Izindlela zokwelapha zomlomo zanamuhla azithinti umsebenzi we-hormonal wesifazane. Banekhono eliphakeme, bevimbela ukukhulelwa okungadingeki. Noma kunjalo, kubalulekile ukukhetha isidakamizwa esifanele ukuthola umphumela wesicelo.
Izakhi zokubeletha zomlomo zisebenza kanjani?
Odokotela isikhathi eside bafunde umphumela wezinkinga zokubeletha ngomlomo ohlelweni lokuzala kanye nomzimba wesifazane yonke. Ukuthuthukiswa kokubunjwa nokubunjwa kwalezi zidakamizwa kuvunyelwe ukunciphisa imiphumela engalungile kanye nezinkinga. Konke ngenxa yesenzo sezinhlobonhlobo zezingxenye zamaphilisi, esekelwe emifanekisweni yokwenziwa kwamahomoni wesifazane ocansi.
Izindlela zokubeletha zomlomo zanamuhla ezihlanganisiwe, ezithathwa ngokuqinile emthamo ophakanyisiwe nangesikhathi, zithinta uhlelo lokuzala kanje:
- Izinqubo ze-ovulatory zivinjelwe. I-hormone engena kumuthi wepilisi wokuvimbela ukuvimbela ukukhula okujwayelekile nokuvuthwa kweqanda, okuyivimbela ukungena emgodini wesisu sokukhulelwa.
- Ukubanjelwa kwe-mucus yomlomo wesibeletho. I-mucus ekhiqizwa emgodini womlomo wesibeletho ishintsha ukuvumelana kwayo, ngenxa yokuthi kungenzeka ukuthi ukungena kwesibindi kungena embelethweni kunciphise.
- Yehlise ukukhula kwezicubu ze-endometrial. Ngenxa yalokho kuguqulwa, ngisho noma iqanda lihlwanyelwa , ukulimala akunakwenzeka.
Ukwelashwa ngokwemlomo - izinzuzo nezingozi
Abaningi bamazinyo gynecologists babheka kabi ukusetshenziswa kwesikhathi eside kwemithi ye-hormonal. Ukulimala kwemithi yokwelapha ngomlomo kungukuphulwa komsebenzi wokujwayela wesistimu ye-endocrine. Ngenxa yalokho, imiphumela elandelayo ingenzeka:
- ukwakheka kwezidumbu;
- umdlavuza webele;
- i-thrombosis;
- ukucindezeleka komzimba;
- ukuphazamiseka komjikelezo wesisindo ;
- shintsha esimweni, isikhathi sokuya esikhathini.
Uma izakhi zokubeletha ngomlomo zisetshenziselwa kahle (ezihambisana nodokotela, isilinganiso, amaphuzu aqaphele), khona-ke amathuba okuba nomthelela omubi anciphisa. Ngokuphambene nalokho, ukusebenzisa lezi zidakamizwa ze-hormonal kusiza ukusimamisa umsebenzi we-hormonal system. Phakathi kwamaphuzu amahle wokwamukelwa okulungile kuyadingeka ukuqaphela:
- kunciphisa ubuhlungu ngesikhathi sokuya esikhathini;
- ukunciphisa isikhathi kanye nokwanda kwezikhathi;
- ukujwayelekile komjikelezo wokuya esikhathini;
- ukuvimbela nokwelashwa kwezifo zesifo somzimba ( endometriosis , adenomyosis);
- ukunciphisa ingozi yokukhulelwa kwe-ectopic.
Ukuvimbela izitho zomlomo - izinhlobo
Noma yikuphi ukukhulelwa komlomo kwabesifazane kufanele kukhethwe ngesimo sezimpawu zomuntu ngamunye. Ingxenye yalesi sici ingenxa yezidakamizwa ezivimbela ukuqala kokukhulelwa. Indlela yokwenza kwabo ifana, kepha ukwakheka kanye nendlela yokukhululwa kuhlukile. Umphumela wokukhulelwa uhlale usebenza yi-progestogen. I-estrogens ekhona ekubunjweni isetshenziselwa ukugcina ukusebenza okujwayelekile kwesistimu yokuzala. I-OK ekhona ihlukaniswe ngo:
- kuhlangene;
- gestagenic.
