Bhanhire reKudzivirira Kubata Pamuviri vs Piritsi: Kushanda, Kuburitswa kweEstrogen, uye Maitiro Ekusarudza

Kushanda kunoshanda kwakaenzana, ingangoita nhumbu 7 kubva pa100 dzinozvishandisa pagore nemetodo ipi zvayo uye ingangoita 0.3% nekushandiswa kwakakwana. Musiyano chaiwo webhanhire rekudzivirira kubata pamuviri nekupiritsi ndiwo estrogen exposure: bhanhire rinopa inopfuura 60% ye estrogen yakawanda, uye rinorega kushanda zvakachengeteka pamusoro pe 198 pounds.

TL;DR: Zvakaenzana zvakakosha

• Kukundikana kwekushandiswa kwakajairika kunosvika 7 kubva pa100 vanoshandisa pagore kune ese ari maviri; kushandiswa kwakakwana kunosvika 0.3% kune ese ari maviri.
• Bhanhire harisi sarudzo yepasi-hormone. Inopa inopfuura 60% ye ethinyl estradiol yakawanda pane yakajairika 35 mcg piritsi.
• Venous thromboembolism inosvika 3 kusvika 12 pa 10,000 mukadzi-makore pane chero nzira yakasanganiswa, ichienzaniswa ne 1 kusvika 5 mune vasingashandisi.
• Bhanhire rinogona kukundikana pamusoro pe 198 lb uye haribvumirwi pa BMI 30 kana kupfuura. Piritsi harina muvharuvhu yakadaro.
• Shandura pasina chipenga chemahormone uye haudi kuchengetedza. Chero chipenga zvinoreva mazuva manomwe ekondomu.

Bhanhire rekudzivirira kubata pamuviri vs piritsi: zvakaenzana kushanda, asi zvinokundikana nenzira dzakasiyana

Zvese zviri zviviri zvinodzivirira zvinodzivirira zvehomoni zvakabatanidzwa nehuwandu hwekutadza kwehupenyu chaihwo yakanyorwa neFDA: ingangoita nhumbu 7 kubva pa100 vanoshandisa pagore nekushandiswa kwakajairika, ingangoita 0.3% nekushandiswa kwakakwana. Kushanda kwebhanhire rekudzivirira kubata pamuviri kunoenderana nepakiti nekuti zvese zvinodzvinyirira ovulation uchishandisa estrogen neprogestin. Zvinosiyana ipi maitiro ekudzinga, huwandu hwe estrogen, uye muvharuvhu yehuremu inoshanda chete kune bhanhire.

Chimwe chinhu patafura hachigoni kuratidza: nzira mbiri dzinopa rondedzero imwe chete yezvinetso zvakakomba izvo FDA inopa kune combined hormonal contraception, kusanganisira ropa rinonaya, chirwere chemoyo, sitiroko, uye BP yakakwira. Bhanhire haridzingi imwe njodzi yemhando neimwe yakanaka.

Bhanhire harisi sarudzo yepasi-hormone: rinopa inopfuura 60% ye estrogen yakawanda

Njodzi yeropa rinonaya rebhanhire rekudzivirira kubata pamuviri ndipo panosiyana nzira mbiri chaidzo, uye kwete munzira inofungidzirwa nevanhu vazhinji. Zvinoenderana ne FDA prescribing information for Xulane, bhanhire rinopa ingangoita 60% ye ethinyl estradiol yakawanda muropa (yakaymbiwa se nzvimbo yepasi pegirafu) pane yakajairika 35 mcg estrogen piritsi, kunyangwe peak concentration yayo iri shoma. Yakasimba inorova yakapfava. Yakasimba zvakare zvinoreva zvakawanda.

Nhamba dzinoriita kuti rirege kurema. Venous thromboembolism inoonekwa mune ingangoita 3 kusvika 12 makesi pa 10,000 mukadzi-makore pakati pevanoshandisa chero combined hormonal contraceptive, piritsi, bhanhire, kana mhete, ichienzaniswa ne 1 kusvika 5 pa 10,000 mukadzi-makore muvanhu vasingamiri vasingashandisi mahormone. Iyo njodzi yakakwira mugore rekutanga rekushandiswa, uye inodzoswa nguva ipi zvayo nzira yakasanganiswa yatangazve mushure mechipenga chevhiki ina kana kupfuura.

