenda a shuga zomwe zilipo. Kuphatikiza apo, asadakhazikitsidwe, ndikofunikira kuwunika zomwe zikuwonetsa momwe magazi amapangidwira, chifukwa chiopsezo chopanga magazi amawundana (magazi amawonjezera).

Chifukwa chake, mapiritsi othandizira kubadwa awa ndi oyenera ngati muli ndi zaka zakubadwa 35 ndipo mulibe zovuta zofanana ndi zotupa za msana komanso ziwopsezo monga kuthamanga kwa magazi, kunenepa kwambiri, kusuta komanso kukhalapo kwa venous thrombosis m'mbuyomu.

Njira zophatikizira zakuthirira pakamwa, zikagwiritsidwa ntchito mu Mlingo waukulu, zimakhudza kufunika kwa insulini, kuonjezera, ndipo Mlingo wochepa mphamvu izi ndizochepa.

Malinga ndi ziwerengero, azimayi amodzi (1) mwa 100 aliwonse omwe amamwa mapiritsiwa nthawi zambiri amakhala ndi pakati. Ubwino wawo ndiwothandiza bwino, owerengeka azotsatira zoyipa, ndipo amagwiritsidwanso ntchito nthawi zopweteka komanso zolemetsa. Ndipo zovuta zake ndi chiopsezo chambiri chakutulutsa magazi (ziwunda za magazi), kufunikira kwa kuvomerezedwa kosalekeza popanda mipata, zotsutsana ndi matenda ena.

Mankhwala okhala ndi progesterone.

Kukonzekera komwe kumakhala ndi progesterone kapena zakumwa zoziziritsa kukhosi (ndiye kuti, "mapiritsi ochepa") kumakhala koyenera kwa amayi omwe ali ndi matenda amtundu wa 1, chifukwa sizikhudza chiwopsezo cha matenda ashuga kapena chiopsezo chokhala ndi zovuta za matenda ashuga. Malinga ndi ziwerengero, azimayi amodzi (1) mwa 100 aliwonse omwe amamwa mapiritsiwa nthawi zambiri amakhala ndi pakati. Zoyipa za njira yolerera za kulera ndizotheka kusakhazikika kwa msambo komanso kuti zimayenera kutengedwa panthawi yotsimikizika. Amachitapo kanthu chifukwa cha kuchuluka kwa ntchofu mu khomo lachiberekero, kupatulira kwa chiberekero, komanso kutsekeka kwa mazira m'mimba. Kuphatikiza apo, mankhwalawa nthawi zambiri amagwiritsidwa ntchito ndi akazi anyama, azimayi opitirira zaka 35, komanso osuta.

Muyenera kuzigwiritsa ntchito molingana ndi malamulo ovomerezeka kuti mudziteteze ku mimba. Zomwe zimayambitsa kulephera kulera pakumwa mapiritsi oletsa kubereka ndi kulumpha, kumwa mankhwala, kapena zinthu zina zomwe zimakhudza kugwira bwino ntchito (monga kumwa maantibayotiki, kusanza, kapena kutsekula m'mimba).

Kuphatikiza kulera kwamlomo

Njira zophatikiza zakulera za pakamwa (COCs) ndi mapiritsi oteteza kubala omwe ali ndi mitundu iwiri ya mahomoni: estrogens ndi progestins. Estrogen m'mapiritsi oteteza kubala amakwanira kuperewera kwa estradiol, kapangidwe kazachilengedwe komwe kumapanikizidwa m'thupi. Chifukwa chake, kuwongolera kwa kusamba kumapitilizidwa. Ndipo progestin (progestogen) imaperekanso njira zolerera za ma COC.

Musanagwiritse ntchito njira yolerera ya mahomoni, kaonaneni ndi dokotala ndikukuwunika. Awa ndi mayeso am magazi a ntchito ya platelet, AT III, factor VII ndi ena. Ngati mayeserowa atakhala oyipa - njira yoletsa kubereka siyabwino kwa inu, chifukwa pali chiopsezo cha venous thrombosis.

Pakadali pano, njira zakulera zophatikizira pakamwa ndizodziwika kwambiri padziko lonse lapansi, komanso mwa azimayi omwe ali ndi matenda ashuga. Zifukwa zake:

Ma COC amateteza modziteteza ku mimba zosafunikira,
Nthawi zambiri amaloledwa ndi akazi,
atayimitsa mapiritsi, azimayi ambiri amatenga pakati pakatha miyezi 1 mpaka 12,
kumwa mapiritsi ndikosavuta kuposa kumangowerenga kumene, kupanga jakisoni, ndi zina zambiri,
njira yolerera yothandizira imakhala ndi zowonjezera zowonjezera zowonjezera komanso prophylactic.