Ukuhlanganiswa kokubeletha komlomo
Igama lezinkinga zokukhulelwa ezihlangene (COC) litholakala ngenxa yokwakhiwa. Zinezinhlobo ezimbili zama-hormone ocansi - i-ethinyl estradiol (estrogen) ne-progesterone (gestagen). Kuye ngokubunjwa kwamaphilisi, bahlukaniswa:
- i-monophasic - izinga lama-hormone ezibhebheni lifanayo kulo lonke iphakheji;
- isigaba ezimbili - i-blister iqukethe amaphilisi anehlanganisela emibili yamahomoni;
- isigaba sesithathu - inhlanganisela emithathu yezinto ze-hormonal ekulungiselelweni okulodwa.
Ngaphezu kwalokho, bahlukanisa izakhi zokubeletha ezihlangene kanye nokuqukethwe kwesakhi se-estrogen kuzo:
- i-high-dose - enokuqukethwe okuphezulu kwe-estrogens (i-Ovidon, engekho i-Ovlon);
- umthamo ophansi - okuqukethwe kwe-estrogens akudluli 30-35 μg kuthebhulethi elilodwa (i-Femoden, i-Marvelon, i-Regulon, i-Janine);
- i-microdosed - kufika ku-15-20 mcg (i-Mersilon, i-Novinet, i-Logest).
Ukukhulelwa kwe-Gestagenic
Izindlela zokwelapha zomlomo zolu hlobo zineprogestogen zokwenziwa kuphela ekubunjweni kwazo. Izidakamizwa zaleli qembu zinqunyelwe abesifazane ngesikhathi sokulahlwa, kanye nabesifazane abaphikisana nokusetshenziswa kwezizalo zokubeletha ezihlangene. Ngokuvamile, izidakamizwa ze-prophylactic, ezisuselwa kumagestagens, zisetshenziswe ekupheleni kwesikhathi sokuzala kwabesifazane ababelethayo kanye ne-nulliparas (emva kweminyaka engu-35). Phakathi kwezidakamizwa ezisetshenziswa kakhulu kuleli qembu kungabonakala:
- Lactineth;
- Charozette;
- Okumangalisayo;
- I-microlut.
Ukukhulelwa kwe-postcoital
Kwezinye izimo, izinyathelo zokukhulelwa kwabesifazane kumele zithathwe emva kokulala ngokocansi. Ezimweni ezinjalo, amantombazane asebenzisa ukukhulelwa kwe-postcoital (ukukhulelwa kokuphuthumayo). Sebenzisa lezi philisi zokukhulelwa ngemuva kwesenzo ngokushesha noma kungakapheli amahora angu-72 emva kokuxhumana. Njengoba ukwanda kwesikhathi, ukusebenza kwezimali ze-postcoital kunciphise kakhulu.
Umphumela wezinkinga zokubeletha eziphuthumayo usekelwe ekusebenzeni okwenziwe kakhudlwana kwesibeletho, umphumela kwi-myometrium. Ngenxa yalezi zinqubo kukhona ukwenqatshwa kwesigaba sokusebenza, njengesikhathi sokuya esikhathini, kanti owesifazane ulungisa unyaka odlula zonke. Ngesikhathi esifanayo, isibeletho kanye neqanda, ezikhulelwe ngesikhathi socansi, shiya isisu. Kumele uqaphele ukuthi amaphilisi okulawula ukuzalwa kokubeletha, amagama ahlelwe ngezansi, abangela ukukhubazeka ohlelweni lokuzala, ngakho asetshenziswe uma kunesidingo. Phakathi kwezidakamizwa zaleli qembu:
- Escapel;
- Mifegin;
- I-Postinor.
Indlela yokukhetha ukubeletha komlomo?
Ukuze uthole ukuthi yiziphi amaphilisi okuvimbela ukwelashwa okungcono ukuthatha, owesifazane udinga ukuphendukela kumjozi wezifo zokwelapha. Ngemva kokuhlolwa nokuhlaziywa, udokotela ukhetha izidakamizwa ngamunye, ecabangela ubudala nesimo somzimba wesiguli. I-algorithm yonke yokukhetha ukukhulelwa kufanele ibonakale kanje:
- ukubonisana komzimba wezifo zokwelapha;
- ukulethwa kwe-smear ye- oncocytology ;
- i-mammologist yokubonisana;
- i-biochemistry yegazi (AST, ALT, iphrofayli profile, ushukela);
- i-ultrasound ngezinsuku ezingu-5-7 zomjikelezo.
