Cha. Izivivinyo eziqondisiwe azitholanga ukuthi i-patch yokulawula inzalo ibangela ukukhuluphala. Esinye isifundo sezinyanga ezintandathu, abasebenzisi be-patch bakhuluphala ngephawundi eli-yishumi nanye nengxenye, futhi iningi lalokho kwakuyisibindi kunokuba amafutha. Inombolo yesisindo ebalulekile ku-patch yileyo eshintsha ukuthi isebenza kahle kangakanani.

TL;DR: Izinto ezibalulekile

  • Ukubuyekezwa kwe-Cochrane kwezivivinyo eziqondisiwe akutholanga bufakazi bokuxhumana okubangela phakathi kwezivimbeli-mzimba ezihlangene, kufaka phakathi i-patch, nokushintsha kwesisindo.
  • Isifundo sokwakheka komzimba siphawule amagremu angu-0.64 (cishe iphawundi eli-1.4) esisindo ezingeni lezinyanga ezintandathu, kanye nelithi u-0.51 L wamanzi omzimba engeziwe. Iningi lokukhuluphala kwakuyisibindi.
  • Umdwebo we-Xulane we-FDA ubhala "isisindo sikhuphuke" ku-2.7% wabahlanganyeli besivivinyo sezokwelapha. Izindawo zokubuyekeza abasebenzisi zibika isilinganiso esiphindwe kahlanu kuya kweyisishiyagalolunye salokho.
  • Isibindi sifika ngokushesha futhi siyakubuka nsuku zonke. Amafutha aqongelele kancane futhi awakwenzeki ubusuku bonke.
  • Ku-198 lb (90 kg) noma i-BMI engu-30 noma ngaphezulu, i-patch ingasebenza kancane, yikho lokho ingxoxo okufanele yenziwe.

Ubufakazi buthi cha: i-patch ayizange iboniswe ukuthi ibangela ukukhuluphala

Ingabe i-patch yokulawula inzalo ibangela ukukhuluphala? Cha ngokusho kobufakazi obuqondisiwe. Isibuyekezo se-Cochrane sezivivinyo eziqondisiwe eziqhathanisa izivimbeli-mzimba ezihlangene, i-patch yesikhumba ifakiwe, ne-placebo noma ukungenelela akutholanga ubufakazi bokusekela ukuxhumana okubangela ukushintsha kwesisindo. Izilinganiso zokuyeka ngenxa yokushintsha kwesisindo azizange zihlukane phakathi kwamaqembu. Isilinganiso esiphakathi esiphakathi cishe sipawundi elilodwa ezingeni lezinyanga ezintandathu, iningi lawo ngamanzi.

Nansi into eminingi emakhasini engayitsheli: i-Cochrane ayizange ibonise ukuthi i-patch ayinalo umthelela esisindweni. Amazwi ayo angempela ukuthi ubufakazi obutholakalayo abubona buanele ukunquma umthelela wezivimbeli-mzimba ezihlangene esisindweni, kodwa akukho mthelela omkhulu owabonakala, futhi abalobi bacela izivivinyo ezizayo nge-placebo noma izigaba zokulawula ezingenawo ama-hormone. Akukho bufakazi bokuxhumana okubangela yikho kuwumsebenzi obuthaka kunokuba ubufakazi bokuthi akukho mphumela, futhi yikho ngokwethembeka.

Izinombolo ezikhona zincane. Ulwazi lokunquma lwe-FDA lwe-Xulane, olusingethwa yi-DailyMed ye-NIH, lubika "isisindo sikhuphuke" njengomphumela omubi ku-2.7% wabahlanganyeli besivivinyo sezokwelapha. Isifundo se-bioelectrical impedance se-ethinylestradiol ne-norelgestromin patch sithole ukuthi isisindo somzimba sikhuphuke amagremu angu-0.64 ngemuva kwezinyanga ezintandathu, ukushintsha ngo-1.1%. Lokho cishe kuwupawundi eli-1.4. Cishe ingilazi enkulu yamanzi.

Inombolo yesisindo ebalulekile ku-patch ingamakhilogremu angu-198, hhayi leyo esikalini sakho

Abantu abafuna ukukhuluphala kwe-Xulane bavamise ukufunda inombolo engalungile kudimboni. I-Ortho Evra iyekisiwe; ama-patch amabili athengiswa e-US namuhla yi-Xulane ne-Twirla, eyokugcina yakhelwe ukungasebenzi kwe-estrogen ephansi. Idimboni le-Xulane likhomba ukuthi yenzelwe kuphela abesifazane abane-BMI engaphansi kwamagremu angu-30 kg/m2 futhi bayakuphika ku-30 noma ngaphezulu ngenxa yengozi eyandayo ye-venous thromboembolism. Iphinde ixwayise ukuthi i-patch "ingasebenza kancane ekunqandeni ukukhulelwa kwabesifazane abanesisindo esingaphezu kwamakhilogremu angu-198 (90 kg) noma ngaphezulu." Izincomo Zomkhuba Ezikhethiwe ze-CDC zisho into efanayo: ukusebenza kungancishiswa ku-BMI engu-30 noma ngaphezulu, noma isisindo esingaphezu kwamakhilogremu angu-90.

