Yini i-Levonorgestrel Intrauterine Route: Ukusetshenziswa, Umthamo, Imiphumela Eceleni nokuningi

I-Levonorgestrel intrauterine route ibhekisela kudivayisi encane, emise okuka-T efakwa ngaphakathi esibelethweni sakho ekhulula i-hormone levonorgestrel ngqo lapho idingeka khona. Le ndlela ihlanganisa ukulawulwa kokuzalwa okuphumelela kakhulu nokuqeda izikhathi ezinzima, okwenza kube yindlela ethandwayo yabesifazane abaningi abafuna ukuzivikela ekukhulelweni isikhathi eside.

Le divayisi isebenza ngokukhipha amanani amancane e-progesterone eyenziwe (levonorgestrel) emgqeni wakho wesibeletho iminyaka eminingana. Lokhu kukhishwa kwe-hormone yendawo kusho ukuthi uthola izinzuzo ngokuchayeka okuncane kwe-hormone uma kuqhathaniswa namaphilisi okulawula ukuzalwa, ngenkathi ujabulela ukulula kokungadingeki ukukhumbula imithi yansuku zonke.

Yini i-Levonorgestrel Intrauterine Route?

I-Levonorgestrel intrauterine route iyidivayisi ye-intrauterine (IUD) ekhulula ama-hormone enikeza ukuzivikela ekukhulelweni okubuyisekayo isikhathi eside. Le divayisi icishe ibe nobukhulu bekota futhi iqukethe indawo yokugcina i-levonorgestrel, uhlobo olwenziwe lwe-hormone progesterone.

Uma isifakwe ngumhlinzeki wakho wezempilo, le divayisi ihlala kamnandi esibelethweni sakho futhi ikhipha kancane amanani amancane e-levonorgestrel ngqo emgqeni wesibeletho. Le ndlela eqondiwe isho ukuthi i-hormone isebenza ikakhulukazi lapho idingeka khona, ngamanani amancane angene egazini lakho uma kuqhathaniswa nezindlela zokuvimbela ukukhulelwa ngomlomo.

Le divayisi ingahlala isebenza iminyaka engu-3 kuya kwengu-8 ngokuya ngohlobo oluthile, ngemuva kwalokho idinga ukushintshwa uma ufuna ukuqhubeka nale ndlela yokuvimbela ukukhulelwa. Ungayikhipha nganoma yisiphi isikhathi uma unquma ukuthi ufuna ukuzama ukukhulelwa noma ushintshele kwenye indlela yokuvimbela ukukhulelwa.

Isetshenziselwani i-Levonorgestrel Intrauterine Route?

Ukusetshenziswa okuyinhloko kwamadivayisi e-levonorgestrel intrauterine ukuvimbela ukukhulelwa, ngenani eliphumelelayo elingaphezu kuka-99%. Kodwa-ke, lawa madivayisi anikeza ezinye izinzuzo ezengeziwe eziwenza abaluleke kakhulu kwabesifazane abathile.

Abesifazane abaningi baba nezikhathi zokuya esikhathini ezilula kakhulu ngemuva kokufakwa, kanti abanye bangase bayeke ukuya esikhathini ngokuphelele. Lokhu kwenza le divayisi ibe yindlela enhle kakhulu kwabesifazane abahlushwa ukuphuma kwegazi okuningi ngesikhathi sokuya esikhathini (menorrhagia) noma izikhathi ezibuhlungu.

Udokotela wakho angase futhi ancome le divayisi uma une-endometriosis, njengoba ukukhishwa kwamahomoni okwenzeka endaweni ethile kungasiza ekunciphiseni ukukhula kwesicubu se-endometrial ngaphandle kwesibeletho. Ngaphezu kwalokho, ingasetshenziswa njengengxenye yokwelashwa ngamahomoni kwabesifazane abase-postmenopausal ukuvikela ukugqoka kwesibeletho lapho kuthathwa i-estrogen.

Abanye abahlinzeki bezempilo basebenzisa lawa madivayisi ukusiza ukuphatha izinhlobo ezithile zokuphuma kwegazi okungajwayelekile kwesibeletho noma njengenketho yokwelashwa kwabesifazane abane-fibroids abafuna ukugwema ukuhlinzwa.

Isebenza Kanjani Indlela Ye-Levonorgestrel Intrauterine?

Le ndlela yokuvimbela ukukhulelwa isebenza ngezindlela eziningi ukuvimbela ukukhulelwa ngempumelelo. I-hormone ye-levonorgestrel yenza amafinyila akho omlomo wesibeletho abe makhulu, okwenza kube nzima kakhulu ukuthi isidoda sifinyelele futhi sivundise iqanda.

I-hormone futhi yenza ukugqoka kwesibeletho sakho (endometrium) kube mancane, okunciphisa amathuba okuthi iqanda elivundisiwe lizifake. Kwabanye besifazane, le divayisi ingase futhi icindezele i-ovulation, nakuba lokhu kungewona umsebenzi wayo oyinhloko.

