Kodi mankhwala amapiritsi ndi njira yosankhira?

Kutenga mimba ndi njira yabwino kwambiri yothetsera mimba yosakonzekera, pogwiritsa ntchito mafananidwe opangidwa ndi progesterone ndi estrogen - mahomoni opatsirana pogonana. Mapiritsi opatsirana pogonana omwe ali m'gulu lino amatsimikizira kuti anthu ambiri ali ndi kachilombo koyambitsa chithandizo, kusalumikizana ndi kugonana, kulekerera kwabwino, kusagwiritsiridwa ntchito bwino, kuyendetsa bwino kayendetsedwe ka kayendedwe kake, kubwezeretsa kubereka pambuyo pakuvomerezeka, chitetezo cha chiwerengero cha amayi omwe ali ndi thanzi labwino. Kusankhidwa kwakukulu kwa mankhwala kumakupatsani mwayi wokha aliyense kusankha OC kwa mkazi aliyense ndikugwiritsa ntchito mankhwala osokoneza bongo.

Chiwerengero cha mapiritsi oletsa kubereka

1. Kuphatikizapo njira zothandizira pakamwa (COCs):
   • monophasic ( Regulon , Lindineth-30 ). Mukhale ndi mlingo wokhazikika wa gestagenic ndi isrogenic mu piritsi iliyonse, kusiyana ndi mtundu wa progestogens, estrogens, mlingo. Perekani njira yapamwamba ya kulera (Pearl index 0.06-0.08), kuchitira bwino matenda a endometriosis, kumakhudza kwambiri nthawi ndi nthawi ya kusamba, poyesa kuchuluka kwa magazi. Milandu ya kutuluka mwazi wamagazi imatchulidwa kawirikawiri;
   • gawo limodzi (Adepal, Antotevin). Ali ndi mlingo wosinthika wa gestagen ndi estrogen nthawi zonse, amawonetsedwa kwa amayi omwe ali ndi chidwi ndi gestagens, ndi zizindikiro za matenda a hyperandrogenism;
   • magawo atatu (Tri-regol, Tri-merci). Amadziwika ndi mavitamini osiyanasiyana otengera steroid malinga ndi magawo a msambo. Iwo amavomereza kuti thupi limakhudza bwanji msambo, perekani zosachepera zochepa, kayendetsedwe kake. Amawonetsedwa kwa amayi oposa 35 omwe ali ochepa kwambiri, osuta fodya.

2. Ndi kuchuluka kwa gawo la estrogen:
   • microdosed: 15-20 μg ethynyl etradiol / tsiku (Logest, Lindineth-20);
   • mlingo wochepa: 30-35 μg ethynyl etradiol / tsiku ( Yarina , Janine , Regulon);
   • mlingo waukulu: 50 μg ethynyl etradiol / tsiku (Ovidon).
3. Mankhwala opatsirana pogonana a Gestagenic ("mini-kumwa").

Njira zina zogwiritsira ntchito COCs ndi mapiritsi okhala ndi progestins okha. Mchitidwe wa kulera wa "mini-pili" umagwirizanitsidwa ndi kusintha kwa mucosal uterine cavity, kuchititsa zovuta kukhazikitsa dzira la feteleza, ndi kuonjezera mamasukidwe akayendedwe a chiberekero cha khomo lachiberekero kumadodometsa kulowa kwa spermatozoa mu chiberekero. Kukonzekera kwa gestagenic kumayambitsa kuponderezedwa kwa mtundu wa lutropin, umene umalepheretsa kutentha. Mankhwala "oledzeretsa": Nthawi zina kutenga mapiritsi ovulation kumachitika - izi zimamveka pansi poyerekeza ndi COC Pearl Index (0.3-0.6).

