Uruhoti rw'isuku rwo kwikingira inda vs Imibumbe: Ubuziranenge, Imisemburo ya Estrogen, n'uburyo bwo guhitamo

Ubuziranenge burasa nk'ubwo, impongano zigera kuri 7 mu bagore 100 bakoresha buri mwaka kuri buri buryo kandi zigera kuri 0.3% mu gihe gikoreshwa neza. Itandukaniro nyaryo hagati y'urhoti rw'isuku n'imibumbe ni imisemburo ya estrogen: uruhoti rutanga 60% byinshi by'imisemburo ya estrogen, kandi rwihagarika neza hejuru ya 198 pounds.

TL;DR: Ibikoresho by'ingenzi

• Kuvugutana mu gihe bisanzwe ni ukugera kuri 7 mu bagore 100 buri mwaka kuri bombi; gukoresha neza ni ukugera kuri 0.3% kuri bombi.
• Uruhoti ntirwo mu bisubizo bya hormone nke. Rutanga kimwe cya gatatu cy'imisemburo ya ethinyl estradiol kuruta imibumbe isanzwe ya 35 mcg.
• Venous thromboembolism ibaho hagati ya 3 kugeza 12 mu bagore 10.000 buri mwaka bakoresha uburyo ubwo ari bwo bwose bwa hormone, ugereranyije na 1 kugeza 5 mu badakoresha.
• Uruhoti rushobora kwanga hejuru ya 198 lb kandi ntrukoreshwa kuri BMI 30 cyangwa hejuru. Imibumbe nta kiro ntarengwa yitiriwe.
• Hindura nta gihemo hagati y'ama hormone kandi ntukeneye ko ugomba gukoresha ikindi gihe. Igihe icyo aricyo cyose bisobanura iminsi irindwi y'amakondomi.

Uruhoti rw'isuku rwo kwikingira inda vs Imibumbe: bifite ubuziranenge bumwe, ariko birangirira mu buryo butandukanye

Bombi ni abakoresha imisemburo ihuza hamwe bafite ikigereranyo cy'ibyo barangirira mu buzima busanzwe cyashyizwe ahagaragara n'ikigo cya FDA: impongano zigera kuri 7 mu bagore 100 bakoresha buri mwaka mu gihe bisanzwe, kugeza kuri 0.3% mu gihe gikoreshwa neza. Ubuziranenge bw'uruhoti rwo kwikingira inda burasa n'ubw'imibumbe kuko bombi bahagarika ovulation bakoresheje estrogen na progestin. Ibisa na byo ni imigendekere yo gutanga, umubare wose wa estrogen, hamwe n'imigozi y'uburemere itari kuri uruhoti gusa.

Ikintu kimwe igitabo cyerekana ntabwo gikishobora kwerekana: bombi bafite urutonde rw'ibibazo bikomeye ko FDA yerekana ko abakoresha imisemburo ihujwe, harimo ibibazo by'amaraso, indwara y'umutima, stroke, n'umuvuduko ukabije w'amaraso. Uruhoti ntiruhindura urutonde rw'ibibazo rumwe ku rugero rworoshye.

Uruhoti ntirwo mu bisubizo bya hormone nke: rutanga hafi 60% byinshi bya estrogen

Ibibazo by'amaraso bivuye ku ruhoti wo kwikingira inda niho uburyo bubiri buhinduka koko, kandi ntabwo muburyo abantu benshi babitekereza. Dukurikije ibyanditswe n'ikigo cya FDA kuri Xulane, uruhoti rutanga hafi 60% byinshi bya ethinyl estradiol mu maraso (yagereranyijwe nk'umubare munini) kuruta imibumbe isanzwe ya 35 mcg, nubwo icyemezo cyacyo gicye cyane. Kugenda neza kuruta kwihuta. Kugenda neza kandi bisobanura byinshi.

Imibare irabigira bikunzwe. Venous thromboembolism ibaho mu bihe byemejwe hagati ya 3 kugeza 12 mu bagore 10.000 buri mwaka mu bakoresha imisemburo ihujwe, imibumbe, uruhoti, cyangwa impeta, ugereranyije na 1 kugeza 5 mu bagore 10.000 buri mwaka mu bantu badategarurwa badakoresha hormone. Ibyo bibazo byinshi biba mu mwaka wa mbere wo gukoresha, kandi bihinduka igihe cyose uburyo buhuje bugarurwa nyuma yo guhagarara ku cyumweru cyangwa kiruta icyo.