Contraindative kugwiritsa ntchito limodzi pakamwa kulera azimayi omwe ali ndi matenda ashuga:

Matenda a shuga salipidwa, i.e. shuga amawonjezereka,
kuthamanga kwa magazi pamtunda wa 160/100 mm RT. Art.,
dongosolo lotsekemera limaphwanyidwa (kutulutsa magazi kwambiri kapena kuchuluka kwa magazi),
zovuta zamatenda a shuga atapangidwa kale - proliferative retinopathy (2 zimayambira), matenda a shuga ndi nephropathy pa gawo la microalbuminuria,
wodwala alibe luso lokwanira kudziletsa.

Zotsatira za kutenga ma estrojeni ngati gawo limodzi la njira zakulera zapakamlomo:

chiopsezo chowopsa cha magazi ndi kufinya kwa mitsempha yamagazi (pimani mayeso ndikufufuza!),
wapeza matenda amisala,
matenda a chiwindi (hepatitis, Rotor, Dabin-Johnson, Gilbert syndromes, cirrhosis, matenda ena omwe amakhala ndi matenda a chiwindi).
kutulutsa magazi kumiseche, zomwe sizimveketsa bwino,
zotupa zodalira mahomoni.

Zinthu zomwe zimawonjezera chiopsezo cha mavuto a estrogen:

kusuta
ochepa matenda oopsa,
zaka zopitilira 35
kunenepa kwambiri kuposa madigiri 2,
cholowa chovuta m'matenda a mtima, i.e.banja panali zochitika za matenda a mtima kapena sitiroko, makamaka osakwana zaka 50,
mkaka wa m'mawere (yoyamwitsa).

Kwa amayi omwe ali ndi matenda ashuga, njira yotsika ndi yokhala ndi kachulukidwe kakang'ono kamakhala koyenera.

Ma COC ochepera - okhala ndi zochepa za 35 μg za estrogen. Izi zikuphatikiza:

monophasic: "Marvelon", "Femoden", "Regulon", "Belara", "Jeanine", "Yarina", "Chloe",
Gawo lachitatu: "Tri-Regol", "atatu-Merci", "Trikvilar", "Milan".

Ma COC osakanizidwa - amakhala ndi 20 mcg kapena kuchepera kwa gawo la estrogen. Izi zikuphatikiza kukonzekera monophasic "Lindinet", "Logest", "Novinet", "Mercilon", "Mirell", "Jacks" ndi ena.

Kwa amayi omwe ali ndi matenda ashuga, njira yatsopano kwambiri yopetsera kubereka inali chitukuko cha KOK, chomwe chili ndi estradiol valerate ndi dienogest, yokhala ndi mtundu wamphamvu wa "Klayra").

Njira zonse zophatikizira zakulera pakamwa zimakulitsa milingo ya triglyceride m'magazi. Koma ichi ndi chiopsezo chokhacho kwa azimayi omwe kale anali ndi hypertriglyceridemia asanamwe mapiritsi. Ngati mayi ali ndi dyslipidemia wolimbitsa thupi (kuchepa kwamafuta metabolism), ndiye kuti ma COC amakhala otetezeka. Koma pakudya kwawo, muyenera kumayesa magazi pafupipafupi kwa triglycerides.

Vaginal mahomoni mphete NovaRing

Njira yachikazi yogwiritsira ntchito mahomoni a steroid yoletsa kubereka, pazifukwa zambiri, ndibwino kuposa kumwa mapiritsi. Kutulutsa kwa mahomoni m'mwazi kumakhala kosasunthika. Zinthu zomwe sizikugwira zimawonekera pang'onopang'ono kudzera pachiwindi, monga momwe amalembedwera mapiritsi. Chifukwa chake, mukamagwiritsa ntchito njira zakulera zazikazi, mlingo wa mahomoni tsiku ndi tsiku umatha kuchepetsedwa.

Mphete yam'mimba ya NovaRing imakhala yoletsa kubereka mwa mawonekedwe a mphete yowonekera, masentimita 54 mm ndi mainchesi 4 mm pamagawo a mtanda. Kuchokera pamenepa, ma micil 15 a ethinyl estradiol ndi ma ma microgram 120 a etonogestrel amamasulidwa kumaliseche tsiku lililonse, iyi ndi metabolite yogwira ya desogestrel.

Mzimayimayala payekhapayekha amaloza mphete yoletsa kubereka kudzera mu nyini, osagwira nawo ntchito zachipatala. Iyenera kuvalidwa masiku 21, ndiye yopuma masiku 7. Njira yolerera yolerera imakhudza kwambiri kagayidwe kazakudya zamafuta ndi mafuta, ofanana ndi microdosed ophatikizana am'kamwa.

