Eyona ndlela ikhethekileyo kukuba udibane nomdlavuza wezifo zonyango oza kuthi umyalelo wokukhulelwa ngomlomo osuselwa kwiimvavanyo kunye nokuhlolwa kwemiboniso. Ukuba kukho naziphi na izizathu akunakwenzeka ukuba uqhagamshelane neengcali ekukhetheni i-hormonal contraceptive, unokuzenza ngokwakho. Umgaqo oyintloko wokhetho: umgangatho wesimo, ukubonisa imvelaphi ye-hormonal. Ukuphuma kwexesha elide kunye nokuhlala ixesha elide kubonisa imisebenzi ephawulekayo ye-estrogens, inqabile kwaye imfutshane - kwimisebenzi yegestagens. Iimpawu zokukhetha okwaneleyo zokukhulelwa komlomo: impilo enempilo, akukho ukuphuma kwamanzi, ukunyamalala kwe-PMS.
Ulwaphulo lokubhema
I-Estrogen-equkethe ukukhulelwa komzimba kunye nokubhema - iingcinga azihambelani. Ukuxiliswa kwe-nicotine engapheliyo ngokwayo kuphazamisa umzimba womfazi, kwaye kunye nokusetyenziswa kwe-progesin + estrogen) yokukhulelwa komzimba, impembelelo engalunganga ye-nicotine iphakamisa amaxesha amaninzi.
Izingozi nemiphumo:
- igazi coagulability landa;
- kukho i-vasospasm yexesha elifutshane;
- ukuhamba kwegazi ngeemvini nemithambo yegazi kunzima;
- umngcipheko we-clots clots, okhokelela kwi-myocardial infarction, atherosclerosis, i-stroke.
Iipilisi zokukhusela ukubhema amabhinqa akufanele ziqukathe i-estradiol valerate, i-ethinyl estradiol, i-estradiol hemihydrate. Bangakwazi ukuthatha i-oral contraceptive ngaphandle kwe-estrogen ("i-mini-drank"): I-Charozetta, Microlut, Laktineth, i-Eksluton. Isalathisi sePearl "i-mini-saws" ngu-0.5-4. Ezi zi yobisi zikhusela ngokuqinisekileyo ekukhulelweni okungenakulungiswa kwaye zibe nomthelela omzimba emzimbeni, kodwa ukulawula ngakumbi umjikelezo, okhokelela ekuphumeni okusisigxina. I-"mini-second" inconywa ukuba iqhutywe ngokuqhubekayo kwipilisi ngosuku ukusuka ngomhla wokuqala wokuphuma kwexesha. Ezinye iindlela zokukhusela: ukujikeleza kwe-hormonal, ukufakelwa kwe-hormonal, izilwanyana ezingekho-hormonal Benatex .
Ulwaphulo lwezityalo ezingenanto
Kwabantombazana abangenabo abaqhelekileyo kunye nabaselula abasemagqabini, isifo sokukhulelwa komlomo esilungelelanisiweyo samhlanje sikulungele. Ziquka i-progestagen kunye ne-ethinyl estradiol, zisebenza kakuhle ekukhuseleni ukukhulelwa kunye nemiphumo eyahlukileyo yokuphulukisa - ukunciphisa iimpawu ze-PMS, ukuyeka intlungu, ukulawula umjikelezo wesini. Kwiintsholongwane ezithatha rhoqo ukuthatha izithintelo zokuzalela, ukubonakaliswa kwe-dysmenorrhea kuyanyamalala, umthamo wegazi ukulahleka kwimihla kuyancipha, kwaye ibhalansi ye-hormone ibuyiselwa.
Ulwaphulo lweentombi:
- Ii-COC zedolo ephantsi: Lindineth-30, Regulon, Belara , Janine ;
- COC encinci: uLindineth-20, uClayra, uJess.
Ababelethi be-Gynecologists abacebisi ukubeka i-endometrial ukuhamba kuma-women ngenxa yengozi ephezulu yezixinzelelo: ukuvuvukala (ubele, umlomo wesibeleko, izilwanyana), umonakalo emlonyeni wesibeleko, ukuphuma kwintsholongwane egazini, ukunqunyulwa kwe-endometrium, echaphazelekayo ngamathambo amanqanaba athile okukhulelwa, ukungabikho komntwana. Ukufumana amantombazana kunye nabaselula abatshabalalisayo kubaluleke kakhulu ukusebenzisa iindlela ezikhuselekileyo zokukhusela: ii-non-hormonal suppositories zeBenatex , iikhondom, iipilisi zokukhusela i-hormonal .