Dore ibyo urupapuro rwinshi ruzajya rutakubwira: FDA yagaragaje icyo gikoresho cya 60% mu 2005 cyo gutanga ubutumwa ku mutekano kandi yongera epidemiology ku rupapuro rw'uruhoti mu 2008 ivuga ko abakoresha uruhoti bashobora guhura n'ikibazo cy'amaraso cy'ibindi bindi kuruta abakoresha imibumbe, ariko ubushakashatsi bwakomeje budahwema kwemera. Imyitozo yahindutse. Ibyavuye mu bushakashatsi bishingiye ku kwikingira inda bwo mu 2020 birafata ibibazo bimwe byombi, bivuze ko nta hormone ihujwe n'amateka yawe ya VTE cyangwa mugihe gikorewe kubaga bikomeye bifatanye no kutagend agenda.

Nuko rero, hitamo ukurikije kwiyumvamo kwawe hamwe n'ibibazo byawe by'amaraso na BMI. Ntabwo ku kwemera ko uruhoti rworoshye kuruta kurya.

Ubuziranenge bugabanuka hejuru ya 198 pounds, imigozi iruta iy'imibumbe ntayo ifite

Ubuziranenge bw'uruhoti rwo kwikingira inda bufite imigozi itari imibumbe: Xulane yavuze ko uruhoti rushobora kuba rutari rubifitiye ubuzima ku bagore bafite 198 lb (90 kg) cyangwa hejuru, kandi ntrukoreshwa kuri BMI ya 30 kg/m² cyangwa hejuru kubera ko ibibazo by'amaraso byiyongereye. Ubuziranenge bw'uruhoti rwo kwikingira inda hejuru y'uburemere ntibuvugwa mu rupapuro, kandi icyo cyihamije ni igisubizo. Iyo imwe muri izo ngero igukwiye, ntukagire ikindi kintu usibye gusaba imibumbe ihujwe, itari ifite imigozi y'uburemere mu byanditswe byayo, cyangwa uburyo ubuziranenge bwawo budashingiye ku buremere bw'umubiri, nk'urufaranga rwa IUD cyangwa implant.

Amaduka na yo ntabwo asimbuzanya. Xulane, Twirla, na Zafemy bifite ururimi rwa BMI n'uburemere bitandukanye, nuko rero soma urupapuro rw'ibicuruzwa runze aho gutekereza "uruhoti" nk'ikintu kimwe. Igitaramo cy'uruhoti ni uko ari ibintu biboneka. Iminsi 52 buri mwaka yo kugonga, ugereranyije na 365. Niba watesheje ibibumbe bibiri cyangwa byinshi mu mezi atatu ashize, uruhoti rushobora kwitwara neza kuruta imibumbe mu buzima bwawe nubwo bombi babisanzwe mu bushakashatsi. Porogaramu y'umufasha w'ubuzima nk'August AI irashobora kugufasha kumenya iminsi yo guhindura uruhoti cyangwa ibibumbe byacitswe kugirango urebe buri buryo bukomeza.

Ibyo utagomba kwibuka, ariko 1 mu bagore 5 bahura n'uburwayi bw'uruhu

Kwizera uruhoti rwo kwikingira inda, ibyiza n'ibibi, bitangira n'uruhu. Ububabare bw'ahakoreshejwe bukunze kugaragara kuri 20% by'abakoresha uruhoti, ariko 3% gusa ni bo bahagarika ubu buryo kubera ko, bivuga ko ibyinshi bikandamizwa kuruta kwanga kwanga. Uruhoti ruboneka, kandi kwihanganira bikorerwa n'ubushyuhe, ubuhehere, kwimoza cyane, koga, n'ibishushyu. Hindura ahantu, shyira ku ruhu rutose, kandi wirinde amavuta n'amavuta mu karere. Kwakira uruhu rwahinduwe buri gihe ni ibyo kwerekana aho guhitamo gutya gusa. Impamvu imwe yo kubona uruhoti: kwinjiza ntikubangamira gusohora cyangwa kurya, ibyo bikaba ibintu byabayeho kubindi ibibumbe mu gihe ugiye mu ndwara yo mu gifu.