Mphete yam'mimba ya NovaRing imasonyezedwa makamaka kuti imagwiritsidwa ntchito ndi azimayi omwe shuga imaphatikizidwa ndi kunenepa kwambiri, magazi okwera a triglycerides kapena kuwonongeka kwa chiwindi. Malinga ndi kafukufuku wakunja, zizindikiro za ukazi sizimasintha pamenepa.

Zikhala zothandiza kukumbukira kuti azimayi omwe ali ndi kunenepa kwambiri komanso / kapena shuga wambiri chifukwa cha matenda ashuga amakonda kwambiri candidiasis vulvovaginitis. Izi zikutanthauza kuti ngati muli ndi thrush, ndiye kuti siyosavuta kugwiritsa ntchito njira yakulera ya NovaRing, koma yafika pazifukwa zina.

Chigamba cholera.

Mtundu wophatikiza kulera wokhala ndi estrogen ndi progesterone.Ichi chigamba chimamangiriridwa pakhungu. Ubwino wamtunduwu ndizosavuta kugwiritsa ntchito, kugwiritsa ntchito bwino, komanso kupepuka komanso nthawi zopweteka. Choyipa chake ndikuletsa ntchito kwa gulu lina la anthu. Simalimbikitsidwa kwa azimayi azaka zopitilira 35, osuta fodya, komanso azimayi olemera kuposa makilogalamu 90, popeza kuchuluka kwa mahomoni kungakhale kosakwanira kuteteza kutenga pakati.

Mpaka njira zopanda mahomoni monga makondomu, ma diaphragms, ma spermicidal gels, njira yolerera yachilengedwe. Ngati mkazi sakufunanso ana, ndizotheka kugwiritsa ntchito njira yolera yotseketsa.

Njira zotchinga.

Izi zikuphatikiza ma kondomu (achimuna, achikazi), ma diaphragms. Amaletsa umuna kuti usalowe muchiberekero. Kuchita kwawo kumachepera pang'ono. Mukamagwiritsa ntchito kondomu ya abambo, azimayi awiri mwa 100 aliwonse amatha kukhala ndi pakati. Ubwino ndi kusowa kwa chiwopsezo chachipatala, komanso mavuto ena. Kuphatikiza apo, kumbukirani kuti makondomu amateteza ku matenda opatsirana pogonana. Zoyipa zake ndikuchepa kwa kudalirika kwa njirayo, kufunika koigwiritsa ntchito nthawi iliyonse, komanso mwayi wophwanya umphumphu wa kapangidwe kake.

Kuchokera pamalingaliro azachipatala, njira zotchinga ndizoyenera kwa azimayi onse omwe ali ndi matenda amtundu wa 1 chifukwa chochepa cha zoyipa ndi zotsatira zake pakulamulira matenda ashuga. Makondomu, ma spermicides ndi ma diaphragms ndi njira zabwino zolerera ngati zigwiritsidwa ntchito moyenera komanso mosalekeza. Komabe, kupambana kwa njirazi kumatengera kudzipereka kwanu munjira iyi komanso kugwiritsa ntchito nthawi zonse. Ndi abwino kwa amayi omwe safuna kumwa mankhwala a mahomoni omwe akukonzekera kukhala ndi pakati pa miyezi isanu ndi umodzi ndi itatu, ndipo, mwanjira zina, azimayi omwe amalephera kugwiritsa ntchito njira zina zotetezera.

Zachidziwikire, kwa azimayi omwe alibe mnzawo wogonana, makondomu amayenera kugwiritsidwa ntchito kuti ateteze kumatenda opatsirana pogonana. Iyi ndiye njira yokhayo yodzitetezera yomwe imateteza ku matenda awa.

Mukamasankha njira zotere, muyenera kudziwitsidwa ndi dokotala za njira zakulera mwadzidzidzi. Njira zakulera zadzidzidzi zimagwiritsidwa ntchito ngati simukufuna kutenga pakati: pogonana popanda njira zakulera, ngati kondomu idawonongeka, ngati mukuphonya mapiritsi oletsa kubereka, kapena ngati mumamwa maantiamu omwe amachepetsa mphamvu ya mapiritsi oteteza kulera.

