Anthu ambiri amene ali ndi hypothyroidism -kapena chithokomiro chosawonongeka-ku United States ndi akazi. Ambiri mwa amayiwa ali ndi zaka za kubala kapena ali odwala / menopausal . Izi zikutanthauza kuti pamene akuchiritsidwa ndi hypothyroidism, ena mwa iwo akumwa mankhwala opatsirana monga mankhwala a mapiritsi kapena mankhwala omwe amachititsa kuti asinthe.
Malingana ndi kafukufuku wochokera ku Guttmacher Instutute, amayi pafupifupi 10 miliyoni + a zaka zapakati pa 15 ndi 44 amagwiritsira ntchito mapiritsi oletsa kubereka.
Mitundu ya mankhwala okwana 57 mpaka 75 miliyoni yothandizira mankhwala ochotsera mahomoni, ambiri mwa iwo kuphatikizapo mtundu wina wa estrogen, walembedwa ku United States. Akatswiri ena amaganiza kuti pafupifupi 5 peresenti ya amayi onse odwala nthawi ndi amayi amatha kumwa mankhwala a mahomoni onse komanso mankhwala ena a chithokomiro.
Ndikofunika kwa mayi aliyense amene akugwiritsa ntchito mankhwala osokoneza mavitamini kuti asamalirane ndi hypothyroidism, monga levothyroxine kapena chilengedwe chodziwika ndi chithokomiro, kuti adziŵe zotsatira zomwe mankhwala omwe ali ndi estrogen akhoza kukhala ndi chithokomiro ndi chithandizo cha hypothyroidism. Mofananamo, muyenera kudziwa ngati muli ndi mankhwala omwe amachititsa kuti mankhwala a hypothyroidism apatsidwe mthupi mwawo mukakhala ndi mapiritsi omwe ali ndi estrogen, kapena mutenga kale mankhwala omwe amachitiranso mtundu wa estrogen.
Zotsatira za Estrogen pa Chithokomiro
Kuwonjezeka kwa estrogen kungakhale chifukwa cha mimba, zina zowonongeka, komanso kugwiritsa ntchito mankhwala monga mapiritsi opatsirana kapena mankhwala othandizira ena. Estrogens omwe amatengedwa ngati mankhwala akhoza kukhala ngati maantirogeni monga ma ethinylestradiol, kapena mitundu yeniyeni ya estrogen monga estradiol, estriol, kapena estrone.
Estradiol imatchedwanso 17 beta-estradiol.
Kaya kuchulukitsidwa kwa estrojeni kukupangidwa ndi thupi lanu kapena kumatengedwa ngati mankhwala amlomo, estrogen imatha kukweza magulu a thyroxine-binding globulin, otchedwa TBG. TBG ndi mapuloteni apadera otchedwa "globulin." Udindo wa TGB ndi kugwirizana ndi mahomoni awiri a chithokomiro-thyroxine (T4) ndi triiodothyronine (T3) -kulumikiza m'magazi anu, ndikuthandizira kutumiza ma hormone m'maselo anu .
Pamene TBG ikukwera, TBG imamanga mahomoni ambiri a chithokomiro, ndipo chifukwa chake, imachepetsanso kuchuluka kwa mahomoni a chithokomiro omwe amapezeka m'magazi anu. Izi, zowonjezera, zingapangitse kuwonjezeka kwa msinkhu wanu wa TSH , zomwe zingayambitse kupanga mahomoni ambiri a chithokomiro.
Malingana ndi kafukufuku, patangopita masabata asanu ndi limodzi okha a mankhwala a estrogen, TBG imatuluka m'madzi ambirimbiri a hypothyroid. Kuwonjezeka kwa TBG kumachitika patatha masabata 12 mutayamba kumwa mankhwala. Mofananamo, magulu a Free T4 amatsika-ndipo nthawi zina, TSH imatuluka-mwa njira yomweyo panthawi yomweyi. Kusintha uku sikuwoneka mwa amayi omwe sali hypothyroid.
