Kodi Kuphatikiza Kugonana Kulimbana Ndi Chiyani?

Mankhwala a Estrogen, Mitundu ya Progestin, ndi Pulogalamu Yowonjezera Yowonjezera

Kodi kuphatikizapo mapiritsi oletsa kubereka ndi chiyani? Ndipo pali kusiyana kotani pakati pa kuchuluka kwa mankhwala osiyana? Ndi ubwino wanji ndi zovuta za njira zosiyanasiyana?

Tanthauzo la Mgwirizano wa Kugonana kwa Piritsi

Mapiritsi oletsa kubereka amatha kugwiritsa ntchito mankhwala opangidwa ndi mankhwala omwe amachititsa isrogen (ethinyl estradiol) ndi progestin , mofanana ndi mahomoni am'thupi (estrogen ndi progesterone) opangidwa mu thupi la mkazi.

Mapiritsi ochepetsa kubereka angathenso kutchedwa "mapiritsi a combo" kapena "mapiritsi".

Mosiyana ndi estrogen (yokonza yokonza ethinyl estradiol) yomwe imapezeka m'magulu osiyanasiyana a mapiritsi osakaniza, palinso mitundu yosiyanasiyana ya progesin yomwe ingagwiritsidwe ntchito (ikufotokozedwa pansipa).

Kupeza Kuphatikizidwa Kugonana Mankhwala

Zonsezi zimagwiritsidwa ntchito ndi mankhwala. Izi zikutanthauza kuti simungathe kugula mapiritsi awa pa pepala.

Dokotala wanu akhoza kapena sangayesetse kupima kwapachipa ndi pap smear kuti apereke mapiritsi oletsa kubadwa. Madokotala ena amapereka mapiritsi a combo pamaziko a mbiri yachipatala mosamala komanso kupanikizika kwa magazi (monga mapiritsi angapangitse kuti magazi azithamanga .) Ngakhale dokotala asakufuneni mapepala a mapepala pofotokoza mapiritsi, ndizofunika kuti mapepala a Pap apange atatu zaka pakati pa zaka 21 ndi kusamba kwa nthawi, komanso kawirikawiri ngati mwakhala ndi Pap smear yachilendo kapena mayeso abwino a HPV.

Musanawone dokotala wanu, fufuzani malingaliro awa momwe mungalankhulire ndi dokotala wanu zokhudza kubeleka ndi mafunso omwe muyenera kufunsa.

Mitundu ya Kusakaniza Mapiritsi Oletsa Kubadwa

Mapiritsi oletsa kubereka amagawidwa ngati amodzi okha, amodzi, kapena atatu omwe amachititsa kuti mahomoni azikhala chimodzimodzi pamasabata atatu oyambirira akuyamba kusamba kapena ngati akusintha.

• Mapiritsi a monophasic ali ndi ofanana ndi estrogen ndi progesin mu mapiritsi onse omwe amagwira ntchito.
• Mapiritsi a biphasic amasintha mlingo wa estrogen ndi progesin nthawi imodzi pamapiritsi ogwira ntchito, ndi mlingo wa progestin ukuwonjezeka mu theka lachiwiri la kayendetsedwe ka mankhwala.
• Mapiritsi osakaniza amachititsa kuti mahomoni azisintha maulendo atatu panthawiyi, ndipo isrogen ndi progesin zingasinthe.

Kuphatikizidwa kwa Kuphatikizidwa kwa Kubadwa kwa Kukula

Mapiritsi oletsa kubereka amayamba mwezi umodzi. Mapiritsi osakaniza amakhalapo pamasamba a masiku 28 kapena 21-masiku.

Mabaibulo awiriwa ali ndi mapiritsi 21 othandiza. Izi ndi mapiritsi omwe amaphatikizapo mahomoni omwe amalepheretsa mkazi kutenga pakati.

Packs Patsiku la 28

Mu phukusi la masiku 28, mapiritsi asanu ndi awiri omalizira amadziwika ngati mapiritsi okumbutsa. Zilibe mahomoni. Mapiritsiwa amatengedwa pa sabata lachinayi, ndipo cholinga chawo ndi kuthandiza mayiyo kuti azikhala ndi mapiritsi tsiku ndi tsiku. Choncho, mayi adzalandira mapiritsi tsiku lililonse pakapita ma sabata 4.

Packs Patsiku Lamasiku 21

Mu phukusi la masiku 21, mapiritsi amatengedwa kwa masabata atatu oyambirira, ndipo mkazi samatenga kalikonse pa sabata lachinayi. Adzayambitsa paketi yatsopano ya mapiritsi masiku asanu ndi atatu mutatha pakiti yapitayi.