Kwa azimayi omwe safunanso kukhala ndi pakati, njira yolera yotsekera ndi yankho linanso. Komabe, njira zomwe zili pamwambazi sizotsika pakulimbitsa thupi ndipo sizikuchita opareshoni. Kuchita chokomera chachikazi ndi njira yochitira opaleshoni njira yolerera, yozikidwa pakapangidwe kazinthu zoletsa ma fallopian machubu. Ndiosavuta kuchita izi munthawi ya cesarean. Samisili yazimayi sichimasintha ma hormonal. Mutha kukambirana za nkhaniyi ndi dokotala nthawi yonse yomwe mwakonzekera. Kuchepetsa amuna ndi kothekanso - vasectomy, opareshoni yomwe kunyamula kapena kuchotsa chidutswa cha vas deferens kumachitika mwa amuna. Ndizofunikira ngati muli ndi bwenzi logonana nthawi zonse.

Njira zachilengedwe zakulera.

Izi zimaphatikizapo kusokonezedwa kugonana ndi kugonana masiku "otetezeka". Zachidziwikire, muyenera kumvetsetsa kuti njirazi ndizothandiza kwambiri. Kuti mudziwe masiku "otetezeka", ndikofunikira kuzungulira kwazonse pogwiritsa ntchito zizindikiro monga kutentha kwa thupi, kutuluka kwamkati ndi mayeso apadera kuti mudziwe tsiku la ovulation. Ubwino wake ndi kusapezeka kwa mavuto, kuwonjezera pa chiwopsezo chachikulu cha kutenga pakati.

Pomaliza, ndikufuna kudziwa kuti kutenga pakati sikuyenera kukhala kokha kosangalatsa, komanso kukonzekera, chifukwa chake ndikofunikira kufikira nkhaniyi mozama. Pakadali pano pali msika wambiri woletsa kulera, ndipo, chifukwa cha izi, mutha kuchita zogonana osawopa kukhala ndi pakati. Kutengera mapulani anu apakati, zomwe mumakonda, momwe mumakhalira, komanso kupezeka kwa zovuta za matenda ashuga, inu ndi dokotala mudzatha kusankha njira yabwino yodzitetezerani.

Kugwiritsa ntchito ozungulira mu shuga

Pafupifupi 20% ya amayi omwe ali ndi matenda osokoneza bongo amakonda kugwiritsa ntchito njira zakulera zamkati, zomwe zimazungulira, monga chitetezo pamimba yosafunikira. Malo ozungulira oterewa ndi kapangidwe kakang'ono ngati T, kamakhala ndi waya wotetezeka kapena pulasitiki wamkuwa, yemwe amaikiratu chiberekero.

Zipangizo zamkati mwa intrauterine zimapangidwa mwanjira yoti kupatula kuvulaza kulikonse kwa uterine mucosa. Amapereka chitetezo pamimba yosakonzekera mwina pogwiritsa ntchito waya wabwino kwambiri wamkuwa kapena chidebe chaching'ono chomwe chili ndi progestin ya mahomoni, yomwe imamasulidwa pang'onopang'ono pakugwiritsa ntchito.

Kudalirika kwa njira zakulera zapakati pa intrauterine ndi 90%, komwe ndiwokwera kwambiri. Kuphatikiza apo, mosiyana ndi mapiritsi omwe amayenera kumwedwa tsiku ndi tsiku, ozungulira amafunika kukhazikitsidwa kamodzi basi osadandaula za chitetezo pazaka 2-5 zotsatirazi.

Ubwino wogwiritsa ntchito kuzungulira kwa matenda ashuga:

Kuzungulira sikukhudza shuga wamagazi, zomwe zikutanthauza kuti sizimapangitsa kuchuluka kwa glucose komanso sikukukulitsa kufunikira kwa insulin,
Njira zakulera za intrauterine sizipangitsa kuti magazi azisunthika komanso samathandizira kuti magazi azitsekeka, motsatiridwa ndi kukula kwa thrombophlebitis.

Zoyipa za njira yolera:

Odwala omwe amagwiritsa ntchito intrauterine, vuto la mkombalo limapezeka kwambiri. Imadziwonetsa pakukhathamira kochulukirapo komanso kotalika (masiku opitilira 7) ndipo imakonda kutsagana ndi kupweteka kwambiri,
Kuzungulira kumawonjezera mwayi wokhala ndi ectopic mimba,
Kulera kwamtunduwu kumatha kudzetsa matenda otupa a ziwalo zoberekera za akazi ndi ziwalo zina za m'chiuno. Kuchepa kwa kutupa kumakulitsidwa makamaka ndi matenda ashuga,
Spirals amalimbikitsidwa kwambiri kwa amayi omwe ali ndi ana kale. Atsikana achichepere amatha kuyambitsa mavuto akulu m'mimba,
Mwa akazi ena, kuvutikira kumapangitsa kupweteka pakati pa kugonana,
Nthawi zina, zimapangitsa kuwonongeka kwa makoma a chiberekero, komwe kumatha kupangitsa magazi kulowa mkati.