Momwe COC ikugwirira ntchito

Njira zogwiritsira ntchito OC zimapangidwa m'magulu osiyanasiyana a hypothalamus-pituitary-ovary-uterine-uterine tube system. Mapuloteni otchedwa steroids amachititsa kuti mahomoni otchedwa gonadotropic asamasulidwe ndi mahomoni ndi mahomoni a hypothalamus, omwe amachititsa kuti anthu asamavutike kwambiri. Pogwiritsa ntchito, gestagens ndi ethinyl estradiol zimapangitsa folliculogenesis, zomwe zimapangitsa kuti kuchepa kwa mazira afupike, kuchepetsa kutsekemera kwa estrogens ndi chinthu chachiwiri. Kulimbana ndi zovuta ndi endometrium - pali vuto la kusintha kwa msinkhu komanso kusinthika kwachinsinsi, pali kusintha kosokoneza maganizo komwe kumakhala ndi mphamvu yotsutsa. Mankhwala opanga mahomoni amachititsa kuti mitsempha yowonongeka iwonongeke, pang'onopang'ono kudutsa dzira la feteleza, kubwezera chiberekero cha khola, chomwe chimapangitsa kuti spermatozoa alowe mu uterine.

Mmene Mungasankhire Mapiritsi Oletsa Kugonana

Mfundo yaikulu yosankha OP ndiyo kugwiritsa ntchito mlingo wosachepera wa steroid, umene ungapereke chitetezo choyenera ku mimba yosakonzekera. Akazi a estrogenic ndi oyenera mankhwala omwe amadziwika ndi chida cholimba cha gestagenic (Ovidon, Rigevidone). Kukonzekera kwa mzere woyamba kwa amayi omwe ali ndi magestagen ambiri - Regulon, Logest. Posankha bwino, muyenera kulingalira kukula kwa chiberekero ndi khalidwe la kusamba, chifukwa magawowa amasonyeza bwino kwambiri kuti mahomoni amatha bwino kusiyana ndi kuunika kwa zizindikiro zakunja. Kuuma msambo kumasonyeza kuchuluka kwa ntchito ya progesterone, yaitali komanso yochulukirapo - za ntchito ya estrogen. Yambani kutenga mankhwala opatsirana pogonana ayenera kukhala ophatikizana ndi mankhwala osakaniza mlingo wazomwe zimalowa. Mapiritsi atatu ndi otsika a dose sakutsutsana wina ndi mzake - pogwiritsira ntchito mokwanira ndi motetezeka komanso ogwira ntchito. Chotsatira cha chisankho choyenera ndicho kusala kwa magazi, kupuma magazi "kupambana". Zambiri zokhudzana ndi kusankha kokha mungapeze pano .

Momwe mungamwetse mapiritsi oletsa kubereka:

• Mankhwala opatsirana pakamwa amatengedwa masiku asanu ndi limodzi (5) pambuyo poyamba kumwa magazi. Makhalidwe a monophasic amayamba kumwa mapiritsi pa tsiku lofanana la sabata, ma multiphase - ndi pepala lolembedwa "kuyambira pa phwando";
• OPs amatengedwa tsiku ndi tsiku, pa nthawi yake, kwa masiku 21;
• mutatha kumwa mapiritsi otsiriza pakutha pakatha sabata imodzi, pamene mukuyamba kusamba. Phukusi lotsatira la mankhwala likuyambira pa tsiku lachisanu ndi chitatu cha kupuma;
• ngati palibe "kuchotsa", mapiritsi akupitirizabe kuperekedwa malinga ndi mwambo wamakhalidwe pamene mimba ilibe. Apo ayi, mankhwalawa achotsedwa;
• mafunso okhudza nthawi zonse a COCs ndi mankhwala (anticonvulsants, antibiotic) amadziwika payekha;
• Ndikofunika kudziwa kuti atasiya COC, kubala pakati kumatha kuchitika kale pakutha koyamba.