Hezvino zvakawanda zvinopa hazvidi kukuudza: FDA yakaratidza iyi 60% exposure gap mune 2005 safety communication uye yakawedzera epidemiology kune label rebhanhire muna 2008 ichitaura kuti vashandisi vebhanhire vaive ne njodzi yepamusoro yekunetseka kune zvekupfimbana kupfuura vashandisi vepiritsi, asi ongororo dzekuenzanisa hadzina kumbobvumirana zvakazara. Tsika dzazvino dzakabatana. A 2020 evidence-based contraception update inoshandisa zvakafanana kudzivirirwa kune ese ari maviri, zvinoreva kuti hapana mahormone akabatanidzwa nenyaya yeperson ye VTE kana kutenderedza kuvhiyiwa kukuru nekusanyanya kufamba.

Saka sarudza pakugara pakugara uye njodzi yako yekunetseka uye BMI. Kwete pakufungidzira kuti bhanhire riri nani pane kumedza.

Kushanda kunodzikira pamusoro pe 198 pounds, muvharuvhu iyo piritsi haina

Kushanda kwebhanhire rekudzivirira kubata pamuviri kuno muvharuvhu iyo piritsi haina: Xulane's boxed warning inoti bhanhire rinogona kushanda zvishoma kune vakadzi vane huremu 198 lb (90 kg) kana kupfuura, uye haina mvumo pa BMI ye 30 kg/m² kana kupfuura nekuda kwekuwedzera njodzi yekunetseka. Kushanda kwebhanhire rekudzivirira kubata pamuviri pamusoro pehuremu hwacho hakusi chinhu chinopa chitarisiko, icho pachacho chiri mhinduro.

Kana imwe yemiganhu iyi ikashanda kwauri, danho harisi rekuedza zvakaomarara nebhanhire. Bvunza nezve piritsi rakabatanidzwa, iro risina muvharuvhu yehuremu muchirongwa charo, kana nezve nzira iyo kushanda kwayo hakutsamire pahuremu hwemuviri zvachose, sekunge IUD kana implant.

Mhando hadzisi dzimwe dzimwe. Xulane, Twirla, uye Zafemy dzine mutauro wakasiyana weBMI nehuwandu, saka verenga chirongwa chechigadzirwa chakakosha pane kungofunga "bhanhire" semhando imwe chete.

Kupikana kwebhanhire kuita kwema arithmetic. Makumi mashanu nemaviri mikana pagore yekukonzerwa, ichienzaniswa ne 365. Kana wakundikana mapiritsi maviri kana kupfuura mumwedzi mitatu yapfuura, bhanhire rinogona kuita nani pane piritsi muupenyu hwako chaihwo kunyangwe zviviri zviri zvakaenzana mune bvunzo. App yekuongorora hutano yakadai saAugust AI inogona kukubatsira kurekodha mazuva ekushandura bhanhire kana mapiritsi akundikana kuti uone kuti ndeupi hurongwa hwaunoshandisa chaizvo.

Chimwe chinhu chisingadi kuchengetwa, asi 1 kubva pa 5 vashandisi vanowana ganda rinotsamwisa

Kuverenga bhanhire rekudzivirira kubata pamuviri zvakanaka nezvakaipa zvese zvinotanga neganda. Kutsamwa kwekushandisa kunobata ingangoita 20% yevashandisi vebhanhire, asi 3% chete vanosiya nzira nekuda kweizvozvo, izvo zvinokuudza kuti mazhinji ma reaction anokunetsa pane kusadzivisa.

Bhanhire rinooneka, uye kubatana kunoedzwa nekupisa, humidity, kusveta kwakanyanya, kushambira, uye hot tubs. Shandura nzvimbo, shandisa paganda rakachena rakaoma, uye chengeta mvura uye mafuta kure nenzvimbo. ganda rakatsamwisa rinotsamwisa rinokosha kusimudza pane kungodzosera nzvimbo pasina kutaura. Imwe mukana chaiwo webhanhire: kubvongodzwa hakudzirwe nekurutsa kana manyoka, izvo zviri chinhu chakakomba chepiritsi rekumedza panguva yemudumbu.