Monga tikuwonera kuchokera pamwambapa, kugwiritsa ntchito intrauterine zida sikuletsedwa mu shuga mellitus. Komabe, ngati mkazi ali ndi zotupa mu chiberekero ndi zowonjezera kapena matenda osachiritsika, ndiye kuti kuyika chida cha intrauterine sikofunikira kwenikweni.

Kuphatikiza apo, ziyenera kudziwika kuti ndi gynecologist yekha yemwe amatha kuyika mpweya motsatira malamulo onse. Kuyesa kulikonse kopanga njira yoletsa kubereka kumatha kukhala ndi zotsatirapo zoyipa kwambiri. Katswiri wa zamankhwala amathandiziranso kuchotsa zozungulira mu chiberekero.

Kwa omwe akukayikira ngati mizere ili yoyenera kwa odwala matenda ashuga, wina ayenera kufotokozera momwe njira zakulera zimagwirira ntchito komanso ndi mtundu wanji wa mpweya womwe umagwira kwambiri.

Mitundu yonse ya zida zamtundu wa intrauterine:

Musalole mazira kulowa mkati mwa khoma la chiberekero.

Amalepheretsa kudutsa kwa umuna kudzera pachiberekero,
Zimaphwanya njira ya ovulation.

Kuwononga umuna ndi ova.

Mitsempha yokhala ndi progestin komanso mkuwa imakhala ndi kudalirika kofanana, komabe, mizere yolumikizana ndi waya wamkuwa imakhala ndi moyo wautali - mpaka zaka 5, pomwe mizere yokhala ndi progestin imagwira ntchito osaposa zaka zitatu.

Ndemanga za kugwiritsidwa ntchito kwa chipangizo cha intrauterine pa matenda ashuga ndizosakanikirana kwambiri. Amayi ambiri adayamika njira yolera yapa kubereka komanso kutha kwake. Kugwiritsa ntchito mpweya kumathandizira kuti azimayi azimasuka komanso kuti musawope kuphonya nthawi yomwera mapiritsi.

Chida cha intrauterine ndi choyenera kwambiri kwa odwala omwe ali ndi matenda ashuga kwambiri, momwe amaletsedwa kugwiritsa ntchito njira zakulera za mahomoni. Koma amayi ambiri amawona kuti kugwiritsa ntchito kwake kumatha kuyambitsa zovuta zoyipa, kuphatikizira kupweteka m'mutu ndi kutsika kumbuyo, kusinthika kwa machitidwe komanso kuchepa kwakukulu kwa libido.

Kuphatikiza apo, kuwerengera ndemanga za odwala omwe ali ndi matenda ashuga, munthu sangathe kulephera kudandaula za kuchuluka kwakukulu kwa kulemera pambuyo pa kukhazikitsidwa kwa spiral, komanso mawonekedwe a edema, kuchuluka kowonjezereka komanso kukulira kwa ma comedones kumaso, kumbuyo ndi mapewa.

Komabe, azimayi ambiri amakhutira ndi kugwiritsa ntchito chipangizo chamkati ndipo ali ndi chidaliro kuti kulera koteroko kwa matenda ashuga ndiko kotetezeka komanso kothandiza kwambiri. Izi zikuwonetsedwa ndi kuwunika kambiri ka odwala matenda ashuga komanso madokotala omwe akuwapatsa.

Ngati, pazifukwa zingapo, wodwala yemwe ali ndi matenda amtundu wa 2 kapena wa 2 sangathe kugwiritsa ntchito pozungulira kuti ateteze pathupi osafunikira, atha kugwiritsa ntchito njira zina zakulera.

Mapiritsi othandizira kubereka a shuga

Mwinanso njira yotchuka kwambiri yotetezera pathupi osafunikira pakati pa azimayi padziko lonse lapansi ndi mapiritsi oteteza kuubala. Zitha kugwiritsidwanso ntchito ngati muli ndi matenda ashuga, koma izi ziyenera kuchitidwa mosamala, powona malangizo onse adotolo.

Mpaka pano, njira zakulera zamkamwa zimapezeka m'mitundu iwiri - kuphatikiza ndi progesterone. Kupanga kwa kulera kophatikizira kumaphatikiza mahomoni awiri nthawi imodzi: estrogen ndi progesterone, mahomoni okhala ndi apohesterone amaphatikiza mahomoni a progesterone okha.

Ndizovuta kunena kuti ndi gulu liti la mankhwalawa lomwe limayenereradi matenda a shuga, iliyonse ya mankhwalawa imakhala ndi zabwino komanso zopweteka zake.