Kugwiritsa ntchito mapiritsi oletsa kubereka:

• posakhalitsa, pafupifupi 100% kukhulupilika kwa kulera;
• chidziwitso cha njirayi, kuphunzira bwino;
• kuthekera kwa kudziwonetsera nokha kwa chonde;
• zowawa zochepa;
• zosavuta kugwiritsira ntchito, zosavuta zowonjezereka;
• kuchepetsa zoopsa za ectopic mimba;
• kuchepa mu zigawo za matenda opweteka a ziwalo zouma;
• kuteteza chitukuko cha zotupa zabwino za chiberekero ndi mazira.
• mpumulo wa zizindikiro za dysmenorrhea, PMS;
• zotsatira zabwino mu endometriosis;
• mankhwala othandizira khungu la seborrhea, ziphuphu zonyansa.

Kuvulaza:

• chiopsezo cha khansara ya chiberekero kwa amayi omwe adagwiritsa ntchito OC kwa nthawi yaitali (zaka zoposa 10) akuwonjezeka.

Mankhwala opatsirana pogonana: zotsutsana

• zipsinjo zoopsa za ziwalo zoberekera / chifuwa;
• mimba / akuganiza kuti ali ndi pakati;
• matenda oopsa a mtima;
• matenda aakulu, matenda aakulu, zilonda za chiwindi;
• thrombosis, thrombophlebitis, thromboembolism;
• Kutuluka magazi kwa matenda osadziwika.

Zowopsa:

• kuledzera kosokonezeka;
• kunenepa kwambiri, porphyria, kuchepa;
• chifuwa chachikulu;
• khunyu, kupsinjika kwa nthawi yaitali, uterine fibroids;
• jaundice, migraine, hypercalcemia, hyperlipidemia.

Zinthu zomwe zimachepetsa kukhulupilika kwabwino:

kutsekula m'mimba, kusanza, kudya kamodzi komweko, mankhwala osokoneza bongo, antibacterial.

Zotsatira zoyipa:

• Matenda a estrogen: kusanza, kunyowa, kuthamanga kwa magazi, mutu, chizungulire, kupweteka kwa thupi, kupweteka;
• Kudalira progestogen: kunachepetsanso libido, kuvutika maganizo, ziphuphu, kupukuta kwa umaliseche, kumutu, kutopa;
• Kuchuluka kwa isrogenic: kuchepa kwa kukula kwa m'mawere, kuchepa kwa libido, kusamba kosauka, kutuluka magazi pakati;
• Kusayenerera kwa progestogenic: kuchedwa msambo, kusungunula kwapakati pa gawo lachiwiri lozungulira, kuchuluka kwa msambo.

Zotsatira pambali ya kutenga chithandizo cha mankhwala ovomerezeka amatha kukhala chifukwa cha kusagwirizana kapena kuchita mapiritsi. Zotsatira zake zingakhale zopanda phindu kapena zoopsa kwa thupi, mosasamala kanthu zomwe zimayambira. Kuthetsedwa kwa mankhwala nthawi zambiri kumapangitsa kupezeka kwa zoterezo pogwiritsa ntchito chithandizo kapena mwachindunji.

Mapiritsi abwino kwambiri olerera

Ndi kuvomerezedwa koyenera, kudalirika kwa njira zothandizira kulera pakamwa kumakhala kukhala 100%, chiŵerengero cha mapiritsi otetezeka "otetezeka / odalirika" sichiposa makondomu. Mukhoza kuphunzira zambiri za makondomu apa . Zomwe zili m'mibadwo yatsopano zili ndi mahomoni otsika mtengo, popanda effect androgenic. Pewani zotsatira zovuta zomwe zingatheke ndi kuyesedwa kwachipatala, zomwe zikulimbikitsidwa musanatenge mapiritsi. Kuchepetsa kubereka kwapadera kumatanthauzanso, kukula kwa kayendedwe ka kayendedwe kake kamadalira nthawi yomwe mankhwala akumwa ndi mahomoni oyambirira. Mankhwala abwino kwambiri sapezeka. Zatsopano - sizikutanthauza zabwino. Lamulo lalikulu: ma homoni amasankhidwa, olamulidwa ndi odwala mazira malinga ndi makhalidwe a thupi lachikazi.