Ama-Estrogen Doses, Izinhlobo ze-Progestin, nezinzuzo ezengeziwe zePillisi
Ziyini izinhlanganisela zokuvimbela ukuzalwa (izitho zomzimba zomlomo) futhi yini umehluko phakathi kobuningi bemikhiqizo ehlukene yemithi? Yiziphi ezinye zezinzuzo nezinsalela zezinketho ezahlukene?
Incazelo yezinhlanganisela zokulawula ukuzalwa kokuzalwa
Amaphilisi okulawula ukuzalwa ayingxenye yokubeletha ngomlomo ehlanganisa i- estrogen (i-ethinyl estradiol) ne- progestin , efana ne-hormone yesifo sangokwemvelo ( estrogen neprogesterone) eyenziwa emzimbeni wesifazane.
Amaphilisi okulawula ukuzalwa angabuye abizwe ngokuthi "amaphilisi ama-combo" noma amane, "iphilisi."
Ngokungafani ne-estrogen (i-synthetic preparation ethinyl estradiol) etholakala emikhakheni ehlukahlukene yamaphilisi okuhlanganiswa, kunezinhlobo ezihlukahlukene ze-progestin ezingasetshenziswa (okuxoxwe ngezansi.)
Ukuthola Ukulawulwa Kokuzalwa Kwamaphilisi Amaphilisi
Yonke inhlanganisela yokulawula amaphilisi okubeletha itholakale kuphela ngomuthi. Lokhu kusho ukuthi awukwazi ukuthenga noma iyiphi yalezi philisi phezu kwekhawunt.
Udokotela wakho angase afune noma afune ukuhlolwa kwe-pelvic ne- Pap smear ukuze anikeze iphilisi yokulawula ukuzalwa. Abanye odokotela bazongena amaphilisi ama-combo ngesisekelo somlando wezokwelapha ngokucophelela kanye nesilinganiso somfutho wegazi (njengoba iphilisi ingakhuphula umfutho wegazi .) Ngisho noma udokotela wakho engadingi i-Pap smear lapho ebeka iphilisi, kubalulekile ukuba nePap smears zonke ezintathu iminyaka ephakathi kweminyaka engu-21 nokuya esikhathini sokuya esikhathini, futhi kaningi uma uye waba ne-Pap smear engavamile noma ukuhlolwa kwe-HPV enhle.
Ngaphambi kokuba ubone udokotela wakho, hlola le mibono yokuthi ungakhuluma kanjani nodokotela wakho mayelana nokulawulwa kokubeletha kanye nemibuzo okufanele uyibuze.
Izinhlobo Zokulawula Ukuzalwa Kwamaphilisi Amaphilisi
Amaphilisi okulawula ukuzalwa ahlukaniswa njenge- monophasic, i-biphasic, noma i-triphasic kuye ngokuthi izinga lama-hormone lihlala yini phakathi kwamasonto amathathu okuqala omjikelezo noma uma lishintsha.
- Amaphilisi e-monophasic anesilinganiso esifanayo se-estrogen ne-progestin kulawo maphilisi asebenzayo epakethe.
- Amaphilisi e-Biphasic ashintsha izinga le-estrogen ne-progestin ngesikhathi esisodwa phakathi kwamaphilisi asebenzayo, nezinga le-progestin ekhulayo engxenyeni yesibili yomjikelezo.
- Amaphilisi esithathu aguqule amazinga amahomoni kathathu phakathi nomjikelezo, futhi kokubili izinga le-estrogen ne-progestin lingashintsha.
Usayizi wePakethe lokuLawula ukuzalwa komzimba
Amaphilisi okulawula ukuzalwa afika ngokuhlinzeka ngenyanga eyodwa. Amaphilisi enhlanganisela avame ukutholakala emaqenjini angu-28 noma angu-21 ngosuku.
Zombili izinguqulo zinamaphilisi asebenzayo angu-21. Lezi amaphilisi afaka amahomoni avimbela owesifazane ukuba akhulelwe.