Koma mapiritsi amakono othandiza kulera ali m'gulu la njira zakulera zophatikizira, chifukwa chake, kusankha iwo kuti akonzekere kubereka ndikosavuta kwa mzimayi kusankha njira yoyenera yokhayokha.

Matenda a shuga komanso kutenga pakati

Ngakhale masiku ano, mwatsoka, pamakhala zochitika zambiri pomwe azimayi omwe ali ndi matenda osokoneza bongo sakhala ndi chidziwitso chokwanira chokhudza njira zodalirika zolerera. Ichi ndichifukwa chake malinga ndi ziwerengero zamankhwala:

mwa 77% ya milandu, amayi omwe ali ndi matenda ashuga sanakonzekere,
pafupifupi mphindi ziwiri zilizonse zimatenga mimba.
azimayi oposa 60% ali ndi mbiri yochotsa mimbayo yambiri.

Chifukwa chiyani amayi amafunika kuchotsa mimba nthawi zambiri? Chifukwa chachikulu, monga lamulo, ndizovuta zomwe zimakhudzana ndi matenda osokoneza bongo, kuwopsa ndi kufalikira kwake. Tikuyankhula za matenda amtima, ma macro- komanso micropathology, mavuto am'mimba, komanso mavuto ndi kwamikodzo.

Njira zakulera za matenda a shuga 1: A mpaka Z

Mbiri ya kulera kwa akazi ndi amuna idayamba zaka masauzande ambiri. Njira zambiri zamakono zakulera zinali ndi machitidwe awo zaka mazana angapo zapitazo.

Tikukhala munthawi yomwe kugonana pakati pa mwamuna ndi mkazi ndi kotheka popanda kutenga pakati.

Pakadali pano, pali kusankha kwakukulu kwa njira zakulera, kutengera zofuna zanu, moyo wanu ndi kusowa kwa zotsutsana.

Kodi njira zakulera ndizothandiza bwanji? Njira iti yothandiza kwambiri? Kodi amaloledwa kukhala ndi matenda ashuga? Kodi zingayambitse kuwonongeka kwa milingo ya shuga, kumayambiriro kapena kukula kwa zovuta za matenda ashuga? Kodi "kuvulaza" ndikugwiritsa ntchito bwanji mankhwala a mahomoni? Momwe mungasankhire njira yoyenera ine? Kodi zitha kunditeteza bwanji? Ndi mafunso ena ambiri. Munkhaniyi tiyesera kuyankha ambiri a iwo.

Kulera (kuchokera ku novolat. "Contraceptio" - makalata. - kupatula) - kuletsa kutenga pakati ndi makina, mankhwala ndi njira zina zakulera.

Kusankha njira yolerera, tiyenera kupeza bwino pakati pa kugwiriridwa kwa njirayo, kuopsa kwake ndi zotsatirapo zake, malingaliro okonzekera kutenga pakati ndi zomwe amakonda.

Kumbukirani kuti kutenga pakati kumachitika ndi kuchuluka kwa hemoglobin yayikulu komanso kusowa kwa chipukutiro cha matenda ashuga, kuopsa kwa kusiyana kwa kubereka kwa ana, zovuta za pakati komanso kubereka kumawonjezeka. Chifukwa chake, ndikofunikira kukonzekera pakati ndipo nthawi yakukonzekera gwiritsani ntchito njira yoyenera yolerera kwa inu.

Kwa amayi omwe sakukonzekera kutenga pakati, nkhani yoletsa kulera ndiyofunikanso kupewa mimba yosafunikira.

Palibe njira zakulera zomwe zimaphatikizidwa kwathunthu mu shuga. Popeza kuchuluka kowopsa kwa mwana wosabadwayo ndi mayi panthawi yapakati yosakonzekera, njira zomwe zimagwira bwino ntchito kwambiri zimasankhidwa.

Chofunikira kwambiri chachipatala chomwe chimasankha kusankha njira zolerera ndi kukhalapo kwa zovuta zamatenda a mtima. Pazifukwa izi, muyenera kuyesedwa ndi dokotala musanasankhe njira yodzitetezera.

Palibe chifukwa chomwe mungayambire kutenga njira za kulera nokha.

Palibe njira imodzi yomwe ilipo 100% yothandiza. Kumbukirani kuti posatengera kulera mwa amayi 100, opitilira 80 amakhala ndi pakati chaka chimodzi.

Kudalirika kwa njira zambiri zotetezera kumatengera kulondola kwa kugwiritsidwa ntchito kwawo.

Muyenera kudzisankhira nokha nthawi yomwe mayi sangathe kukhala ndi pakati - mwezi, chaka, zaka 10, kapena simukonzekera ana konse. Pali njira zakulera zazifupi komanso zazifupi.

