Pana Mana Whakawhānau vs Pire: Te Whai Kaha, Te Puta Mai o te Estrogen, me te Tikanga Kōwhiri

Ko te whai kaha he rite tonu, tata ki te 7 haputanga mō te 100 kaiwhakamahi ia tau ki ngā tikanga e rua, ā, tata ki te 0.3% ki te tino whakamahi. Ko te tino rereketanga o te pana mana whakawhānau me te pire ko te puta mai o te estrogen: ka tukuna e te pana tata ki te 60% atu te estrogen katoa, ā, ka mutu te mahi pono i runga ake i te 198 pauna.

TL;DR: Ngā Kōrero Matua

• Ko te rahunga o te whakamahi noa tata ki te 7 mō te 100 kaiwhakamahi ia tau mō ngā mea e rua; ko te tino whakamahi he 0.3% mō ngā mea e rua.
• Ehara te pana i te kōwhiringa iti-homone. Ka tukuna e ia tata ki te 60% atu te ethinyl estradiol katoa atu i te pire paerewa 35 mcg.
• Ko te venous thromboembolism ka puta tata ki te 3 ki te 12 mō te 10,000 tau wahine i runga i te tikanga whakakotahi, ki te 1 ki te 5 ki te hunga kāore e whakamahi.
• Ka taea e te pana te rahunga i runga ake i te 198 lb, ā, kāore e taea te whakamahi i te BMI 30 teitei ake rānei. Karekau he taumata penei te pire.
• Whakawhitiwhiti me te kore he waahi kāore he homone, ā, kāore koe e hiahiatia he tautoko. Ko ngā wāhi katoa e hiahiatia ana kia whitu ngā rā o ngā konōmu.

Pana mana whakawhānau vs pire: rite te whai kaha, engari ka rahunga rāua i ngā huarahi rerekē

Ngā mea e rua he rongoā whakakotahi me te homone hei aukati i te hapūtanga, ā, he rite tonu te reiti o te rahunga o te ao tūturu i tuhia e te FDA: tata ki te 7 haputanga mō te 100 kaiwhakamahi ia tau me te whakamahi noa, tata ki te 0.3% me te tino whakamahi. Ko te whai kaha o te pana mana whakawhānau ka rite ki te pire nā te mea ka aukatihia e rāua te ovule mā te whakamahi i te estrogen me te progestin. Ko te rerekētanga ko te tikanga hoatu rongoā, te katoa o te horopeta o te estrogen, me te taumata taumaha e pā ana ki te pana anake.

Kotahi te mea kāore e taea e te ripanga te whakaatu: ka mau ngā tikanga e rua ki te rarangi rite o ngā raruraru nui e whakaingoatia ana e te FDA mō te rongoā homone whakakotahi hei aukati i te hapūtanga, tae atu ki ngā toto toto, te mate ngākau, te whiu, me te toto toto tiketike. Kāore te pana e whakawhitiwhiti ana i tētahi raruraru mō tētahi atu pai ake.

Ehara te pana i te kōwhiringa iti-homone: ka tukuna e ia tata ki te 60% atu te estrogen

Ko te raruraru toto toto o te pana mana whakawhānau te wāhi ka wehewehea ai ngā tikanga e rua, ā, ehara i te huarahi e whakaarohia ana e te nuinga o te tangata. E ai ki ngā kōrero whakahaere a te FDA mō Xulane, ka tukuna e te pana tata ki te 60% atu te ethinyl estradiol katoa ki roto i te toto (kua whanganga hei rohe i raro o te pihi) atu i te pire 35 mcg noa, ahakoui teitei ake te kukū o tona piki. Ko te tononga ka toa i te mōhukihuki. Ko te tononga hoki te tikanga nui atu.

Ko ngā tau ka taea ai tēnei te taumaha. Ka puta te venous thromboembolism ki te tata ki te 3 ki te 12 take mō te 10,000 tau wahine i roto i ngā kaiwhakamahi o te rongoā homone whakakotahi hei aukati i te hapūtanga, te pire, te pana, te mowhiti, ki te 1 ki te 5 mō te 10,000 tau wahine i roto i te hunga kāore i te hapū, kāore hoki e whakamahi homone. Ko te nui o te tupono kei roto i te tau tuatahi o te whakamahinga, ā, ka tautuhi anō i ngā wā katoa ka tīmata anō tētahi tikanga whakakotahi i muri i te wā o te whitu wiki te roa rānei.