Amaphakethe wezinsuku ezingu-28
Emphakathini wezinsuku ezingu-28, amaphilisi ayisishiyagalolunye okugcina ayaziwa ngokuthi amaphilisi okukhumbuza. Aziqukethe ama-hormone. Lawa maphilisi athathwa phakathi nesonto lesine, futhi inhloso yawo ukusiza lo wesifazane ukuba alondoloze isimiso sakhe sokuthatha iphilisi nsuku zonke. Ngakho-ke, owesifazane uzothatha iphilisi ngosuku ngalunye umjikelezo weviki 4.
Amaphakethe wezinsuku ezingu-21
Emphakathini wezinsuku ezingu-21, amaphilisi athathwe amasonto amathathu okuqala, futhi owesifazane akatholi lutho ngesikhathi sesonto lesine. Uzoqala iphakethe elisha lamaphilisi emva kwezinsuku eziyisishiyagalolunye ngemuva kokuba iphakethe langaphambilini ligcwaliswe.
Isibonelo somkhiqizo wepilisi ofika emphakathini wezinsuku ezingu-21 ngu- Loestrin . Lezi phakethe zamaphilisi zingaba yinkimbinkimbi ngoba abesifazane kudingeka bakhumbule ukuqala iphakethe labo elitsha lamaphilisi ngaphandle kwamaphilisi okukhumbuza.
Amaphakethe wezinsuku ezingu-24
Kunezinhlobo ezimbili zokuhlanganiswa kokuzalwa kwamaphilisi okuba nezinsuku ezingu-24 ezisebenzayo namaphilisi amane ase-placebo. Lokhu kufaka:
- I-Yaz 28 (no- Beyaz ): Umthamo wokulinganisa we-Yaz uhlukile ngoba uqukethe amaphilisi angu-24 we-hormone, kulandelwa amaphilisi angu-4 okukhumbuza. Lolu khetho lungase lunikeze abantu ukushintsha kwe-hormone encane kunezinsuku ezingu-21 zendabuko zamaphilisi asebenzayo ngomjikelezo wezinsuku ezingu-28. (Bheka isixwayiso, kodwa, mayelana noJasmin noJaz ngezansi.)
- Loestrin 24 Fe: Kuvunywe yi-FDA ngo-2006, lo mkhiqizo wepilisi wawuyizinsuku zokuqala zokubeletha zomlomo ezingu-24 ezivunyelwe e-US.
Amaphilisi we-Cycle Extended
Amaphilisi okuhlanganisa umjikelezo owandisiwe (owaziwa nangokuthi amaphilisi okujikelezayo aqhubekayo ) anezipilisi eziningi emphakathini ngamunye. Lawa maphilisi angakuvumela ukuba usuke ngokuphelele isikhathi sakho noma wehlisa imvamisa yenkathi yakho. Ucwaningo lubonisa ukuthi amaphilisi okujikeleza asele aphephile . Zingaba lula futhi zithuthukise izinga lempilo yabesifazane abaningi ababhekana nezinkinga ezihlobene nokuya esikhathini. Ama brand adumile afaka:
- I-Seasonale iphilisi eliqhubekayo elithwala i-ethinyl estradiol / levonorgestrel. Kungathathwa ngokuqhubekayo ngezinsuku ezingu-91 futhi i-FDA ivunyelwe ukuvimbela ukuvimbela inzalo ngo-2003. Lo mgomo uvumela abesifazane ukuba babe nezinyanga ezimbalwa ngonyaka. Leli pilisi liphethe amaphilisi angu-84 asebenzayo namaphilisi angu-7 e-placebo.