Mpaka kulera kwa nthawi yayitali kuphatikiza zida za intrauterine ndi zodulira zam'mimba. Njira zakulera izi sizitanthauza kuti mukhale nawo pachiwonetsero ndipo ndinu otetezeka, kuphatikizapo matenda ashuga amtundu 1. Kukhazikitsa kwawo kumatenga mphindi zingapo, kupereka njira yodalirika yolerera.

Kulera Za Matenda A shuga

Chaka chilichonse, chithandizo cha matenda a shuga chikuyenda bwino. Izi zimakupatsani mwayi wopewa zovuta zamtundu wa mtima kapena kuchedwetsa nthawi yowonekera kwawo. Chifukwa chake, kwa azimayi omwe ali ndi matenda ashuga, kutalika kwa nthawi yobereka kumakula.

Matenda a shuga amatha kupanga zovuta kusankha njira yoyenera yolerera.

Nthawi yomweyo, azimayi onse omwe ali ndi matenda ashuga amafunika kukonzekera mwanzeru pakakhala ndi pakati.Mutha kungoyambira kutenga pakati pomwe kuchuluka kwa shuga m'magazi anu kuli pafupi kwambiri, ndiye kuti kubwezeretsedwa bwino kwa shuga.

Mimba yosakonzekera yomwe imayambitsa matenda ashuga imawopseza mayi ndi mwana wake wamtsogolo. Izi zikutanthauza kuti nkhani yoletsa kubereka m'matenda a shuga ndiyofunika kwambiri. Amalandira chidwi ndi madokotala komanso odwala omwe ali ndi matenda ashuga.

Kusankha njira zoyenera kwambiri zakulera ndi ntchito yovuta. Izi zimathetsedwa payekhapayekha kwa mkazi aliyense. Ngati ali ndi matenda a shuga, ndiye kuti mungam'patsa zina. M'nkhani ya lero, muphunzira zonse zomwe muyenera, limodzi ndi dokotala, kudziwa kulera kwa matenda ashuga.

Zotsatirazi zikufotokoza njira zamakono zopeera njira zakulera. Ndizoyenera azimayi omwe ali ndi matenda ashuga, kutengera mtundu wawo. Sitikambirana za njira yopyapyala, zosokoneza zokhudzana ndi kugonana, kugwa ndi njira zina zosadalirika.

Kuvomerezeka kwa njira zakulera kwa amayi omwe ali ndi matenda ashuga

Intrauterine kulera

Njira zakulera za intrauterine zimagwiritsidwa ntchito ndi azimayi 20% omwe ali ndi matenda ashuga. Chifukwa njira yolerera yodalirika ndi nthawi yomweyo imateteza motsutsana ndi pakati posakonzekera. Amayi amakhala omasuka kwambiri kuti safunikira kuyang'aniridwa mosamala tsiku lililonse, monga kumwa mapiritsi a kulera.

Zowonjezera za njira zakulera za intrauterine za matenda ashuga:

siziwonjezera chakudya ndi mafuta kagayidwe,
Musachulukitse mwayi wamagazi ndikutseka magazi.

Zoyipa zamtundu uwu wa kulera:

azimayi nthawi zambiri amakhala ndi kusamba kwa msambo (hyperpolymenorrhea ndi dysmenorrhea)
chiopsezo chowonjezereka cha ectopic mimba
Nthawi zambiri matenda opatsirana a m'chiberekero amapezeka, makamaka ngati ali ndi shuga m'magazi a shuga amakhala wambiri.

Amayi osabereka samalimbikitsidwa kuti azigwiritsa ntchito njira zakulera za intrauterine.

Chifukwa chake, mwaphunzira zifukwa zomwe mungasankhire njira imodzi kapena ina yoletsera kulera. Mkazi wazaka zobereka azitha kusankha yekha njira yoyenera, onetsetsani kuti mukugwira ntchito ndi dokotala. Nthawi yomweyo khalani okonzeka kuyesa njira zingapo mpaka mutasankha njira yabwino kwambiri.

Kukonzekera kutenga pakati

Ngati mumasamala musanakonzekere kutenga pakati pa mwana, mutha kupewa mavuto ambiri, chofunikira, khalani odekha komanso olimbikitsa. Koyambira?

Ndikofunikira kutulutsa shuga m'magazi.

Dziwani ndi kuchiza matenda amisala komanso matenda owonjezera.

Onetsetsani kuti kubwezeretsedwa kwa matenda ashuga kwakwaniritsidwa ndipo kwatsala miyezi itatu (komanso isanu ndi umodzi) lingaliro lisanachitike.