Inkinga: idimboni nesiqondiso sikahulumeni azivumelani. Izimiso Zokufaneleka Zezokwelapha zase-US ze-CDC zibeka ukukhuluphala njengeSigaba 1 noma 2 sezivimbeli-mzimba ezihlangene, okusho ukuthi ngokuvamile akukona ukuphikisana, futhi zithi ukukala isisindo noma i-BMI akudingekile ukunquma ukufaneleka. Ingcuphe yokubila ezimweni eziphakeme nayo iyadluliselwa kunokuba ikalwe: i-CDC ithi abasebenzisi be-contraceptives ehlangene nabakhuluphale banengozi ye-VTE ephindwe kahlanu kuya kweyisishiyagalolunye kubasebenzisi abangewona abakhuphukela kubantu abakhuluphale, futhi ukuthi izifundo eziqhathaniswayo ezibheke ku-patch ngesisindo azikaze zitholakale. Lesi sinqumo singesodokotela owaziyo umlando wakho, hhayi isihlungu esishicilelwe ebhokisini.

Ngaphambi kwalokho kuphokotheka, uhlelo lokusebenza lomngane wezempilo olufana ne- August AI lungakusiza uguqule ukukhathazeka okungacacile ngamaphawundi kube imibuzo ethize mayelana nokusebenza kanye nengozi yokubila ngesisindo sakho. Likulungiselela ingxoxo. Alwenzi isinqumo.

Iningi lalokho isikali esikukhombisayo enyangeni yokuqala ngamanzi, hhayi amafutha

Ukugcinwa kwamanzi ku-patch kuchaza iningi lalokho abantu abazwa njengokukhuluphala. Esifundweni esifanayo se-impedance, amanzi omzimba aphelele akhuphuke amagremu angu-0.51 ezingeni lezinyanga ezintandathu, ukwanda ngo-1.7%, kanye namagremu angu-0.64 esisindo. Kancane kunepinti elilodwa lesibindi lichaza iningi lokukhuluphala.

I-Estrogen ikhuthaza ukugcinwa kwe-sodium namanzi. Ngokwenzeka lokho kusho ukuqunjelwa kwe-patch yokulawula inzalo, ibhande elizwa liqina kusihlwa, iminwe noma izinyawo ezivuthiwe, nesikali esifunda ngokuhlukile ekuseni okubili okuhlelekile.

Ukuzihlola kulula kakhulu. Isibindi sifika ngokushesha, siyahlukahluka usuku nosuku, futhi sibonakala njengokuqunjelwa. Ukukhuluphala kwamafutha kuqongelela kancane kancane izinyanga futhi akukaze kube khona ukuhlehla ubusuku bonke. Amaphawundi amathathu aphezulu ngoLwesibili nama-lawa amabili ngoLwesine ukugcinwa kwamanzi ku-patch, hhayi izicubu.

Ukuhlehla kwamanzi kuvame ukuhlala ezingxenyeni ezimbili kuye kwezintathu zokuqala. Ukuqiniswa okuqotho ngalokho kuhamba ngezinyawo: iwindi eliphakathi kwamaviki amathathu libekwe kulawulo lwezivimbeli-mzimba ezihlangene, hhayi ngokukalwa ngqo kwe-patch. Futhi umphikiso obuye ukubambe? I-patch iletha ukuvezwa okuphezulu kwe-estrogen jikelele kunama-pill amaningi ahlangene, futhi idatha yesivivinyo isabonisa akukho mphumela omkhulu wesisindo.

Uma ufuna ukwazi ipathen kawe ngempela kunokucabangela ngayo, uhlelo lokusebenza lomngane wezempilo olufana ne- August AI lungakusiza ukuthi ubhale isisindo, ukuqunjelwa, nosuku lomjikelezo ukuze ufike nerekhodi esikhundleni sokukhumbula. Kuyisengezo sokunakekelwa, hhayi isikhundla sawo.