Ukukhulelwa emva kokukhipha isisu nokukhulelwa kwesisu
Ukuchithwa kokukhulelwa ngokuchanekileyo emva kokukhipha isisu okanye ukuphuphuma kwesisu kubalulekile indima - inceda ukuqhelanisa imvelaphi ye-hormone, ukuthintela ukuvela kweenkqubo zokuvuvukala kwizitho zangasese, ukuvimbela ukukhulelwa komzimba, ukhusela ukuphela kwe-endometriosis, kunciphisa ubunzima bokuphuma kwegazi. Emva kokukhipha isisu, i-mucosa yesibindi sesibindi sinokulimala, ukukhulelwa okuphindaphindiweyo kunqatshelwe ngokukodwa, kodwa ukukwazi ukukhulelwa kuyabuyiselwa kwangoku ngomhla we-8 ukuya kwe-12, ngoko ke, ukukhethwa kweepilisi zokukhulelwa komlomo kufuneka kuthethwe ngokufanelekileyo.
Ukukhulelwa emva kokukhipha isisu nokukhulelwa komzimba
Zoqhawulo Ziquka i-dosage ephantsi ye-estrogen kunye neprogestogens zanamhlanje. Kuboniswe ukuba kwamkelwe ngomhla we-1-2 ngosuku emva kokukhipha isisu. Ukunciphisa ubude bendawo, ukunciphisa ubunzima beempawu zomzimba, ukulawula ukushisa komzimba, ukuthintela ukuvuvukala kwimizimba yeplavic, ukunciphisa inani leengxaki zokuqala:
- i-monophasic (Regulon, Yarina, Lindineth-30, Belara);
- isigaba esithathu (Triziston, Trinovium, Trikvilar).
I-Gestagennye contraceptives ("i-mini-drank"): I-Charozetta, iMicrolut, iLaktineth, i-Eksluton. Zahluke ngosebenzo olufanelekileyo lokukhulelwa komzimba, musa ukwandisa uxinzelelo lwegazi, musa ukwandisa umngcipheko we-thrombosis, ungatshintshi iimpawu zeesibindi.
Ukukhulelwa emva kokukhulelwa kunye necesarean section
Ukukhulelwa kwe-Hormonal kwesizukulwana esandula ukuqinisekisa ukukhuselwa kokungabikho okufunayo, u-1% uhlala xa izidakamizwa zithathwa xa uthatha isiza. Ulwaphulo lokukhulelwa ngexesha lokukhulelwa, umntwana akalimazi, oogqirha abanalo ulwazi oluchanekileyo malunga nolwalamano olukhoyo phakathi kokusetyenziswa kokukhulelwa kunye nokungalunganga kwintsana, ukuba umfazi uthatha ipilisi ingabi ngaphezu kweenyanga 1 yokukhulelwa. Ukususela ngeveki yesi-6, umntwana uqala ukwenza inkqubo yesondo, inqabile kwizenzo zama-hormone, ngoko ukuthatha imithi ekhulelwe yeli qela kunokubangela ukuphazamiseka komsebenzi kumntwana. Emva kokufunda malunga nokukhulelwa kowesifazane, kufuneka uqhagamshelane nomzimba wezifo zonyango oza kuphakamisa indlela efanelekileyo yokusombulula ingxaki.
Izindlela zokukhulelwa emva kokubeleka kunye nokuzikhusela:
Spermicides (iBenatex, Pharmatex, Contraceptin). Isetyenziswe xa kuqaliswa kwakhona ubudlelwane bezesondo kunye nemvelaphi ye-lactation okanye kunye nezinye iindlela zokukhusela. Ukunyaniseka kwendlela ku-90-92%, umphumo wokukhulelwa kwenzeka emva kwemizuzu emi-5 ukuya kwemihla emva kokulawulwa, ihlala iiyure ezingama-2-6.