- I-Seasonique ingenye imithi ehlanganisiwe yokuhlanganisa i-pilisi yokuzalwa yokuzalwa eyavunyelwa yi-FDA ngonyaka ka-2006. I-Seasonique ifana neSeasonale kuleyo ethinyl estradiol / levonorgestrel ithathwa ngokuqhubekayo izinsuku ezingu-84. Nge-Seasonique, noma kunjalo, izinsuku ezingu-7 zokugcina zomjikelezo wezinyanga ezintathu ziqukethe i-ethinyl estradiol ephansi kakhulu kunamaphilisi e-placebo.
- I-LoSeasonique nayo iyatholakala. Lokhu kwakha kune-estrogen encane kanye ne-progestin kuno-Seasonique.
- I-Lybrel iyiphilisi yokulawula ukuzala okuqhubekayo ephansi. Kuthathwa izinsuku ezingu-365 zonyaka. Ngo-Meyi 2007, kwakuyipilisi yokuqala i-FDA evunyelwe ukuba isetshenziswe ukuyeka unyaka nonyaka wesifazane. Abesifazane abaningi abasebenzisa uLybrel bayakujabulela ukungabi nesikhathi sabo kodwa baxoxe ngokuhlangenwe nakho okuhlangenwe nakho nale brand brand.
Abesifazane bangahlola i-pill yabo iphakheji ukuze bathole ukuthi yiziphi i-hormone ezikhona nokuthi yiziphi izilinganiso kulo lonke umjikelezo.
Ukuya esikhathini
Uma usebenzisa amaphilisi okulawula ukubeletha, abesifazane ngokuvamile bazoba nokukhipha igazi (isikhathi) phakathi nesonto lesine. I-hormone equkethe amaphilisi asebenzayo avimbela ukukhulelwa phakathi nenyanga, ngakho-ke ngisho nangesonto lesine (kungakhathaliseki ukuthi uthatha amaphilisi okukhumbuza noma akukho amaphilisi nhlobo), owesifazane uvikelekile ekukhulekeni.
I-progestin amaHormoni ePilisi Yokuhlanganiswa
Zonke amaphilisi okuhlanganiswa aqukethe i-estrogen (ngokuvamile i-ethinyl estradiol) kanye nohlobo oluthile lwe-progestin elenzelwe ukulingisa i-progesterone ye-hormone yemvelo. Lezi zinhlelo ze-progestin zihlanganisa:
- Desogestrel
- I-Ethynodiol Diacetate
- Levonorgestrel
- Norethindrone
- I-Norethindrone Acetate
- I-Norgestimate
- I-Norgestrel
- I-Drospirenone
Ungase ufise ukufunda kabanzi mayelana nendima ye-progestin epilisi nokuthi kungani ezinye izinhlobo ze-progestin zingahlangabezana nezidingo zakho kangcono kunomunye.
Isexwayiso mayelana noJasmin noJaz 28
Ngokungafani namanye amaphilisi okulawula ukuzalwa, i-Yasmin i-Yaz 28 iqukethe i-progestin drospirenone engakwandisa amazinga e-potassium, futhi lokhu kwanda kwe-potassium kungase kubangele izinkinga ezihlobene nenhliziyo noma ezinye izinkinga. Lezi amaphilisi angeke ibe yindlela efanele kuwe uma uke waba nezinso, isibindi, noma isifo se-grenal adrenal . Kukhona futhi ukukhathazeka ukuthi i- drospirenone ingandisa ingozi yezindwangu zegazi .
I-Estrogen Izilinganiso ku-PIll
I-Ethinyl estradiol yilona uhlobo lwe-estrogen yokwenziwa etholakalayo emithini yokukhulelwa ngomlomo. Ukuphakama inani le-estrogen emapilisi (ephakeme inani le-micrograms ye-ethinyl estradiol) kusho imiphumela enkulu ye-estrogen emzimbeni wakho (kokubili okuhle nokubi.)