Odwala Chithokomiro: Zotsatira Zanu Zotsatira
1. Yang'aninso ntchito ya chithokomiro Pambuyo poyambitsa ndi kusiya Piritsi kapena Homoni m'malo
Azimayi abwinobwino sakhala ndi kusintha kwakukulu kwa chithokomiro pamene akugwiritsa ntchito njira za kulera kapena mankhwala opatsirana pogwiritsa ntchito estrogen. Komabe, kafukufuku wasonyeza kuti pafupifupi 40 peresenti ya amayi omwe akudwala mankhwala otentha a hormone omwe amawonjezera mankhwala omwe ali ndi estrojeni amachepetsa m'magazi a T4. Izi zikutanthawuza kuti zizindikiro za hypothyroidism monga kutopa ndi kupindula kulemera kungabwerere pokhapokha mlingo wa mankhwala a chithokomiro ukuwonjezeka. Ichi ndi chiopsezo kwa amayi omwe apulumuka khansa ya chithokomiro ndipo amafunika kusunga mahomoni a chithokomiro kuti athandizidwe kuteteza khansa ya kanseri.
Chifukwa pafupifupi theka la amayi opatsirana pogonana adzakhudzidwa ndi estrogen, ndikofunika kuti chithokomiro chanu chichedwetsedwe mkati mwa miyezi itatu ngati muli ndi mankhwala otsekemera a mahomoni otengera mankhwala ndi kuyamba kapena kuletsa kulera pakamwa kapena mankhwala am'therojeni. Mungafunikire kuwonjezeka kapena kuchepa muyezo wanu wa mankhwala otchedwa hormone m'malo mwake.
2. Musalole kutenga mapiritsi anu kapena mahomoni m'malo mwa kuyang'ana ntchito ya chithokomiro
Malinga ndi kafukufuku wina Dr. Robert Utiger, amayi ena omwe amagwiritsa ntchito hypothyroid omwe amatenga estrogen kapena njira yoberekera angapezeke ndi zizindikiro, ndipo amatha kusiya kumwa mahomoni m'malo mwawo, kubereka, kapenanso mahomoni. Mmalo mwake, malinga ndi Dr. Utiger, kuyang'ana mahomoni a chithokomiro ndikuwonjezereka mankhwala a chithokomiro cha hormone akhoza kuthetsa vuto kwa amayi amenewo.
3. Ganizirani za Mini-Piritsi Yopereka Kulera
Ambiri a mapiritsi a mapiritsi amatenga "mapiritsi" omwe amaphatikizapo maantirogen ndi progesterone. Zina mwa mapulogalamu otchuka a mapiritsi awa amodzi ndi awa Lo / Ovral, Loestrin, Lybrel, Mircette, Norinyl, Ortho-Novum, Ortho Tri-Cyclen, Seasonique, Seasonale, Yasmin, ndi Yaz. Mapiritsiwa akhoza kuthana ndi ma ARV ndi ntchito ya chithokomiro.
Mapiritsi opatsirana pogonana omwe samaphatikizapo estrogen sakhudza miyeso ya TBG, ndipo chifukwa chake, sangathe kusinthiratu ntchito ya chithokomiro. Mipiritsi imeneyi imatchedwa "mini-pilill". Ena mwa mayina otchuka a mapiritsi amenewa ndi a Camila, Errin, Micronor, Nor-QD, Norethindrone, ndi Ovrette. Mankhwala a contrastetive a estrogen sagwiritsidwa ntchito mobwerezabwereza poyerekeza ndi mapiritsi osakaniza, ndipo pali mafunso ena ngati akuwoneka ngati othandiza.
Mapiritsi ophatikizana amakhala othandiza kwambiri popewera mimba kuposa "mapiritsi a mini." Pomwe amatengedwa molondola, mapiritsi ophatikizidwe ali ovomerezeka pakati pa 91% ndi 99.9% ogwira ntchito. (Pomwe watengedwa molondola, piritsi ya miniyi yavotera kuchokera 87% mpaka 99.7% ogwira ntchito.)
