Isixhumanisi Phakathi Kokuhluleka Kwesisindo Nokulawulwa Kwokuzalwa
Into ebaluleke kunazo zonke ekuvikeleni ukukhulelwa okungahleliwe ukusetshenziswa kokukhulelwa okuphephile nokusebenzayo ngabesifazane abangafuni ukukhulelwa. Kodwa cishe isigamu sabo konke ukukhulelwa okungalindelekile kwenzeka kubabesifazane ababika ukuthi basebenzisa ukukhulelwa kwenyanga phakathi nenyanga abayithandayo.
Enye yezinkinga ezingase zibe negalelo ekuhlulekeni kokubeletha kokuzalwa isisindo sesifazane.
Abesifazane abakhulu bangase bangaqapheli ukuthi isisindo sabo singase sithinte ukuphumelela kwendlela yabo yokukhulelwa .
Ukukhula ngokweqile kwamanani kule minyaka engamashumi amabili edlule futhi kuqhubeka ukukhathazeka kwezempilo emphakathini e-United States nasezweni lonke. Ukukhuluphala kuthiwa yi-index mass mass (BMI) engama-30 noma ngaphezulu, kanti umuntu oweqile kakhulu une-BMI ka-25 kuya ku-29.9. I-BMI ibalwa kusukela ngesisindo somuntu nokuphakama kwayo futhi inikeza isibonakaliso esizwakalayo sokudla komzimba nesigaba somzimba esingabangela izinkinga zempilo.
Ngeshwa, ukucwaninga kokubeletha akufakiwe ukugqilaza nokuqhathanisa abesifazane besilingo. Lokhu kuye kwaba nomzimba onqunyelwe wemininingwane mayelana nokusebenza kokukhulelwa nokuphepha kwabesifazane abakhuluphele nabakhulu ngokweqile. Lokho kuyinhlanhla, kunikezwe ukuthi ukubeletha okuphumelelayo kubaluleke nakakhulu kubesifazane abakhulu kakhulu abanikezwa iqiniso lokuthi bangengozini enkulu yokukhulelwa okuhlobene nokukhulelwa.
Ukuze uthole ukuqonda okubanzi ukuthi ukusebenza komzimba kunganciphisa kanjani ukukhuluphala ngokweqile, ngiphenyisisa i-athikili ye- UpToDate - isitatimende se-electronic esethembekile esetshenziswa odokotela abaningi neziguli:
"Izinqubo eziningi ze-metabolic zithinteka kakhulu, futhi lezi zinguquko ekusetshenzisweni kwemithi zingase zithinte ukuphumelela kokuvimbela ukuvimbela ukuvimbela ukuvimbela ukuvimbela ukuvimbela ukuvimbela ukuvimbela ukuvimbela ukukhulelwa. I-BMI ekunqumeni ukuhlukahluka ekusebenziseni ukuvimbela ukukhulelwa komzimba. Ukulingana okuphakeme kakhulu nokulinganisa izinga lokunciphisa umzimba. Ngokukhethekile, ukususwa kwezidakamizwa ezisetshenziswe ngokucophelela, njenge-steroids yokukhulelwa, kwanda ngokukhula kwesisindo somzimba. Ngokweqiniso, ukuphila kwengxenye yalezi zidakamizwa kungase kube mfushane Abesifazane nabanamazinga e-serum abangaphezu kwamandla angase bangenele ukugcina umphumela wokukhulelwa. Ngaphezu kwalokho, abesifazane banomzimba owedlula ukwedlula umthamo wegazi okwedlula ukwesifazane ovamile wesisindo. Lokhu kungabangela ukuhlushwa okuphawulekayo kwe-steroids yokukhulelwa, ngaleyo ndlela ukunciphisa ukusebenza komzimba. ama-steroids athathwa yizicubu ze-adipose, ngakho-ke abesifazane abane-adipo ngaphezulu i-se ingaba ne-steroid encane etholakalayo ukuze isakaze.
Ngokusekelwe emiphumeleni engaba khona yokukhuluphala kwi-pharmacokinetics ye-steroids yokukhulelwa, kuyamangalisa ukumane nje uncoma ukuphindaphinda kabili umthamo wokukhulelwa osetshenziswa abesifazane abakhuluphele. Noma kunjalo, imiphumela emibi kanye nezingozi nazo ziyokhula. Isibonelo, izinga eliphezulu le-estrogen elinezinzalo zokukhulelwa liyokwandisa ingozi ye-thrombosis ejulile enomzimba futhi izoba yingozi engozini kakade yabesifazane abakhuluphele. "
Ngakho-ke, kusho ukuthini lokhu? Ake siphule lolu lwazi olubalulekile.