Chitsanzo cha mtundu wa mapiritsi omwe amabwera mu paketi ya masiku 21 ndi Loestrin . Mapiritsi a mapiritsi akhoza kukhala achinyengo chifukwa amai amafunika kukumbukira kuyamba mapiritsi awo atsopano popanda mapiritsi omwe amakumbutsa.

Packs Patsiku la 24

Pali mitundu iwiri yokhala ndi mapiritsi ophatikizira odwala omwe ali ndi masiku 24 ogwira ntchito ndi mapiritsi anayi okha a placebo. Izi zikuphatikizapo:

• Yaz 28 (ndi Beyaz ): Dongosolo la mankhwala a Yaz ndilopadera chifukwa liri ndi mapiritsi a makumi awiri ndi makumi awiri ndi awiri (24 hormone) potsatira mapiritsi a tsiku. Njirayi ingapangitse anthu kuchepa kwa mahomoni kusiyana ndi masiku 21 a mapiritsi ogwira ntchito pamasiku 28. (Onani machenjezo, komabe, za Yasmin ndi Yaz 28 pansipa.)
  

• Loestrin 24 Fe: Yavomerezedwa ndi FDA mu 2006, piritsiyi ndilo loyamba lakumapeto kwa masiku makumi awiri ndi awiri (24) lachonde lovomerezeka ku US.

Mapiritsi Owonjezera

Mapiritsi ophatikizana owonjezera (omwe amadziwikanso kuti mapiritsi oyendayenda ) ali ndi mapiritsi ambiri mu paketi iliyonse. Mapiritsiwa akhoza kukulolani kuti muchepetse nthawi yanu kapena kuchepetsa nthawi ya nthawi yanu. Kafukufuku amasonyeza kuti mapiritsi ozungulira amakhala otetezeka . Zikhoza kukhala zabwino ndikusintha umoyo wa amayi ambiri omwe akudwala matenda okhudzana ndi msambo. Mankhwala otchuka ndi awa:

• Seasonale ndi mankhwala opatsirana omwe ali ndi ethinyl estradiol / levonorgestrel. Ikhoza kutengedwa mosalekeza kwa masiku 91 ndipo FDA inavomerezedwa kuti ikhale ndi chizolowezi choletsa kubereka m'chaka cha 2003. Izi zimapangitsa amayi kuti azikhala ndi nthawi yochepa ya kusamba pachaka. Piritsi iyi imakhala ndi mapiritsi okwana 84 ndi mapiritsi 7 a placebo.
  
• Seasonique ndi mankhwala ena opatsirana omwe amavomerezedwa ndi FDA mu 2006. Seasonique ndi ofanana ndi Seasonale mu ethinyl estradiol / levonorgestrel imatengedwa mosalekeza kwa masiku 84. Koma ndi Seasonique, masiku asanu ndi awiri omaliza a miyezi itatuyi ali ndi dose ya ethinyl estradiol mmalo mwa mapiritsi a placebo.
  
• LoSeasonique imapezanso. Mapangidwe awa ali ndi zochepa za estrogen ndi progestin kuposa Seasonique.
  
• Lybrel ndi mapiritsi ochepa omwe amatha kupatsira ana. Zimatenga masiku 365 pachaka. Mu May 2007, ndiwo mapiritsi oyamba a FDA omwe amavomerezedwa kuti athetsere mwezi uliwonse. Amayi ambiri omwe amagwiritsa ntchito Lybrel amasangalala kuti asakhale ndi nthawi yawo koma amagawana zosiyana zosiyanasiyana ndi mankhwalawa.

Akazi akhoza kuyang'ana ma piritsi awo kuti awone kuti ndi mahomoni omwe alipo komanso kuti ndiyeso yanji pa nthawi yonseyi.

Kusamba

Pogwiritsira ntchito mapiritsi oletsa kubereka, amayi nthawi zambiri amasiya kutuluka magazi (nthawi) pa sabata lachinayi. Mahomoni omwe ali m'kati mwa mapiritsi amateteza mimba mwezi wonse, kotero ngakhale pa sabata lachinayi (mosasamala kanthu kuti akumwa mapiritsi kapena ayi mapiritsi), mkazi amatetezedwa kuti asakhale ndi pakati.

