Kugwirizana pakati pa Kunenepa ndi Kulephera Kuletsa Kubereka
Chovuta kwambiri poletsa kutenga mimba yosakonzekera ndi kugwiritsa ntchito njira zoyenera zothandizira kubereka ndi amayi omwe safuna kutenga pakati. Komabe pafupifupi theka la mimba yonse yosakonzekera imachitika kwa amayi omwe amalemba kuti akugwiritsa ntchito njira zoberekera pakhomo pamwezi omwe adatenga.
Chimodzi mwa zinthu zomwe zingapangitse kuti kulephera kuchepetsa kubereka ndi kulemera kwa mkazi.
Azimayi ovuta kwambiri sangadziwe kuti kulemera kwake kungapangitse kuti njira yawo yolera njira zothandizira .
Kuchulukitsa kwawonjezeka kwazaka makumi awiri zapitazo ndikupitirizabe kukhala ndi thanzi labwino ku United States ndi padziko lonse lapansi. Kutaya thupi kumatanthawuza ngati thupi lachimake (BMI) la 30 kapena lalikulu, pamene munthu woposa kunenepa ali ndi BMI ya 25 mpaka 29.9. BMI imawerengedwa kuchokera kulemera kwake kwa munthu ndi kutalika kwake ndipo imapereka chizindikiro choyenera cha mafuta a thupi ndi zolemera zomwe zingayambitse matenda.
Mwamwayi, kufufuza za kulera sikuphatikizapo amayi obisala ndi onenepa kwambiri m'mayesero a zachipatala. Izi zachititsa kuti chiwerengero chochepa cha deta chikhale chokhudzana ndi chithandizo cha kulera komanso chitetezo mwa amayi olemera komanso onenepa kwambiri. Izi ndi zomvetsa chisoni, kupatsidwa kuti kulera koyenera ndikofunikira kwambiri kwa amayi owonjezera omwe amapatsidwa chiopsezo chachikulu chokhudzidwa ndi mimba.
Pofuna kumvetsetsa momwe njira zothandizira kulera zimachepetsedwa ndi kunenepa kwambiri, ndinayesa nkhani yonena za UpToDate - mawu ovomerezeka omwe amagwiritsidwa ntchito ndi madokotala ambiri ndi odwala:
"Njira zambiri zamagetsi zimakhudzidwa ndi zovuta, ndipo kusintha kwa metabolism kungasokoneze njira zothandizira kulera. Popeza kusintha kwa metabolism kumaphatikizira kwambiri kusiyana ndi thupi (ie, thupi mass index [BMI]), kulemera kumakhala kofunika koposa Bungwe la BMI pakuzindikiritsa kusinthika kwa mphamvu ya kulera. Kulemera kwakukulu kumagwirizanitsa ndi kuchuluka kwa kuchuluka kwa mankhwala osokoneza bongo. Makamaka, kuthetsa mankhwala osokoneza bongo, monga kulera kwa steroids, kumawonjezeka ndi kulemera kwa thupi.Therere, theka la moyo wa mankhwalawa akhoza kukhala lalifupi mu Azimayi olemera kwambiri komanso ma seramu sangakhale okwanira kuti akhalebe ndi kachilombo ka HIV.Kowonjezeranso, amayi amaonjezera magazi ochulukirapo kusiyana ndi amayi olemera omwe amawoneka kuti ndi ofunika kwambiri. Steroids imatengedwa ndi minofu ya adipose, kotero amayi omwe ali ndi adipo se ikhoza kukhala ndi steroid yochepa yomwe ikupezeka kuti ikhale yozungulira.
Malinga ndi zotsatira zowonjezera kwambiri pa pharmacokinetics za steroid za kulera, zimayesedwa kungowonjezera kaŵirikaŵiri mlingo wa kulera wogwiritsidwa ntchito ndi amayi owonjezera. Komabe, zotsatirapo ndi zoopsa zikhoza kuwonjezeka. Mwachitsanzo, mlingo waukulu wa estrogen umene umakhala ndi njira zowathandiza kulera anawo ukhoza kuonjezera chiwopsezo cha kupweteka kwakukulu kwa mimba ndipo chidzawonjezeredwa ndi chiopsezo chomwe chapezeka kale kwa amayi ochepa kwambiri. "
Kotero, izi zikutanthawuza chiyani? Tiyeni tipewe mfundo zofunika izi.