Kungani abantu abaningi bebika ukukhuluphala kwe-patch yokulawula inzalo lapho izivivinyo zingatholi lutho

Ukukhuluphala kwe-patch yokulawula inzalo kubonakala kaningi ezibuyekezweni abasebenzisi kunezivivinyweni, futhi ubukhulu besikhala yikho okubalulekile. Ku-The Lowdown, 23% bababuyekezi be-Evra abayi-131 babike ukukhuluphala, kuyilapho 50% babike ukuthi akukho shintsho futhi 5% babike ukunciphisa. Ukubalwa kweDrugs.com kudlula cishe ku-11.8%. Isilinganiso sesivivinyo sezokwelapha kudimboni ye-Xulane ye-FDA singama-2.7%. Ezimbili zokuqala ziyidatha yombiko wokuzenzela, hhayi ubufakazi bezokwelapha.

Ukuziloba kuphakama ngezizathu ezicacile. Akukho iqembu lokulawula, ngakho-ke akukho okukutshela ukuthi isisindo sakho besingenzani noma kunjalo. Ukukhumbula okubuyisa emuva lokho obukholwa ukuthi ubunokho. Ukunikezwa kwecala kufinyelela kulokho okushintshe kamuva nje, futhi ukuqala kokuvimbela inzalo kuvame ukuba yinto yakamuva. Abantu abanesikhalazo bashiya izibuyekezo; abantu abangenalo ulwazi abenzi. Futhi isisindo siyanda ngeminyaka kungakhathaliseki ukuvimbela inzalo.

Kuyileyo ngwenya efanayo njengokubeka isimpawu kwisizathu sokushintsha kwenyanga edlule lapho ukucindezeleka kungabangela izimpawu ezingokomzimba ezikhona ngempela ezingahlangene nayo. Ukulungisa akujabulisi. I-CDC iphawula ukuthi nakuba ukukala isisindo kungadingeki ukufaneleka, ukubhalisa isisindo esiyisisekelo kungasiza ekubhekaneni nokukhathazeka mayelana nokushintsha ngokuhamba kwesikhathi. Bhala inombolo phansi osukwini lokuqala.

Ukukhuluphala okungazelelwe nokuvuvukala kwezinyawo akukona umphumela ohlangene: kuyisibonakaliso sokuxwayisa

Shayela u-911 noma uye egumbini lezimo eziphuthumayo manje uma:

  • Unezinhlungu ezibuhlungu, ukudideka, ubunzima bokukhuluma noma ukushintsha kombono (isifo sohlanga esingenzeka)
  • Unezinhlungu zesifuba, isindwa sesifuba noma ukuphefumula okungazelelwe (i-clot engenzeka emaphashini, noma ukuhlasela kwenhliziyo)
  • Unezinhlungu ezibuhlungu, ukuvuvukala, ukufudumala noma ukubomvu, ikakhulukazi esiqwini (i-deep vein thrombosis engenzeka)
  • Unezinhlungu ezibuhlungu zesifuba noma zesisu
  • Isikhumba sakho noma amhlophe emehlweni akho aphenduka abephuzi
  • Unezizunguze ezingalindelekile noma ukuquleka

Bhukha ukuvakashelwa phakathi nesonto elizayo uma: isisindo sakho siqhubeka nokukhuphuka ngokuqhubekayo ngemuva kwezinyanga ezintathu zokuqala, ukuqunjelwa kungakahlali, noma imiphumela ohlangene iyinzima noma iyaqhubeka. I-MedlinePlus ibeka ukukhuluphala phakathi kwezimpawu zokutshela udokotela uma zinzima noma zingadluli, zigcinwa ngokuhlukile ezinhluwayo zokuxwayisa eziphuthumayo.

Khuluma nodokotela ngaphambi kokuthi uqale uma: i-BMI yakho ingama-30 noma ngaphezulu noma unesindo esingaphezu kwamakhilogremu angu-198 (90 kg), ugwayi futhi ungaphezu kweminyaka engu-35, uthola umhlaza onombono, noma unomlando wakho noma womndeni wama-clot egazini noma umfutho wegazi ophakeme.

Kwesinye isigaba, u- $39 we-online urgent care ukuxhumanisa nodokotela ogunyazwe yi-US ongahlola ukuqunjelwa okuqhubekayo noma ukushintsha kwesisindo okunzima futhi aphinde aqinisekise lapho kufanelekile; udokotela unquma ukuthi kufanelekile. Yiba ngqo ngomkhawulo: ukuvakashelwa kwevidiyo akukwazi ukuphika i-clot noma isifo sohlanga. Lokho kudinga ukuhloliswa komuntu siqu nokudweba izithombe. Izinhlungu ezivamile zinezizathu ezivamile, futhi izinhlungu ezingalindelekile ezinyaweni ngaphandle kokulimala okusobala ngokuvamile kuvamile, kodwa izinhlungu zesiqubu nokuqunjelwa, ukufudumala noma ukubomvu ngenkathi use-patch kuyiphuthumayo, phuma.