Isilinganiso semithi yokukhulelwa ngomlomo
Ngokusho odokotela, amaphilisi angcono kakhulu okukhulelwa yiwo afanelekayo wesifazane futhi angabangeli imiphumela emibi. Yonke into iyingqayizivele, ngakho-ke ungathembeki ekuhlangenwe nakho kokusebenzisa izindlela ezifanayo zomngani, umngane. Ukusetshenziswa kwezibeletha zomlomo ngombiko noma izincomo zabanye besifazane kungathinta impilo.
Njengoba kunikezwe leli qiniso, ukukhuluma ngezidakamizwa ezinhle zokukhulelwa kungenasisekelo. Kodwa-ke, singabiza ukusetshenziswa okusebenzayo kwezibeletha zomlomo ngabesifazane, uhlu olubukeka kanje:
- Regulon ;
- Marvelon;
- I-Yarina;
- UDiane-35;
- Lactineth;
- I-Novinet;
- I-Three-Regol;
- Jess.
Ukusetshenziswa kwezibeletha zomlomo
Ukwamukelwa kwemithi yokwelapha ngomlomo kwenziwa ngokuvumelana nesimiso esiboniswe emfundisweni, kucatshangelwa izincomo ezikhishwe yi-gynecologist. Noma iziphi izikhalo ezivela ngesikhathi sokusetshenziswa kufanele zixoxwe nongcweti.
Ukufeza umphumela wokusebenzisa izisu zokubeletha, kubalulekile ukuhambisana nemibandela eminingi:
- Amathebulethi athathwa nsuku zonke, cishe ngesikhathi esifanayo (mhlawumbe ebusuku).
- Ukuhlukumeza umbuso, ukweqa ukwamukela akuvunyelwe.
- Ukungabikho kokuthatha esikhathini sokuya esikhathini-kudinga ukuqhubeka kwemithi kanye neseluleko sochwepheshe (ukukhulelwa kufanele kukhishwe).
- Ukubonakala kwesimangalo esibi (ukwanda kwengcindezi yegazi, ikhanda, izinhlungu zesifuba, ukukhubazeka okubukwayo, i-jaundice, ukuphefumula kanzima) kuyisibonakaliso sokuhoxiswa kwezidakamizwa kanye nokukhethwa kwenye indlela yokuvikela.
Indlela yokuphuza amaphilisi okulawula ukubeletha?
Ngaphambi kokuthatha izisu zokubeletha ngomlomo, owesifazane kufanele afunde ngokucophelela imiyalelo emuthi. Uma lona wesifazane engazange asebenzise izisu zokubeletha ngomlomo ngaphambi kwalokhu, khona-ke ukwamukelwa kuqala ngosuku lokuqala lomjikelezo (kungaba kusuka ku-5, kodwa udinga ukusebenzisa ikhondomu). Ukuthatha amaphilisi kwenziwa ngokusho kwesimiso esithile, ukwephulwa okuthinta ukusebenza. Izakhi zokubeletha zomlomo zanamuhla zithatha loluhlelo 21-7-21 (usuku lwama-21 lokungeniswa, izinsuku ezingu-7 zokuphazanyiswa kanye nenqubo entsha).
Ukuphazamisa ukwamukelwa ngaphambi kokuphela kwenkambo kuvunyelwe. Uma ithebulethi elandelayo ingathathwa ngesikhathi, bese ulandela imithetho elandelayo:
- Uma sekuphelile amahora angaphansi kwangu-12, thatha iphilisi elingabanjwanga bese uqhubeka uthatha isimiso.
- Kwathatha amahora angaphezu kuka-12 - bathatha futhi baqhubekele inkambo, behambisana nesimiso esidala futhi bavikelwe ikhondomu phakathi nesonto.
Ukukhanselwa kwezibeletha zomlomo
Ukwesulwa kwamaphilisi okukhulelwa kungenzeka ekupheleni kwenkambo. Lapho ithebhulethi yokugcina evela kuphakheji yamukelwa, okusha akuqalwanga. Ngemuva kokukhansela ngaphakathi kwezinsuku ezingu-1-2 qalisa ngenyanga. Ubunjwa bazo bungashintsha kancane (ukuthuka, ukukhipha). Ukuqeda ukuvota kwevolumu kanye nobude bokuya esikhathini kwenzeka kumjikelezo ka-2-3. Ngaphandle kwalokho, kudingekile ukubonisana okhethekile.