Amaphilisi Okunciphisa Amancane
Amaphilisi okuhlanganiswa kwezinga elincane aqukethe isilinganiso esincane kakhulu se-estrogen (20 mcg) kanye nenye yezinhlobo ze-progestin. Amagama omdanso walolu hlobo lwephilisi afaka:
- Yenza kahle
- Aviane-28
- Levlite
- Loestrin 1/20
- Mircette
Amaphilisi Okuhlanganiswa Ngamanye Amandla
Amaphilisi avamile njalo anezi-30 kuya ku-35 mcg estrogen kanye nenye yezinhlobo ze-progestin. Amagama omdanso walolu hlobo lwephilisi afaka:
- Brevicon
- Demulen 1/35
- Desogen
- Femcon Fe
- Levlen
- Lo / i-Ovral
- Modicon
- Nordette
- Levora
- Loestrin
- I-Low-Ogestrel
- I-Necon 1/35
- I-Norinyl 1/35
- I-Ortho-Cept
- I-Ortho-Cyclen
- I-Ortho-Novum 1/35
- I-Ortho Tri-Cyclen Lo
- I-Ovcon 35
- Seasonale
- Yasmin
- I-Zovia 1 / 35E
Amaphilisi e-Phasic Combination
Amaphilisi okuhlanganiswa kwama-phasic anezilinganiso eziguqukayo ze-estrogen ne-progestin eklanyelwe ukulinganisa ngokucophelela izigaba ze-hormone ngesikhathi sokuhamba komama wesifazane. Amagama omdanso walolu hlobo lwephilisi afaka:
- I-Ortho Tri-Cyclen Lo
- I-Jenest-28
- I-Ortho Tri-Cyclen
- I-Cyclessa
- I-Triphasil
- Tri-Levlen
- I-Ortho-Novum 10/11
- I-Trivora
- I-Tri-Norinyl
- Estrostep Fe
- I-Ortho-Novum 7/7/7
Amaphilisi Okuhlanganiswa Okuphezulu
Amaphilisi okuhlanganiswa aphezulu aphezulu anama-50 mcg we-estrogen kanye ne-progestin. Amagama omdanso walolu hlobo lwephilisi afaka:
- I-Ortho-Novum 1/50
- I-Ovral
- Demulen 1/50
- I-Ogestrel
- I-Ovcon 50
Amapillisi Okuhlanganiswa Ngezinhloso Ezingeziwe
Inhloso eyinhloko yamaphilisi okulawula ukubeletha yiqiniso, ukuvimbela ukukhulelwa. Noma kunjalo kukhona ezinye izinhlobo kanye nezinhlanganisela zamahomoni ezingase zipakishe i-punch eyengeziwe, kanye nosizo nezinye izinto ezikhathazayo. Ngamanye amazwi, kunezinzuzo ezithile ezingenakuphikisana zephilisi ehluka phakathi kwezinto.
Ezinye zezimo lapho iphilisi ingasiza khona (futhi ngezinye izikhathi zivunyelwe futhi) zibandakanya induna , isifo se-premenstrual dysphoric , endometriosis , nezikhathi ezibuhlungu . Ngaphezu kwalokho, iphilisi ingasiza ekunciphiseni ingozi ye-uterine, i-ovarian, i-colon kanye ne-cancer ehlobene negazi, nakuba kungase kube khona ingozi yomdlavuza wamaphaphu kubantu ababhema kanye namabele omlomo wesibeletho namabele omlomo kubasebenzisi abasebenzisa iphilisi (okwandisiwe ingozi ibonakala ihamba phakathi neminyaka emihlanu yokumisa iphilisi.)
Ukuqala iphilisi
Uma uqala nje iphilisi, kungasiza ukufundela kwezinye izinto eziyisisekelo okudingeka wazi ukuthi usebenzise iphilisi ngempumelelo . Ungase futhi ube nemibuzo mayelana nokuthi iphilisi isebenza kanjani .
Uma uthatha iphilisi, kubalulekile futhi ukwazi ukuthi imiphi imithi inganciphisa ukusebenza kwephilisi . Isibonelo, abantu abaningi abazi ukuthi ukuthatha imishanguzo yegciwane lesandulela ngculazi kunganciphisa kakhulu ukuphumelela kwephilisi-futhi kwandise amathuba okuba ukhulelwe.