Progestin Hormones mu Piritsi Yophatikiza

Mapiritsi onse ophatikizidwa ali ndi estrogen (makamaka ethinyl estradiol) ndi mtundu wina wa progestin wokonzedwa kuti ufanane ndi progesterone yakuthambo. Ma progestin awa ndi awa:

1. Desogestrel
2. Ethynodiol Diacetate
3. Levonorgestrel
4. Norethindrone
5. Norethindrone Acetate
6. Osgestimate
7. Norgestrel
8. Drospirenone

Mungafune kudziwa zambiri zokhudza ntchito ya progesin mu mapiritsi ndi chifukwa chake mitundu ina ya progesin ingakwaniritse zosowa zanu kuposa wina.

Chenjezo Pa Yasmin ndi Yaz 28

Mosiyana ndi mapiritsi oletsa kubereka, Yasmin ndi Yaz 28 ali ndi dropirenone ya progestin yomwe ingapangitse potaziyamu kuwonjezeka, ndipo kuwonjezeka kwa potassium kungayambitse mavuto okhudza mtima kapena mavuto ena. Mapiritsiwa sangakhale njira yoyenera kwa inu ngati munakhalapo ndi impso, chiwindi, kapena matenda a adrenal gland . Palinso vuto lina lomwe drospirenone likhoza kuonjezera chiopsezo chokhala ndi magazi .

Estrogen Dosages mu PIll

Ethinyl estradiol ndi mtundu wa synthetic estrogen wopezeka m'mimba yopangira mankhwala. Pamwamba piritsi la estrogen pa mapiritsi (apamwamba kwambiri a micrograms a ethinyl estradiol) amatanthauza zotsatira zazikulu za estrogen pa thupi lanu (chabwino ndi choipa.)

Mapiritsi Osakanikirana Ochepa

Mapiritsi ochepetsa mapiritsi ali ndi ochepa kwambiri a estrogen (20 mcg) kuphatikizapo imodzi mwa mitundu ya progestin. Mayina a mapiritsi awa ndi awa:

• Zindikirani
• Aviane-28
• Alevi
• Loestrin 1/20
• Mircette

Mipiritsi Yowonjezera Nthawi Zonse

Mapiritsi a nthawi zonse amakhala ndi 30 mpaka 35 mcg estrogen kuphatikizapo mtundu umodzi wa progestin. Mayina a mapiritsi awa ndi awa:

• Brevicon
• Afunseni 1/35
• Desogen
• Femcon Fe
• Levlen
• Lo / Ovral
• Modicon
• Nordette
• Levora
• Loestrin
• Ogestrel Low
• Okoni 1/35
• Norinyl 1/35
• Ortho-Citi
• Ortho-Cyclen
• Ortho-Novum 1/35
• Ortho Ortho-Lo
• Ovcon 35
• Seasonale
• Yasmin
• Zovia 1 / 35E

Pills Combination Pills

Mapiritsi ophatikizana amakhala ndi kusintha kwa maselo a estrogen ndi progestin omwe amawunikira kuti azitsatira kwambiri nthawi yomwe mayi amayamba kusamba. Mayina a mapiritsi awa ndi awa:

• Ortho Ortho-Lo
• Jenest-28
• Ortho Tri-Cyclen
• Cyclessa
• Triphasil
• Tri-Levlen
• Ortho-Novum 10/11
• Trivora
• Tri-Norinyl
• Estrostep Fe
• Ortho-Novum 7/7/7

Mipiritsi Yambiri Yophatikizana

Mankhwala a mapiritsi apamwamba ali pafupi 50 mcg ya estrogen kuphatikizapo progestin. Mayina a mapiritsi awa ndi awa:

• Ortho-Novum 1/50
• Ovral
• Afunseni 1/50
• Ogestrel
• Ovcon 50

Mapiritsi Osakaniza ndi Zophatikiza Zowonjezera

Cholinga chachikulu cha mapiritsi oletsa kubereka ndizowononga mimba. Komabe palinso mitundu yambiri ya mahomoni omwe angatenge phokoso yowonjezera, komanso kuthandizidwa ndi mavuto ena. Mwa kuyankhula kwina, pali mapiritsi ena osamvetsetseka a mapiritsi omwe amasiyana pakati pa malonda.

Zina mwazimene mapiritsi angathandizire (ndipo nthawi zina amavomerezedwa) zimaphatikizapo ziphuphu , matenda opatsirana am'mimba , endometriosis , ndi nthawi zopweteka . Kuphatikiza apo, mapiritsi angakuthandizeni kuchepetsa chiopsezo cha khansa ya uterine, ovari, colon ndi khansa, ngakhale kuti pangakhale ngozi yowonjezera khansa ya m'mapapo mwa anthu omwe amasuta ndi khansa ya m'mawere ndi chiberekero omwe akugwiritsa ntchito piritsi (yowonjezera chiwopsezo chimawoneka kuti chikupita mkati mwa zaka zisanu za kusiya pilisi.)