Imibuzo evame ukubuzwa

Ingakanani isisindo engizosithola ku-patch?

Ngokuvamile akwanele ukubona. Lapho abantu bebuza ukuthi ingabe i-patch yokulawula inzalo ibangela ukukhuluphala, bafuna inombolo. Lindela ukuhlehla okujwayelekile kwansuku zonke njengoba wonke umuntu enakho, amaphawundi ambalwa aphezulu noma phansi kuye ngosawoti, umthamo wokudla, nesigaba somjikelezo, kanye namaphawundi amabili kuya kwamabili amanzi esigabeni sokuqala. Lawo manzi akuyona amafutha futhi awaqongeleli inyanga ngemuva kwenyanga.

Ingabe ukukhuluphala nge-patch yokulawula inzalo kuyadlula uma uyiyeka?

Yebo. Noma yimaphi amanzi i-patch ebiwagcina ayadlula phakathi namaviki ambalwa ngemuva kokuyikhipha, futhi isikali sivame ukubuyela lapho siqale khona. Uma uvumelana nenye indlela ehlangene, lindela ukuthi ukuhlehla okufanayo kwamanzi kuphinde kube khona ngenkathi ulungisa. Uma isisindo sakho siqhubeka nokukhuphuka ngemuva kokuthi i-patch isidlulile, okuthile okunye ngaphandle kokuvimbela inzalo kuyakubangela lokho futhi kufanele kubhekwwe.

Ingabe i-patch ingenza izinso zakho zizizwe zigcwele noma zinzima?

Yebo. I-Estrogen yandisa amanzi ezicubu zezinso futhi ingenza izinso zizizwe zigcwele, zinzima noma zizwelayo, ngokuvamile ezingxenyeni ezimbili zokuqala. Leyo iyisimo sezicubu namanzi kunokuba ngukukhuluphala kwamafutha, yingakho ingabonakala ezinsukwini futhi ihlezi ngaphandle kokuthi isikali sihambele nhlobo. Ukuzwela okuqhubekayo, iqhubu elisha, noma ukushintsha uhlangothi olulodwa kudinga ukuhlolwa komuntu siqu.

Ingabe i-Twirla ibangela ukukhuluphala okuncane kune-Xulane?

Cha. Akukho sivivinyo esiqondile esibonise umehluko wesisindo phakathi kwazo. I-Twirla yakhelwe ukuhambisa ukusebenza kwe-estrogen ephansi kune-Xulane, okungase kubaluleke kwezinye izizathu ezifanele ukuxoxwa nodokotela, kodwa ukusebenza okuphansi akuboniswanga ukuthi kushintsha imiphumela yesisindo. Ukukhetha phakathi kwazo ngokusekelwe esisindweni kusho ukukhetha ngobufakazi obungabikhona.

Ingabe kunokuvimbela inzalo okubonwe ukuthi kubanga ukukhuluphala?

Yebo. I-Depo-Provera, i-injection ye-depot medroxyprogesterone acetate, yikona okungukuhlukahluka kweqiniso, ngokukhuluphala okubhalwe ngokungaguquguquki ngokwanele ukuthi odokotela bayibeke ngaphambi kokunquma kunokuyihlehlisa, okuyikho kanye lapho ubufakazi bayo bungafanele busetshenziselwe ukuxoxa nganoma yini mayelana ne-patch noma okunye okuhlangene kwe-hormonal.

Isiphetho mayelana ne-patch nesisindo sakho

Ngakho-ke, ingabe i-patch yokulawula inzalo ibangela ukukhuluphala? Izivivinyo eziqondisiwe azitholanga uxhumano olubangela, futhi isilinganiso esiphakathi esikalwe, cishe iphawundi eli-1.4 ezingeni lezinyanga ezintandathu, kwakuyizinhlobo zamanzi. Ingxoxo yesisindo efanele ukwenziwa ngukuthi ngabe i-patch izokusiza yini ngesisindo somzimba wakho, hhayi ukuthi izongeza amaphawundi. Bhalisa isisindo esiyisisekelo namuhla, uyinike amaviki amabili kuya kwamathathu, uphinde uphakamise izigaba ze-BMI 30 kanye nezinamakhilogremu angu-198 nodokotela wakho ngaphambi kokuthi unqume noma yini.

Isitatimende: Lesi sihloko ngenhloso yolwazi kuphela futhi asihlanganisi iseluleko sezokwelapha. Njalo thintana nomhlinzeki wezempilo oqeqeshiwe ngezinqumo zokuxilonga nokwelashwa. Uma ubhekana nesimo esiphuthumayo sezokwelapha, shayela u-911 noma uye egumbini lezimo eziphuthumayo eliseduze ngokushesha.