Zvinobatsira zvepiritsi zvinonyarara uye zvakasimba. Haisi inooneka, inouya mune mafomatsheni mazhinji uye estrogen doses, uye pane progestin-chete sarudzo kune vanhu vasingagoni kutora estrogen. Bhanhire harina progestin-chete vhezheni. Kana uri kuwedzera kunaka kwema side effect profile, kusanganisira ndiyo nzira yekudzivirira kubata pamuviri yakanaka pakugadzikana kwemafungiro, piritsi rinokupa zvakawanda zvekuvhara. App yekuongorora hutano yakadai saAugust AI inogona kukubatsira kurekodha spotting, ma headaches, kana ganda rinotsamwisa mumwedzi mitatu yekutanga, saka chiremba anoona chimiro panzvimbo yekuyeuka.

Kushandura nzira kunosiya chipenga chemazuva 7 chisingatarisirwi nevanhu vazhinji

Kushandura kubva kubhanhire rekudzivirira kubata pamuviri kuenda kubhanhire ndipo panonyangarika kufambira mberi pakunyarara. Mutemo uri nyore: shandisa bhanhire rako rekutanga pazuva rakuva waidzinga pasuru yako inotevera yekushanda, pasina chipenga chemahormone, uye hapana kuchengetedza kunodiwa. Kana paine chipenga, shandisa kondomu kana imwe nzira yekuchengetedza kwemazuva manomwe. Zvakafanana zvinoshanda pakubva kubhanhire kuenda kupiritsi.

Usawedzera nzira mbiri pamwe chete kuti uwedzere chipenga pasina chiremba achikuudza kuti uite. Uye kana wakarega kwevhiki ina kana kupfuura pane kushandura zvakananga, kutangazve kunodzosera njodzi yepamusoro yekunetseka kwegore rekutanga.

Ichi ndicho chinhu chimwe chete pane peji rino apo kushanya kunonyatsoshanda senhanho inotevera. A $39 online urgent care visit neUS-licensed clinician inogona kuongorora nhoroondo yako uye kupa mushonga kana zvichibvira. Chiremba ndiye anoona, uye mushonga hausi waranti. Kushanya kwemuvhidhiyo kunogonawo kutarisa BP yako kana kuita marabhoritari, izvo vamwe vanhu vanoda vasati vatanga nzira yakasanganiswa. Kana uri kuverenga zvakawanda zvezvakanaka, tava kutarisa kuti urgent care inogona kupa here mushonga wekudzivirira kubata pamuviri zvakasiyana.

Zviratidzo zwebhanhire kana piritsi zvinoreva kumira nekutarirwa

Zviratidzo zvitsvuku izvi zvakafanana kune ese ari maviri nzira. Nzira yekuburitswa haishanduri zvinoitika se emergency.

Fonera 911 kana enda kuchipatara chekukurumidzira ikozvino kana:

• Kurwadziwa kwechipfuva kwakangoerekana kwaitika kana kushaya mweya
• Kurwadziwa kwakakomba kwechetekwete kwakasiyana nema headaches ako akajairika, kana shanduko yekuchikona yakangoerekana yaitika kana kurasikirwa kwechiona.
• Kusagadzikana kwakangoerekana kwaitika, kusagadzikana, kana kunetseka kutaura kune rimwe divi remuviri
• Kurwadziwa kwakangoerekana kwaitika nekuzvimba mune rimwe gumbo
• Kurwadziwa kwakakomba mudumbu kana mudumbu nekunzwika
• Kuvheneka kweganda kana maziso ne weti yakasviba nekurasikirwa kwechido

Ronga kushanya mukati mevhiki rinouya kana:

• Uchiona bundu idzva rechikadzi
• Kutevera kweropa kunova kwakanyanya kupfuura kwakajairika uye kunogara kwemazuva anopfuura 7, zvichienderana ne MedlinePlus guidance on combined hormonal contraception
• Nzvimbo yebhanhire inoramba yakatsvuka, yakasviba, kana yakatsvuka pakati pekushandura
• Mapasa anoramba achidonha
• Unopotsa mapiritsi achioneka

Taura nechiremba usati watanga kana:

• Unosvuta uye uri pamusoro pe 35
• BMI yako iri 30 kana kupfuura, kana huremu hwako 198 lb kana kupfuura
• Iwe kana hama yako yekutanga vakave neropa rinonaya, DVT, kana pulmonary embolism
• Uchiverenga migraine ine aura
• BP yako haina kudzivirirwa
• Wanga uchivhiyiwa kukuru kana kusanyanya kufamba nguva pfupi yapfuura
• Unonwa rifampin, vamwe anticonvulsants, kana St. John's wort

Mibvunzo Inobvunzwa Kakawanda

Kana bhanhire rangu rikadonha, ndichiri kuchengetedzwa here?