Ngati muli ndi mankhwala otchedwa hormone m'malo mwake ndipo mukufuna kuonetsetsa kuti chithandizo chanu cha chithokomiro sichidzakhudzidwa ndi mapiritsi opatsirana ndi estrogen, komabe muyenera kukambirana za "pilisi mini" ndi dokotala wanu.
4. Ganizirani Chigawo Chogonana
Pali chidepa choletsa kubereka, chomwe chimagwiritsidwa ntchito khungu, chomwe chimakhala ndi mahomoni omwewo, amaperekedwa transdermally (kupyolera pakhungu), ngati mapiritsi amlomo. Zina zotchuka zomwe zili pachigwirizanocho ndi Ortho Evra ndi Xulane.
Izi zimapangitsa kuti TBG isasokonezeke, ndipo zotsatira zake sizingasinthe chithokomiro.
Ngati muli ndi mankhwala otchedwa hormone m'malo mwake ndipo mukufuna kuonetsetsa kuti chithandizo chanu cha chithokomiro sichidzakhudzidwa ndi mapiritsi opatsirana ndi estrogen, muyenera kukambirana njira yomwe mungagwiritsire ntchito chida chogonana ndi dokotala wanu.
5. Talingalirani Zokwanira Zowonongeka Kwambiri za Hormone
Kafukufuku wasonyeza kuti mitundu yokha ya estrogen imakhala ndi zotsatira za chiwerengero cha TBG. Mitundu yodziwika bwino ya mapiritsi (mapiritsi) mitundu ya mankhwala a estrogen okha kapena mankhwala ophatikizidwa a hormone ndi awa Activella, Angeliq, Cenestin, Enjuvia, Estrace, Femhrt, Femtrace, Menest, Prefest, Premarin, ndi Prempro.
Ngati mukuganiza za mankhwala otchedwa hormone m'malo omwe akuphatikizapo estrojeni, muyenera kuganizira mitundu ya transroermal yokhayokha kapena yothandizira mankhwala omwe amawagwiritsira ntchito, monga mapepala, ma gels, kapena mapiritsi a vaginja. Mitundu yotchukayi imaphatikizapo chigamba cha Alora, Climara patch, Combipatch patch, Gel Divigel, Extraderm patch, Estring galasi, EstroGel gel, Evamist spray, Minivell chigamba, Vagifem phalasitiki, ndi Vivelle patch.
> Zotsatira:
> Agren, U et. Al. "Zotsatira za kugonana kwachisawawa komwe kuli ndi nomegestrol acetate ndi 17β-oestradiol poyerekeza ndi imodzi yomwe ili ndi levonorgestrel ndi ethinylestradiol pa zizindikiro za ntchito ya endocrine." 2011 Dec; 16 (6): 458-67. do: 10.3109 / 13625187.2011.614363. Epub 2011 Sep 26.
> Guttmacher Institute. "Ku United States Kugwiritsa Ntchito Mankhwala Opatsirana: 2016 Mapepala Owona." https://www.guttmacher.org/fact-sheet/contraceptive-use-united-states
> Pinkerton, J, Santoro, N. "Amadzimadzi ambirimbiri othandizira mahomoni." Kusamba kwa nthawi, 2015; 1 DOI: 10.1097 / GME.0000000000000420
> Raps, M et. Al. "Kugwiritsira ntchito mankhwala opatsirana pogonana kumayambitsa mazinga a TBG, makina a TSH okwera kwambiri." Thromb Res. 2014 Apr; 133 (4): 640-4. lembani: 10.1016 / j.thromres.2013.12.12.0. Epub 2014 Jan 7.
> Santin, A et al. "Udindo wa Estrogen m'ntchito ya chithokomiro ndi kukula kwa malamulo." J Thyroid Res. 2011; 2011: 875125. Lofalitsidwa pa Intaneti 2011 May 4. do: 10.4061 / 2011/875125