Ibyiza by'ibibumbe ntibigaragara kandi birakomeye. Ntabwo bigaragara, biza mu buryo bwinshi n'imisemburo ya estrogen, kandi hari uburyo bwa progestin gusa kubantu badashobora gufata estrogen. Uruhoti ntirufite uburyo bwa progestin gusa. Niba urimo ushimangira ibibazo bya side, harimo uburyo bwiza bwo kwikingira inda kuri mood stability, ibibumbe biraguhindura byinshi. Porogaramu y'umufasha w'ubuzima nk'August AI irashobora kugufasha kumenya ahantu, umutwe, cyangwa uburwayi bw'uruhu mu mezi atatu ya mbere, kugirango umuganga abone uko ahantu, aho kwibuka.

Guhindura uburyo bisigira 7-cyumweru hagati, abantu benshi ntibabiteganya

Guhindura ku mibumbe yo kwikingira inda kugana ku ruhu ni aho ubwishingizi buhitira budasanzwe. Itegeko ni ryoroshye: shyira uruhoti rwawe rwa mbere ku munsi wari witeguye gutangirira ku rupapuro rwawe rw'ibihindu, nta gihemo hagati y'ama hormone, kandi ntukeneye ko ugomba kwishyura. Niba hari igihemo, koresha amakondomi cyangwa ubundi buryo bwo gushyigikira iminsi irindwi. Kimwe kirahagije kugana ku ruhu.

Ntuzigere wigira uburyo bubiri mugihe cyo kwihutira kubaza umuganga. Niba wahagararitse iminsi 40 cyangwa irenga aho kugana, gusubira inyuma bitera kwongera kwiyongera kw'ibibazo by'amaraso by'umwaka wa mbere.

Iki ni ikintu kimwe ku rupapuro ruriho aho gusura ari ikintu cy'ingenzi. Gusura indembe 39 kuri online hamwe numuganga wemewe wemewe n'ibibanza byemewe n'amategeko bizakubaza amakuru y'ubuzima bwawe kandi bikaguha kwemerera mugihe bikwiriye. Umuganga ni we uhitamo, kandi kwemerera ntikwemeza. Gusura virtual ntishobora kandi kugenzura umuvuduko wawe w'amaraso cyangwa gukora imizigo, ibyo bamwe bashobora kwaka mbere yo gutangira uburyo buhuje. Niba urimo usaba kwemererwa kuva ku rugo, twavuguruje niba urgens care ishobora gutanga ibibumbe byo kwikingira inda kubice.

Igihe ibimenyetso by'uruhoti cyangwa imibumbe bivuga gusaba kugurisha

Ibi bimenyetso by'akaga ni bimwe kuri bombi. Inzira yo gutanga ntabwo ihindura uko ikibazo giteye.

Hamagara 911 cyangwa jya ku cyumba cy'ibitaro byihutirwa ubu niba:

• Kubabara mu gatuza cyangwa guhumeka bikabije bikabije
• Umutwe bikabije utari nka imisatsi yawe isanzwe, cyangwa impinduka za viziyo cyangwa kumva amaso bidafite uko bibiri
• Kumva gukomeye, kudafite, cyangwa ingorane zo kuvuga ku ruhande rumwe rw'umubiri
• Kubabara bikabije n'ikibero cy'ikibazo mu kibuno kimwe
• Kubabara bikabije mu gifu cyangwa mu gifu n'ububabare
• Uruhu cyangwa amaso bimera nk'umuhondo bifite umuhondo mwinshi kandi udashaka kurya

Koresha gusura mu cyumweru gitaha niba:

• Ubonye imbisi nshya mu mabere
• Amanywa arahanuka arenga gusanzwe kandi akamara iminsi irenze 7, nk'uko ubuyobozi bwa MedlinePlus ku bikoresho bya hormone byahuze bwerekana
• Uruhoti ruguma ari rutukura, rwuzuye, cyangwa rutera isesemi hagati yo guhindura
• Uruhoti rwa kaga ruragiza
• Urasiba kenshi ibibumbe

Vugana n'umuganga mbere yo gutangira niba:

• Uruzi kandi ufite imyaka irenze 35
• BMI yawe ari 30 cyangwa hejuru, cyangwa ufite ibiro 198 lb cyangwa hejuru
• Wowe cyangwa umuntu wa mbere mu muryango wawe wagize ikibazo cy'amaraso, DVT, cyangwa pulmonary embolism
• Uragira imisatsi ihujwe na aura
• Umuvuduko wawe w'amaraso ntugenzurwa
• Wakoze kubaga bikomeye cyangwa wagaragaje igihe kirekire udatiganda
• Ufata rifampin, abana runaka, cyangwa St. John's wort

Bimwe mu bibazo bikunze kubazwa

Niba uruhoti rwanjye ruguye, ndacyakingiwe?