I-Gestagennye yokukhulelwa komlomo (Charozetta, Microlut, Laktionet, Eksluton). Ukulungiselela kweli qela kuqala ukuthatha iiveki ezi-6-6.5 emva kokuziswa. Ngokusetyenziswa rhoqo kunye nokwaneleyo kweepilisi ze-mini, ukuphumelela kokukhulelwa komzimba kufinyelela ku-97-98%.
Kulungile . Ukwamkelwa kwe-gestagen estrogens kunokwenzeka kuphela xa ukuncelisa ibele kuphelile, ngenxa yokuba i-estrogen inefuthe elibi kumgangatho / ubuninzi bebisi lwebele, kunciphisa ubude bendawo. Iibhulile kufuneka zithathwe kwishedyuli ethile, ngaphandle kokushiya. Ukuthembeka kokukhulelwa kweCOC ku-99-100%.
Ulwaphulelo emva kwecandelo le-caesarean lifana nokukhuselwa emva kokunikezelwa kwemvelo, umahluko omnye - iipilisi kufuneka ziqalwe kuthatha iiveki ezi-8-9 emva kokuzalwa.
Ulwaphulo lwezilwanyana ze-varicose kunye nama-cyst ovarian
Isifo se-Varicose asibhekiseli kwiingqinisiso ezingapheliyo ekusebenziseni ukukhulelwa kwe-hormonal, nangona kunjalo, ama-progestins afakwe kwiilungiselelo ze-gestagens kunye ne-estrogens inokudambisa ukonakala kwegazi kunye nemeko yeenqwelo ezithintekayo. Ukukhupha umngcipheko we-pathology engathandabuzekiyo-inzulu ye-thrombosis, kuyanconywa ukuba xa kuthathwa i-contraceptive yomlomo eqhubekayo, jonga i-phlebologist. Ukubonakala kokuvuvukala kweengcambu eziphantsi, intlungu, ukungathandeki, ubunzima malunga nemvelaphi yokuthatha amacwecwe e-hormone-sisihlandlo sokwenza unyango ngokukhawuleza kwingcali.
I-contraceptive ye-Hormonal kwi-cyst ovarian ye-genesis esebenzayo isetyenziswe njengeyona ndlela yonyango yokuqala. I-cysts yesikhashana (esebenzayo) iyenzeka kubasetyhini beminyaka yobudala, kunye neyeza ezikhethiweyo ezikhethiweyo, emva kweenyanga ezi-2-3. Ngama-cyst engavunywanga, izicathulo zomlomo zomzimba ezimbini kunye ne-singleophasic ziboniswa ngokubambisana ne-acupuncture kunye neyeza-vitamin.
Ulwaphulo lokubeleka xa uncelisa
Ulwaphulo lokunakekelwa kwengqondo kunye ne-myoma ye-uterine
Ukudibanisa umlomo wokudibanisa ngomlomo ukuxhaswa kwengqondo yindlela ekhethiweyo yokukhulelwa. Kubasetyhini abathatha i-COC ixesha elide, imeko iya kuphucula kakhulu, umjikelezo wokuya esikhathini uyazinqanda, ukunyameka kweengcambu ze-mammary kuyaphela, kwaye ukuhla kweyantlukwano kubangelwa ukuhamba kwexesha. Iziyobisi ezikhethiweyo: COC monophasic (Lindineth-20, Yarina , Janine , Regulon ), i-COC kunye nomsebenzi ophantsi we-androgenic (uJeanine, Jess).
I-COC nge-uterine ye-myoma-isisu esinomdla we-myometrium, silungele imvelaphi ye-hormonal, ebangela ukunciphisa inkqubo yokukhula / yokugqithisa kwe-fibroids. Iziyobisi ezikhethiweyo: uJeanine, Regulon, Lindineth-20/30.
Ulwaphulo lwe-endometriosis
I-Monophasic yokukhulelwa komzimba ekupheleni kwe-endometriosis inempembelelo yokwelapha kwi-myometrium kunye ne-endometrium, ukuphumelela kokonyango kwesi sifo kunye neziyobisi zeli qela ngu-57-59%. Iziyobisi ezikhethiweyo: uJeanine , Regulon , u- Yarina .