Ko te mea kāore e kōrerohia e te nuinga o ngā whārangi: I tohu te FDA i taua 60% te wāhi puta mai i roto i tētahi whakawhitiwhiti haumaru o te tau 2005, ā, ka tāpirihia te epidemiology ki te tapanga o te pana i te tau 2008 e kii ana ka nui ake te tupono toto toto o ngā kaiwhakamahi pana atu i ngā kaiwhakamahi pire, engari kāore ngā rangahau whakatairite i whakaae tonu. Mai i taua wā kua āta whakatika. Ko tētahi whakahoutanga rongoā whakawhānau e hāngai ana ki ngā taunakitanga o te tau 2020 ka whakamahi i ngā tikanga tiaki rite mō ngā mea e rua, arā, kāore he homone whakakotahi me te hītori whaiaro o te VTE, me te taha ki te pokanga nui me te kore nekehanga.

Na reira, kōwhirihia i runga i te urutanga ki tō oranga me tō tūponotanga toto toto me te BMI. Kaua e tūmanako he pai ake te pana i te horomanga.

Ka heke te whai kaha i runga ake i te 198 pauna, he taumata kāore i te pire

Ko te whai kaha o te pana mana whakawhānau he rohe kāore i te pire: ka kii te whakatūpato pouaka a Xulane ka iti ake te whai kaha o te pana ki ngā wahine e 198 lb (90 kg) te taumaha, ā, kāore e taea te whakamahi i te BMI 30 kg/m² teitei ake rānei nā te nui o te tūponotanga toto. Te whai kaha o te pana mana whakawhānau i runga ake i taua taumaha ehara i te mea ka whakamāramatia e te tapanga, ā, ko tērā anō te whakautu.

Ki te pā ana tētahi o ēnei rohe ki a koe, kāore te otinga kia kaha ake te whakamahi i te pana. Pātai mō tētahi pire whakakotahi, kāore nei he taumata taumaha i roto i tana tapanga, mō tētahi tikanga rānei kāore e whakawhirinaki tōna whai kaha ki te taumaha tinana, pēnei i te IUD, i te implant rānei.

Kāore hoki e taea te whakawhitiwhiti ngā waitohu. Ko Xulane, Twirla, me Zafemy ka mau i ngā reo BMI me te taumaha rerekē, na reira, panuitia te tapanga hua motuhake kaua ki te kii "te pana" he kotahi noa te hua.

Ko te kōrero pāhēhē mō te pana ko te tatauranga. E rima tekau mā rua ngā whai wāhi i te tau kia whakaroa, ki te 365. Ki te ngaro koe i ngā pire e rua neke atu rānei i roto i te toru marama kua pahure, ka kaha ake te mahi a te pana i te pire i roto i tō ao tūturu ahakoi e rite ana rāua i roto i tētahi whakamātautau. Ko tētahi taupānga hoa hauora pēnei i a August AI ka āwhina i a koe ki te tuhi i ngā rā whakarereke pana, i ngā pire ngaro rānei hei kite ko tēhea tikanga ka mau koe.

Tētahi atu mea hei maumahara, engari 1 i te 5 kaiwhakamahi ka raru kiri

Ko te taumaha pono o ngā painga me ngā raru o te pana mana whakawhānau ka tīmata ki te kiri. Ko te mamae o te wāhi tono ka pā ki te 20% o ngā kaiwhakamahi pana, engari 3% noa iho te whakamutu i te tikanga nā te mea, e kii ana ka nui ngā tauhohenga he whakararuraru engari ehara i te mea whakakore.

Ka kitea te pana, ā, ka whakamātauhia te piri e te wera, te haumākū, te werawera nui, te kauhoe, me ngā pati wera. Hurihia ngā wāhi, tono ki te kiri ma, maroke, ā, kia matara te kirīmi me te hinu i te rohe. Ko ngā pana kiri ka puta anō he mea nui kia kōrerohia atu i te whakanoho puku anō. Ko tētahi painga pono o te pana: kāore te mimiti e takahia e te ruaki, te mate puku rānei, he ara rahunga tūturu tērā mō te pire ā-waha i te wā o te mate puku.

Ko ngā painga o te pire he ata noa, ā, he roa. Kāore e kitea, ka puta ki roto i ngā momo maha me ngā horopeta estrogen, ā, he kōwhiringa progestin-anake mō te hunga kāore e taea te tango estrogen. Kāore he putanga progestin-anake o te pana. Ki te whai koe i te kaupapa o ngā pānga taha, tae atu ki ko wai te mana whakawhānau pai rawa mō te noho rangatira o te wairua, ka nui ake ngā huarahi a te pire. Ka āwhina tētahi taupānga hoa hauora pēnei i a August AI i a koe ki te tuhi i te pakarutanga toto, te mamae o te mahunga, te tauhohenga kiri rānei i roto i ngā toru marama tuatahi, kia kite te rata i tētahi tauira, ehara i te mahara.