Ngati malamulowa amasungidwa mosamala, palibe kukaikira kuti kuchuluka kwa zovuta zapakati pa kubereka ndi kubereka mwana kudzacheperachepera.

Mitundu ya kulera

Mpaka pano, zatsimikiziridwa kuti ndi matenda osokoneza bongo a shuga, kugwiritsa ntchito mankhwala okhala ndi mahomoni a estrogen ngati njira zakulera ndizosayenera. Koma simuyenera kudandaula ndi izi, chifukwa pali njira zina zambiri ndi njira zopewera kutenga pakati posafuna.

Njira zotchinga (kondomu, diaphragm) - njira yosavuta, koma magwiridwe ake ntchito amakhala ochepa.
Kugonana kosokoneza - magwiridwe ake alinso otsika ndipo pamakhala chiwopsezo chakukulitsa matenda ogonana.
Njira zamankhwala (Mankhwala a Pharmatex) - mwatsoka, zovuta zoyipa sizingatheke, zotsatira zake zimakhala zazifupi, koma chiopsezo chotenga matenda opatsirana pogonana chimachepetsedwa kwambiri.
IUD (chida chamtundu wa intrauterine) ndi njira yolowerera yoberekera yomwe imagwira ntchito kwambiri, imasinthidwa mwachangu.
Mirena - Chida cha intrauterine chomwe chili ndi levonorgestrel ndi njira yothandiza kwambiri koma yolowerera. Imakhala ndi zotsutsana pang'ono ndipo imakhala ndi zotsatira zochizira.

Makina omasulira a Hormonal amasiyanitsidwa ndi kayendetsedwe ka makolo ndi njira zosavuta zogwiritsira ntchito (sabata iliyonse, pamwezi komanso nthawi yayitali). Mwachitsanzo, dongosolo lotsegulira la NovaRing ndi mphete yowonekera bwino yomwe mkazi amatha kulowa payokha.

Ma COC (ophatikiza kulera kwa pakamwa) ndi njira yothandiza kwambiri yolerera, imakhala ndi zowonjezera zowonjezera, zimatha kusintha, mankhwala akasiya, mimba imachitika msanga. Komabe, njirayi imafunikira kudziletsa kwambiri.

Njira zabwino zakulera za matenda ashuga

Kodi maubwino ndi mawonekedwe a njira zamakono kwambiri zoteteza - kuphatikiza kulera pakamwa ndi chiyani?

Ma COC (ophatikiza kulera pamlomo) amathanso kupatsidwa kwa azimayi omwe ali ndi matenda amtundu wa 2 komanso matenda a shuga a 2, mosasamala kanthu za kupezeka kwa mtima kapena zovuta zina. Komanso, ma COC otsika kapena microdosed okhala ndi ethinyl estradiol osakwana 30/20 μg angagwiritsidwe ntchito bwino mwa odwala omwe ali ndi vuto la kulipila kapena subcomproll ya carbohydrate metabolism.

Kodi tili ndi chiyani lero? Nthawi zambiri, madokotala amakonda mapiritsi a gawo limodzi, omwe mayina awo ndi Novinet, Logest, Mercilon, Lindinet, Mirell, Jess.

Chochititsa chidwi

Kulera koyambirira kwamlomo kunalembedwa kale mu 1960. Zaka zotsatila, zoyesayesa zonse zamakampani opanga mankhwala zinali zothandiza kuchepetsa mavuto obwera chifukwa cha kulera kwapakamwa. Zotsatira zake, kupambana kwakukulu kwakwaniritsidwa pakupanga njira zatsopano za kulera, kuphatikiza kusintha kwa mankhwala oledzeretsa omwe amapezeka m'magawo akuluakulu mpaka pakumwa mankhwala ochepa.

Kuphatikiza apo, mankhwalawa adawoneka ngati njira zakulera zophatikizidwira, kuphatikiza kwa mahomoni ndi mphete zamkati, mapiritsi oletsa kubereka a progestogen komanso zodalirana. Mpaka pano, azimayi opitilira 70 miliyoni padziko lonse lapansi amasankha njira zakulera za mahomoni. Kutchuka koteroko kumakhala koyenera, choyambirira, ndi kuchuluka kwa kudalirika kwa njirayi - 99%.

Mulimonse momwe zingakhalire, kufunsa dokotala wazamankhwala ofunika kwambiri ndikofunikira, chifukwa ndi dokotala wodziwa bwino yemwe angalimbikitse njira yoyenera yolerera ya mayi aliyense. Ndipo kumvera malingaliro ake kumatanthauza kusamalira thanzi lanu komanso thanzi la mwana wanu. Ndipo chofunikira kwambiri chiti kwa mayi wamtsogolo?