Njira zamagetsi ndizochitika zamoyo kuti selo yamoyo kapena zamoyo zimagwiritsa ntchito kupereka mphamvu zofunika pamoyo ndi kukula. Metabolism imatanthawuza kuchitika kwa mankhwala mu maselo a thupi omwe amasintha mafuta kuchokera ku chakudya kupita ku mphamvu zathu matupi athu amayenera kugwira ntchito. Anthu omwe ali ndi zolemera kwambiri (chifukwa cha mafuta ochuluka kwambiri) amawoneka kuti ali ndi chiwerengero chapamwamba cha mankhwala. Kugwiritsa ntchito mankhwala osokoneza bongo, monga maseŵera a mimba, amatengeka ndi chiwopsezo cha thupi ndikufika pachiwindi pamaso pa thupi lonselo. Chiwindi chimayambitsanso mankhwalawa, kotero kuti mankhwalawa amachepetsedwa kwambiri panthawi yomwe imalowa m'thupi. Azimayi olemera kwambiri akhoza kukhala ndi mavitamini apamwamba m'chiwindi omwe amathyola mahomoni mofulumira. Choncho, popeza pali minofu yambiri imene magazi amafunika kuyendera, maulendo ozungulira mahomoni akhoza kuchepa. Kuchuluka kwa ndalamazi sikungakhale ndi malo okwanira kuti apereke chitetezo cha mimba (mwachitsanzo, kupewa kutsekemera, kutseketsa mkaka wa chiberekero, kapena kuchepetsa chiberekero cha uterine).
Ndiponso, theka la moyo wa mankhwala (makamaka, zimatengera nthawi yayitali bwanji kuchotsa m'magazi) zikhoza kukhala zazifupi kwa amayi olemera kwambiri chifukwa zimakhala zofulumira kwambiri - kotero, pangakhalebe homoni yokwanira yachitsulo yotsalira m'thupi kuti akhale ndi zotsatira zowathandiza kulera.
Chinthu china chikukhudzana ndi kufalikira kwa magazi. Pofuna kukhala oyenerera, mahomoni oyenera kulera ayenera kulumikiza kudzera m'magazi a mkazi. Ngati mayi ali ndi thupi lalikulu, zingakhale zovuta kuti ma circulation azichitika, chifukwa cha kuchuluka kwa magazi omwe amazungulira kuzungulira matupi. Chifukwa cha kuchepa kwa ma hormone m'mimba, njira yaikulu ya magazi imatha kuchepetsa mahomoni ndi kuwachititsa kukhala opanda mphamvu.
Kulimbana ndi vutoli, estrogen ndi progestin zimasungidwa mu minofu ya adipose. Maselo ambiri omwe mayi ali nawo, amakhala ndi mwayi waukulu kuti mahomoni adzagwedezeka mu mafuta mmalo mwakutuluka m'magazi.
Chifukwa cha momwe thupi la mayi wolemera kwambiri likhoza kutenga, kufalitsa, kuchepetsa ndi kuthetseratu kulera kwa mahomoni, pali ena omwe amanena kuti mphamvu ya kulera ingathe kusungidwa ngati kuchuluka kwa mankhwala a mthupi kumakhala kobwerezabwereza. Izi zimabweretsa vuto, komabe chifukwa cha zotsatira zake . Kuphatikizapo mlingo waukulu wa estrogen pa njira za kulera kungawonjezere chiopsezo chokhala ndi zotsatira zoyipa monga zowawa zapakhosi (blood clots), kupweteka kwa magazi, kuthamanga kwa magazi kapena matenda a mtima - zoopsa zomwe zimayambitsidwa kale ndi kunenepa kwambiri.
Choncho pankhani ya kulemera ndi kubereka kwabwino, nthawi zonse ndi kofunika kuyerekezera zoopsa za mimba yosakonzekera ku ubwino ndi zovuta zomwe zimagwiridwa ndi njira yowalera. Kawirikawiri, njira, kumene kuchepetsa kulera kumakhala kosavuta kuchitika mwa amayi ovuta kwambiri kusiyana ndi amayi omwe ali ndi kulemera kwabwino, kuphatikizapo: njira zothandizira kulera , chithandizo cha kulera , ndi Implanon / Nexplanon .
Kwa amayi ochepetsetsa , ma IUDs ndi kuperewera kwa opaleshoni angakhale njira zowathandiza kulera. Komabe, chifukwa cha kuchuluka kwa thupi, njirazi zingakhale zovuta kukwaniritsa.
Njira zina zomwe sizikhudzana ndi kulemera ndizoyimitsa thupi ( Zowonjezera ) ndi njira zopewera monga makondomu , makondomu azimayi , siponji , zidutswa za chiberekero ndi makokosi achiberekero .
Mukufuna kuphunzira zambiri? Onaninso mutu wa mutu wakuti, "Uphungu wa kulera kwa amayi oposa," kuti mudziwe zambiri zachipatala zokhudza uphungu wochuluka kwambiri kwa amayi okhudzana ndi njira zawo zothandizira njira za kulera komanso kufufuza momwe kulemera kungathandizire kulepheretsa kulera.
Chitsime:
Edelman, Alison ndi Kaneshiro, Bliss. "Uphungu wopereka uphungu kwa amayi oposa." Zaposachedwa. Kupezeka: May 2011