Izinqubo ze-metabolic ziyizinqubo eziphilayo ukuthi iseli eliphilayo noma imvelo isebenzisa ukunikeza amandla okudingekayo empilweni nasekukhuleni. I-metabolism ibhekisela ekusebenzeni kwamakhemikhali emangqamuzaneni omzimba okuguqula uphethiloli kusukela ekudleni kuya emandleni umzimba wethu udinga ukusebenza. Abantu abanesisindo esiphakeme (ngenxa yamanoni amaningi omzimba) kubonakala sengathi banamanani aphezulu okuxubile. Ukusebenzisa izidakamizwa ngokwemvelo, njengezivimbela imithi ye-hormonal, zithathwa yi-system digestive futhi zifinyelela esibindi ngaphambi komzimba wonke. Isibindi senza umuthi wenziwe ngeziqu, ukuze ukuhlushwa kwemithi kuncishiswe kakhulu ngenkathi kungena ohlelweni lokujikeleza. Abesifazane abakhuluphele ngokweqile bangase babe namathuba amaningi okuba nama-enzyme aphakeme esibindi esizoqeda ama-hormone ngokushesha. Ngakho-ke, njengoba kunezicubu eziningi lapho igazi kufanele lijikeleze khona, amazinga e-hormone ajikelezayo angancipha. Leli nani lingenalo ukugxila okwanele ukuhlinzeka ukuvikelwa kokukhulelwa (okungukuthi, ukuvimbela i-ovulation, ukunqanda umqubu womlomo wesibeletho, noma ukunciphisa uhlaka lwe-uterine).
Futhi, isigamu sempilo yesidakamizwa (ngokuyinhloko, kuthatha isikhathi esingakanani isigamu sazo sokuqedwa egazini) kungase kube mfushane kubantu besifazane abangaphezu kwenani eliphakeme ngoba kusetshenziselwa ukuphuza ngokweqile-ngakho-ke, kungenzeka ukuthi akusikho okwanele kwe-hormone yokukhulelwa kwesokunxele emzimbeni ukuba abe nomthelela wokukhulelwa.
Esinye isici sibhekene nokujikeleza kwegazi legazi. Ukuze kube nempumelelo, ama-hormone okukhulelwa adinga ukujikeleza ngegazi lomfazi. Uma owesifazane enesisindo esikhulu somzimba, kungase kube nzima kakhulu ukuhambisa okwanele okwenzekayo, ngenxa yamanani aphezulu egazi azungeze imizimba. Ngenxa yamazinga e-hormone aphansi kakhulu ezakhiweni zokubeletha, umthamo omkhulu wegazi unganciphisa ama-hormone futhi uwenze ungasebenzi kahle.
Ukuncintisana nesimo, i- estrogen ne- progestin zigcinwe ezicubu ze-adipose. Ama-fat cells amangqamuzana owesifazane anakho, amathuba amakhulu ukuthi ama-hormone azoboshwa emafutheni esikhundleni sokugeleza ngegazi.
Ngenxa yendlela umzimba wesifazane onamandla ngokweqile ungase ubambe, usakaze, uhlanganise futhi uqede ukukhulelwa kwe-hormonal, kukhona labo abaphikisana ngokuthi ukusebenza kahle kokubeletha kungagcinwa uma inani le-hormonal in the contraceptive liphindwe kabili. Lokhu kubangela inkinga, noma kunjalo ngenxa yemiphumela emibi . Kubandakanya ukulinganisa okuphakeme kwe-estrogen emithini yokukhulelwa kungakhuphula ingozi yokuthuthukisa imiphumela emibi njengengcindezi ejulile yegazi (i-blood clots), isifo, isifo segazi esiphakeme noma ukuhlasela kwenhliziyo - izingozi ezivele zihlotshaniswa nokukhuluphala.
Ngakho uma kuziwa ngesisindo nokulawulwa kokubeletha, kuhlale kubalulekile ukuqhathanisa izingozi zokukhulelwa okungahlosiwe ngokumelene nezinzuzo nezinsalela ezihlobene nendlela ethile yokukhulelwa. Ngokuvamile, izindlela, lapho ukwehluleka kokuvimbela ukuvimbela ukuvimbela ukuvimbela ukuvimbela ukuvimbela ukuvimbela ukuvimbela ukuvimbela ukuvimbela ukuvimbela ukuvimbela ukuvimbela ukuvimbela ukuvimbela ukuvimbela ukuvimbela ukuvimbela ukuvimbela ukuvimbela ukuvimbela imithi .
Kwabesifazane abakhuluphele, i- IUDs kanye nokugcizelela ukuhlinzwa kungase kube izindlela eziningi zokuvimbela ukukhulelwa. Nokho, ngenxa yokwanda komzimba, lezi zinqubo zingase zibe nzima ukuqedela.
Ezinye izindlela ezingathinteki isisindo ziyi- sterization (i- Essure ) kanye nezindlela zokuvimbela izimbambiso ezifana namakondomu , amakhondomu amantombazane , isiponji , imifucumfucu kanye nekhanda lomlomo wesibeletho .
Ufuna ukufunda kabanzi? Bheka isihloko se- UpToDate , "Ukwelulekwa kokubeletha kwabesifazane abakhuluphele," ukuze uthole ukwaziswa okujulile kwezokwelapha ekululekeleni abesifazane abakhulu kakhulu ngokukhetha kokukhulelwa nokuhlola ukuthi isisindo singabangela kanjani ukwehluleka kokukhulelwa.
Umthombo:
Edelman, Alison no Kaneshiro, Bliss. "Ukwelulekwa kokubeletha kwabafazi abakhuluphele." Kusesikhathini. Kufinyelelwe: May 2011