Rimwe na rimwe. Ubuziranenge bw'uruhoti rwo kwikingira inda nyuma yo kugwa burundu bishingiye ku gihe. Niba byari byaraguye amasaha 48 cyangwa atarenze, koresha uruhoti rwa mbere cyangwa rushya kandi wibuke umunsi wawe wo guhindura, nta gusubiramo. Ku masaha 48 cyangwa arenga, tangira uruhoti rushya, koresha gushyigikira iminsi irindwi, kandi wibaze ku buryo bwo gutabaza bw'induranyugumo niba wakoze imibonano mpuzabitsina mu gihe cy'icyo gihe. Impengeri z'uruhoti zifata nk'igihe cyo kugwa.

Uruhoti rwo kwikingira inda rutera kwiyongera kw'ibiro kuruta imibumbe?

Oya. Ku ruhu rwo kwikingira inda vs imibumbe, ibihamya bya Cochrane kuri abakoresha imisemburo ihujwe byagaragaje ko hagera kuri 0.4 kg (munsi ya pound 1) mu mwaka, nta tandukaniro risobanutse hagati y'inzira zombi. Ibyo ni ibihamya bivuye mu bushakashatsi aho kuba ibyavuye muri FDA, kandi bihagije ku kwiyongera k'uburemere buri mwaka ko abantu benshi badashobora kubitandukanya n'ibindi bibazo.

Nshobora gusiba icyumweru kidafite uruhoti kugira ngo nshinge igihe cy'ubuhumure?

Yego. Gukoresha uruhoti rushya aho gusiba icyumweru kidafite uruhoti ni uburyo bwo gukoresha burambye cyangwa ubudahwemo, bukoreshwa nk'uko abantu bakoresha ibibumbe by'impapuro inshuro nyinshi. Tegereza amaraso yo hagati, cyane cyane mu mezi ya mbere, kandi utegere ko igenda igenda. Fungura gahunda n'umuganga mbere, kuko ihindura uko ubara iminsi yawe yo guhindura.

Antibiyotike zirahagarika uruhoti cyangwa imibumbe gukora?

Mubisanzwe ntabwo. Antibiyotike zisanzwe nka amoxicillin na doxycycline ntizigabanutse ubuziranenge bw'uburyo bumwe, nubwo ibyo bigaragara nk'ibyo bigaragara. Ibikorwa by'ingenzi ni rifampin na rifabutin, abana runaka, na St. John's wort, bihurutsa metabolism y'ama hormone. Bwira uwaguha antibiyotike ko ukoresha imisemburo yo kwikingira inda kandi wibaze niba hagomba gushyigikirwa kuri iyo ntangangu ngenera.

Nshobora kubona uruhusa rw'uruhoti cyangwa imibumbe kuri interineti ntikore imizigo?

Yego. Nta mizigo ya pelvic cyangwa Pap test isabwa kugirango utangire imisemburo ihujwe. Icyo umuganga aba akeneye ni ukugena umuvuduko wawe w'amaraso usanzwe hamwe n'ibimenyetso by'ubumwe, imisatsi, n'umunwa w'ubuzima. Niba umuvuduko wawe w'amaraso utazi cyangwa amateka yawe afite ingorane, tegereza gusabwa kuza cyangwa kugena umuvuduko mbere yo kwemererwa.

Ibyo buri gihe

Ku ruhu rwo kwikingira inda vs imibumbe, ubuziranenge burasa, nuko guhitamo birangira ahandi. Ubuziranenge bw'uruhoti rwo kwikingira inda, ibyiza n'ibibi bigufitiye akamaro niba warafitanye ibibazo by'ibimenyetso buri munsi kandi BMI yawe iri munsi ya 30 kandi ufite ibiro biri munsi ya 198 pounds. Imibumbe ihindura ku misemburo ya estrogen, guhitamo impinduka, kutagaragara, no kuboneka kw'uburyo bwa progestin gusa. Icyo uhisemo cyose, hindura nta gihemo hagati y'ama hormone, kandi uzamenye ibimenyetso by'akaga by'ibinyabuzima bibiri mbere y'igice cyawe cya mbere.

Inama: Ingingo iyi ni iy'amakuru gusa kandi ntibisobanura inama nyinshi. Burigihe usaba umuganga ufite ubushobozi kugirango uhitemo kandi ufate ibyemezo by'ubuvuzi. Niba ufite ikibazo gikomeye cy'ubuzima, hamagara 911 cyangwa jya ku cyumba cy'ibitaro byihutirwa ako kanya.