Dzimwe nguva. Kushanda kwebhanhire rekudzivirira kubata pamuviri mushure mekunge rabviswa kunoenderana zvachose newachi. Kana rakanga riripo kwemazuva anosvika 48, shandisa bhanhire rimwe chete kana kuisa chimwe chitsva uye chengeta zuva rako rekushandura rekutanga, pasina kuchengetedza kunodiwa. Panguva ye 48 maawa kana kupfuura, tanga bhanhire idzva, shandisa kuchengetedza kwemazuva manomwe, uye bvunza nezve emergency contraception kana wakambogara panguva iyoyo. Mipendero yakasimudzwa inoverengwa seyakadzimwa.

Bhanhire rekudzivirira kubata pamuviri rinokonzera kuwedzera kurema kudarika piritsi here?

Kwete. Pa birth control patch vs pill weight gain, Cochrane review evidence on combined hormonal contraceptives found roughly 0.4 kg (under 1 pound) over a year, with no meaningful difference between the two routes. That is review evidence rather than an FDA figure, and it is close enough to normal annual weight fluctuation that most people cannot separate it from everything else going on.

Ndinogona kusvetuka vhiki risina bhanhire kuti ndisvetuke period yangu here?

Hongu. Kushandisa bhanhire idzva panzvimbo pekushandisa vhiki risina bhanhire inzira yakagadziriswa yekuwedzera kana yekutenderera, inoshandiswa kunze kwechiratidzo nenzira imwecheteyo vanhu vanoshandisa mapiritsi akatevedzana. Tarisira kubuda kweropa, kunyanya mumwedzi yekutanga, uye tarisira kuti zvichadzorera. Gonesa chirongwa nachiremba kutanga, sezvo chichishandura maverengero emazuva ako ekushandura.

Zvinodzivirira mahomoni zvichidzinga bhanhire kana piritsi kuti risashande here?

Kazhinji kwete. Maantibayotiki akajairika akadai se amoxicillin ne doxycycline haadzingi kushanda kwechero nzira, kunyangwe paine kuenderera kwenyevero iyoyo. Zvinetso chaidzo ipuro rifampin ne rifabutin, vamwe anticonvulsants, uye St. John's wort, izvo zvinomhanyisa hormone metabolism. Udze ani zvake anopa mushonga wekudzivirira kuti unoshandisa hormonal contraception uye bvunza kana kuchengetedza kunodiwa kune icho chipenga chakakosha.

Ndinogona kuwana mushonga webhanhire kana piritsi online pasina kuongorora kwemuviri here?

Hongu. Hapana pelvic exam kana Pap test inodiwa kutanga combined contraception. Zvatinoda chiremba ndiyo inozivikanwa BP yakatarwa uye nhoroondo yekunetseka, migraine, uye yekusvuta. Kana BP yako isingazivikanwe kana nhoroondo yako yakakanganiswa, tarisira kukumbirwa kuti uuye kana kuwana muverengo usati wapi mushonga.

Chinhu chekupedzisira

Pabhanhire rekudzivirira kubata pamuviri vs piritsi, kushanda kunoita hondo, saka sarudzo inogara kune dzimwe nzvimbo. Zvakanaka nezvakaipa zvebhanhire rekudzivirira kubata pamuviri zviri nani kana wanga uchinetseka nemishonga yemazuva ese uye BMI yako iri pasi pe 30 uye huremu hwako kuri pasi pe 198 pounds. Piritsi rinokunda pakuburitswa kwe estrogen, sarudzo yemhando, kusanyanya kuoneka, uye kuwanikwa kwenzira ye progestin-chete. Chero chaunosarudza, shandura pasina chipenga chemahormone, uye ziva zviratidzo six emergency zvisati zvasvika mushonga wako wekutanga.

Disclaimer: Chinyorwa ichi chiri chekuzivisa chete uye hachisi zano rekurapa. Gara uchibvunza mushandi wezvehutano akakodzera kuti aongorore uye agadzirise. Kana uri kuona emergency yekurapa, fonera 911 kana enda kuchipatara chekukurumidzira chepedyo pakarepo.