Ko te whakawhitiwhiti tikanga ka waiho he 7-ra te wāhi kāore e whakaritea e te nuinga o te tangata

Ko te whakawhitiwhiti i te pire mana whakawhānau ki te pana te wāhi ka ngaro haere te tiaki. He ngāwari te ture: tono tō pana tuatahi i te rā ka tīmata koe i tō pōka pire kaha e whai ake nei, me te kore he wāhi kāore he homone, ā, kāore he tautoko e hiahiatia ana. Ki te wāhi, whakamahia ngā konōmu, tetahi atu tikanga tautoko rānei mō ngā wiki e whitu. Ka rite ano te haere mai i te pana ki te pire.

Kaua e rua ngā tikanga e whakamahi hei hono i te wāhi kaore he tohutohu a te rata. Ā, ki te mutu koe mō te whitu wiki neke atu rānei, kaua ki te whakawhitiwhiti tika, ko te tīmata anō ka tautuhi anō i taua tūponotanga toto toto nui o te tau tuatahi.

Ko tēnei te wāhi kotahi i runga i tēnei whārangi e tino hiahiatia ana tētahi haerenga. Ko tētahi haerenga tiaki ohorere ipurangi $39 me tētahi rata whai raihana o Amerika ka taea te kapi i tō hītori me te whakahaere pire ina tika. Ko te rata te whakatau, ā, kāore e taurangitia he whakahaere pire. Kāore hoki tētahi haerenga mariko e taea te whakahaere i tō pehanga toto, te whakahaere rānei i ngā whakamātau taiwhanga, e hiahiatia ana e ētahi tangata i mua i te tīmatanga o tētahi tikanga whakakotahi. Ki te taumaha koe i ngā kōwhiringa haerenga kore-ara, kua kapi mātou i te mea ka taea e te tiaki ohorere te whakahaere pire mana whakawhānau motuhake.

Ki te puta ngā tohu o te pana, o te pire rānei, me mutu ka kitea

Ko ēnei whakatūpato whero he rite tonu mō ngā tikanga e rua. Kāore te ara tuku e whakawhitiwhiti i te ahua o te wāhi ohorere.

Waea atu ki te 911, ki te haere rānei ki te ruwhareka o te wāhi ohorere inaianei ki te:

• Te mamae o te uma, te uaua rānei o te manawa i te ohorere
• Te mamae o te mahunga nui i te ohorere, he rereke ki ō mahunga noa, ki te whakarerekē tere rānei o te tirohanga, te ngaro rānei o te tirohanga
• Te ngoikore ohorere, te koretanga, te uaua rānei ki te korero i tetahi taha o te tinana
• Te mamae me te pupū ohorere i tētahi waewae
• Te mamae nui o te puku, te kōpuku rānei
• Te kōwhai o te kiri, o te karu rānei me te mimi pouri me te kore hiahia kai

Whakaritehia tētahi haerenga i roto i te wiki e whai ake nei ki te:

• Ka kite koe i tētahi pukupuku uma hou
• He kaha ake te toto mai i te pakitara i te tikanga, ā, ka roa ake i te 7 rā, kia rite ki te arongao a MedlinePlus mō te rongoā homone whakakotahi hei aukati i te hapūtanga
• Ka noho whero, pakaha, te ngau rānei te wāhi pana i waenganui i ngā whakarereketanga
• Ka tonu te matara o ngā pana
• Ka ngaro tonu koe i ngā pire

Kōrero ki tētahi rata i mua i te tīmatanga ki te:

• Ka hikareti koe, ā, kua neke atu koe i te 35
• Ko tō BMI he 30 teitei ake rānei, ā, ko tō taumaha he 198 lb teitei ake rānei
• Koe, tētahi rānei o ō matua whakatupu, kua whai toto toto, DVT, me te mate pukupuku pūrua rānei
• Ka whiwhi migraines me te aura koe
• Kāore e whakahaerea tō pehanga toto
• Kua whai koe i te pokanga nui tata nei, me te kore nekehanga roa rānei
• Ka tango koe i te rifampin, ētahi rongoā whakaheke pākeri, me te St. John's wort

Ngā pātai auau

Ki te matara taku pana, kei te tiakina tonu ahau?