Ukushintsha iPhilisi Yakho Yokulawula Ukuzalwa
Kukhona amaphilisi amaningi okumele ukhethe kuwo, kodwa kubalulekile ukukhuluma nodokotela wakho mayelana nokushintsha amaphilisi okulawula ukubeletha uma wenza kanjalo.
Ukuqhathaniswa kwamaphilisi okuhlanganiswa namaPill Progestin-kuphela
Iphilisi yokulawula i-combination iyasebenza kangcono kunephilisi ye- progestin kuphela . Kodwa ezinye izidumbu zabesifazane aziphathe kahle i-estrogen kule pilisi yokuhlanganisa. Kulabo abanakho ukukhathazeka, okufana nokuphakama kwengcindezi yegazi kuphilisi elihlanganisiwe, iphilisi le-progestin kuphela lingase libe yindlela enhle.
Ngaphansi Kokulawula Ukuzalwa Kwamaphilisi Amaphilisi
Ekuhambeni ngokusebenzisa ulwazi olungenhla, cishe uye waphawula ukuthi kunezinhlobo eziningi ezizocatshangelwa ekukhetheni iphilisi efanele. Uhlobo lwe-estrogen emaphilisi lufana (i-ethinyl estradiol) kodwa umthamo ungahluka. I-Estrogen ingaba nomphumela omuhle futhi omubi emzimbeni, futhi umthamo oqondile kuwe uzoxhomeka ezifisweni zakho kanye nomlando wakho wezokwelapha.
Ngokungafani ne-estrogen, kunezinhlobo ezihlukahlukene ze-progestins ezingasetshenziswa. Ngayinye yalezi zinsuku zingase zibe nezinzuzo zombili (ezifana nokulawulwa kwe-acne) noma izingozi (njengengozi yezindwangu zegazi) futhi kubalulekile ukukhuluma nodokotela wakho ngokuthi iyiphi i-progestin engase ibe ngcono kuwe.
Ubuhle bokuba nezinhlanganisela eziningi ezahlukene zamaphilisi ukuthi kunezinye eziningi ongakhetha kuzo uma uhlobo olulodwa luholela emibikweni. Ngesikhathi esifanayo, kubalulekile ukukhuluma nodokotela wakho mayelana nokushintsha amaphilisi okulawula ukubeletha uma wenza kanjalo.
Iphilisi iphumelela kakhulu uma isetshenziswe kahle, futhi ingabulala ngisho nezinyoni ezimbili izintshe ngetshe elilodwa labanye abantu abane-premenstrual syndrome, induna, ukuhamba esikhathini, nezinye izimo. Lokhu kusho ukuthi kuphumelela kakhulu kuwo wonke lawa makghono uma kusetshenziswe ngokucophelela ukuze amaphilisi angaphuthelwa futhi uma ukhuluma nodokotela wakho ngokushesha nganoma yimuphi umphumela noma ukukhathazeka.
> Imithombo:
> Cunningham, F. Gary., NoJohn Whitridge Williams. Williams Obstetrics. ENew York: McGraw-Hill Medical Medical, 2014. Phrinta.
> Iversen, L., uSivasubramaniam. S., Lee, A., Fielding, S., noP. Hannaford. Ingozi yomdlavuza wesikhathi esigcwele kanye nokukhulelwa komlomo okuhlanganisiwe: I-Royal College ye-General Practitioners 'Oral Contraception Study. Journal American of Obstetrics and Gynecology . 2017. 216 (6): 580.e1-580.e9.
> Kluft, C., Zimmerman, Y., Mawet, M. et al. Imiphumela ye-Hemostatic eyancishisiwe nge-Contraspirenone-Based Based Contraceptives Yomlomo Eline-Estetrol VS. I-Ethinyl Estradiol. Ukwelashwa . 2017. 95 (2): 140-147.