Kuyambitsa Piritsi

Ngati mukuyamba kumwa mapiritsi, zingakhale zothandiza kuwerengera zina mwazofunikira zomwe mukuyenera kugwiritsa ntchito kugwiritsa ntchito mapiritsiwo mogwira mtima . Mwinanso mungakhale ndi mafunso okhudza momwe mapiritsi amagwirira ntchito .

Mukamamwa mapiritsi, nkofunikanso kudziŵa kuti mankhwala amachepetsa bwanji mapiritsi . Mwachitsanzo, anthu ambiri sakudziwa kuti kumwa mankhwala opatsirana pogwiritsa ntchito mankhwala a chikhodzodzo kungachepetse kwambiri mapiritsi-ndi kuwonjezera mwayi kuti mukhale ndi pakati.

Kusintha Piritsi Yanu Yoyamba Kubadwa

Palinso mapiritsi osiyanasiyana omwe mungasankhe, koma ndi kofunika kulankhula ndi adokotala za momwe mungasinthire mapiritsi oletsa kubereka ngati mutero.

Kuyerekezera mapiritsi a Mgwirizano ndi mapiritsi a Progesin okha

Pulogalamu yowononga yobereka imakhala yothandiza kwambiri kuposa mapiritsi a progestin okha . Komabe matupi a amayi ena sachita bwino ndi estrogen mu mapiritsi osakaniza. Kwa omwe ali ndi nkhawazi, monga kupatsirana kwa magazi pampiritsi wophatikiza, piritsi yokhayokhayo ingakhale yabwino.

Pansi pa Mchitidwe Wolimbana ndi Kugonana

Pogwiritsa ntchito zomwe zili pamwambazi, mwinamwake mwazindikira kuti pali mitundu yambiri yomwe muyenera kuganizira posankha mapiritsi abwino. Mtundu wa estrogen mu mapiritsi ndi ofanana (ethinyl estradiol) koma mlingo ukhoza kusiyana. Estrogen ikhoza kukhala ndi zotsatira zabwino ndi zoipa m'thupi, ndipo mlingo woyenera kwa inu udzadalira zofuna zanu komanso mbiri yanu ya zamankhwala.

Mosiyana ndi estrogen, pali mitundu yosiyanasiyana ya progestins yomwe ingagwiritsidwe ntchito. Zonsezi zingakhale ndi madalitso onse (monga kulamulira kwa acne) kapena zoopsa (monga chiopsezo cha magazi) ndipo n'kofunika kuti muyankhule ndi dokotala wanu za progesin zomwe zingakhale zabwino kwa inu nokha.

Kukongola kokhala ndi mapiritsi osiyanasiyana ndikuti pali zina zambiri zomwe mungasankhe ngati mtundu umodzi umabweretsa mavuto. Pa nthawi yomweyi, ndi koyenera kulankhula ndi adokotala za momwe mungasinthire mapiritsi oletsa kubereka ngati mutero.

Mapiritsi amakhala othandiza kwambiri ngati amagwiritsidwa ntchito moyenera, ndipo akhoza kupha mbalame ziwiri ndi mwala umodzi kwa anthu ena omwe ali ndi matenda oyambirira, ziphuphu, kumaliseche, ndi zina. Izi zinati, zimakhala zogwira mtima kwambiri muzitha zonsezi zikagwiritsidwa ntchito mosamala kuti mapiritsi asaphonye ndipo mukalankhula kwa dokotala mwamsanga za zotsatirapo kapena zodetsa nkhawa.

> Zotsatira:

> Cunningham, F. Gary, ndi John Whitridge Williams. Williams Obstetrics. New York: Medical Medical McGraw-Hill, 2014. Print.

> Iversen, L., Sivasubramaniam. S., Lee, A., Fielding, S., ndi P. Hannaford. Kuopsa kwa Khansa ya Moyo Wonse ndi Kuphatikizana Kwabwino kwa Mlomo: Royal College of General Practitioners 'Oral Contracep Study Study. Journal American Obstetrics ndi Gynecology . 2017. 216 (6): 580.e1-580.e9.

> Kluft, C., Zimmerman, Y., Mawet, M. et al. Zotsatira za Hemostatic zochepetsedwa ndi Drospirenone-Based Based Oral Contraceptive Zili ndi Estetrol VS. Ethinyl Estradiol. Kulera . 2017. 95 (2): 140-147.