I ētahi wā. Ko te whai kaha o te pana mana whakawhānau i muri i tō matara ka whakawhirinaki katoa ki te matawā. Ki te 48 haora te iti ake rānei tō matara, whakahokia te pana kotahi, whakahokia rānei tētahi atu, ā, kia mau tonu tō rā whakarereke taketake, me te kore tautoko. I 48 haora te roa ake rānei, tīmata tētahi pana hou, whakamahia he tautoko mō ngā wiki e whitu, ā, pātai mō te rongoā ohorere ki te whai koe i te tangata i roto i taua matapihi. Ko ngā taha kua paku ara ko te tikanga kua matara.

Ka nui ake te taumaha o te pana mana whakawhānau i te pire?

Kāore. I runga i te pana mana whakawhānau vs pire te taumaha, ko ngā taunakitanga o te arotake a Cochrane mō ngā rongoā homone whakakotahi hei aukati i te hapūtanga i kite tata ki te 0.4 kg (iti iho i te pauna) i roto i te tau, me te kore he rereketanga nui i waenganui i ngā ara e rua. Koira ngā taunakitanga arotake ehara i te nama FDA, ā, he tata rawa ki te rereketanga o te taumaha o te tau e kore e taea e te nuinga o te tangata te wehewehe i te reira i ngā mea katoa e tupu ana.

Ka taea e au te peke i te wiki kāore he pana hei peke i tōku paheketanga?

Āe. Ko te tono i tētahi pana hou hei utu mō te tango i te wiki kāore he pana he tikanga roa, tōraro rānei, hei whakamahi i te taha ki te ture, pēnei i te omaoma o ngā pōka pire tētahi ki tētahi. Taria te pakarutanga toto, otirā i roto i ngā marama tuatahi, ā, taria kia ata noho. Whakaūngia te mahere ki tētahi rata i mua, nā te mea ka whakarerekē te tatau o ngā rā whakarereke.

Ka taea e ngā raukami te aukati i te pana, i te pire rānei kia kore e mahi?

Kāore i te nuinga. Ko ngā raukami noa pēnei i te amoxicillin me te doxycycline kāore e whakaiti i te whai kaha o ngā tikanga e rua, ahakoi te tohe o taua whakatūpato. Ko ngā taunekeneke tūturu ko te rifampin me te rifabutin, ētahi rongoā whakaheke pākeri, me te St. John's wort, e tere ai te whakawhanake homone. Kōrero ki te tangata e whakahaere ana i te raukami e whakamahi ana koe i te rongoā homone hei aukati i te hapūtanga ā, pātai mō te tautoko e hiahiatia ana mō taua tarukino motuhake.

Ka taea e au te tiki whakahaere pire, pana rānei i te ipurangi me te kore he whakamātau tinana?

Āe. Kāore he whakamātau kopirua, he whakamātau Pap rānei e hiahiatia ana hei tīmata i te rongoā homone whakakotahi hei aukati i te hapūtanga. Ko te mea e hiahiatia ana e tētahi rata he rekoata pehanga toto tata nei, ā, he hītori pono mō te toto toto, te migraines, me te hikareti. Ki te kāore e mōhiotia tō pehanga toto, ā, ka uaua tō hītori, tūmanako kia tonoa koe kia haere mai, kia tiki rānei i te rekoata i mua i te whakahaeretanga o tetahi pire.

Ko te mutunga

I runga i te pana mana whakawhānau vs pire, he rite te whai kaha, nō reira ka noho te whakatau ki etahi atu wāhi. Ko ngā painga me ngā raru o te pana mana whakawhānau ka tautoko i a ia ki te mea kua tino uaua koe ki te hoatu rongoā ia rā, ā, ko tō BMI kei raro i te 30, ā, ko tō taumaha kei raro i te 198 pauna. Ko te pire ka toa i te putanga o te estrogen, te kōwhiringa tauira, te ngaro noa, me te wātea o tētahi ara progestin-anake. Ahakoa tēhea te kōwhiri, whakawhitiwhiti me te kore he wāhi kāore he homone, ā, mōhio ki ngā tohu ohorere e ono i mua i tō horopeta tuatahi.

Whakakape: Ko tēnei tuhinga mō ngā kōrero anake, ā, ehara i te mea he tohutohu hauora. Me whakapā tonu ki tētahi kaiwhakarato hauora whai mana mō ngā whakatau tātaritanga me ngā maimoatanga. Ki te wheako koe i tētahi wāhi ohorere hauora, waea atu ki te 911, ki te haere rānei ki te ruwhareka o te wāhi tata tonu.