Njengendlela yokuvimbela ukukhulelwa, ama-levonorgestrel IUD athathwa njengasebenza kahle kakhulu kodwa hhayi njengoba enamandla njengezinqubo zokuzala unomphela. Asebenza kahle kakhulu kunezibhebhe zokulawula ukuzalwa, iziqeshana, noma izindandatho ngoba akukho ngozi yephutha lomsebenzisi njengokukhohlwa ukuthatha iphilisi.

Uhlelo lokulethwa kwamahomoni endawo lusho ukuthi uthola ukuvikeleka okuqhubekayo kokuvimbela inzalo ngaphandle kokukhumbula imithi yansuku zonke. Idivayisi iqala ukusebenza ngokushesha ngemva kokufakwa futhi iyaqhubeka nokuhlinzeka ngokuvimbela inzalo okuthembekile iminyaka eminingi.

Kufanele Ngiyithathe Kanjani Indlela Yokufaka I-Levonorgestrel Intrauterine?

Ngokungafani nemithi yomlomo, awuyithathi le ndlela yokuvimbela inzalo ngendlela yendabuko. Kunalokho, umhlinzeki wokunakekelwa kwezempilo oqeqeshiwe ufaka le divayisi esibelethweni sakho ngesikhathi senqubo esheshayo ehhovisi.

Ngaphambi kokufakwa, akudingeki ukuthi uzile noma ugweme ukudla, nakuba abanye abahlinzeki bencoma ukuthatha umuthi wokwelapha ubuhlungu ongaphezu kwekhawunta njenge-ibuprofen cishe imizuzu engama-30-60 ngaphambi kokuhlolwa kwakho. Lokhu kungasiza ekunciphiseni ukuqaqamba ngesikhathi nangemva kwenqubo.

Inqubo yokufaka ngokuvamile ithatha imizuzu embalwa nje. Umhlinzeki wakho uzosebenzisa i-speculum ukuze abone isitho sakho sangasese, ahlanzekise indawo, bese esebenzisa i-inserter ekhethekile ukubeka idivayisi ngesitho sakho sangasese singene esibelethweni sakho. Ungase uzwe ukuqaqamba okufana nokuqaqamba kwesikhathi ngesikhathi sokufakwa.

Ngemva kokufakwa, akudingeki ukuthi wenze lutho olukhethekile ukuze ulondoloze idivayisi. Izosebenza ngokuqhubekayo ngaphandle kwesenzo esidingekayo kuwe. Umhlinzeki wakho uzosika izintambo zokususa ukuze zendlale kancane esithweni sakho sangasese, okukuvumela ukuthi uhlole ukuthi idivayisi isekhona yini.

Kufanele Ngiyithathe Isikhathi Esingakanani Indlela Yokufaka I-Levonorgestrel Intrauterine?

Ubude besikhathi buxhomeke ekutheni iyiphi i-levonorgestrel IUD onayo, njengoba amabhrendi ahlukene evunyelwe izikhathi ezihlukene. Amadivayisi amaningi asebenza iminyaka emi-3 kuya kwemi-8, kanti ezinye izinhlobo ezintsha zihlala iminyaka engama-8.

Ungayigcina idivayisi isikhathi esigcwele esivunyelwe uma ujabule ngayo futhi ungenazo izinkinga. Abesifazane abaningi bakhetha ukuthi idivayisi yabo ithathelwe enye entsha uma iphelelwa yisikhathi ukuze baqhubeke nokujabulela izinzuzo ezifanayo.

Noma kunjalo, awuzibophezelwe ekugcineni le divayisi impilo yayo yonke. Ungayisusa nganoma yisiphi isikhathi uma ufuna ukuzama ukukhulelwa, uhlangabezana nemiphumela emibi ongayitholi, noma ukhetha nje ukushintshela kwenye indlela yokuvimbela inzalo.

Uma usebenzisa le divayisi ikakhulukazi ngenxa yokuphuma kwegazi okuningi kunokuvimbela inzalo, udokotela wakho uzosebenza nawe ukunquma umugqa wesikhathi ongcono kakhulu ngokusekelwe ekutheni izimpawu zakho zithuthuka kangakanani nezidingo zakho zempilo eziphelele.

Yini Imiphumela Emibi Ye-Levonorgestrel Intrauterine Route?

Abesifazane abaningi bayayithola kahle i-levonorgestrel IUDs, kodwa njengazo zonke izindlela zokwelapha, zingabangela imiphumela emibi. Izindaba ezinhle ukuthi imiphumela eminingi emibi ingeyesikhashana futhi ithuthuka njengoba umzimba wakho ujwayela le divayisi ezinyangeni ezimbalwa zokuqala.

Nansi imiphumela emibi evame kakhulu ongase uyithole, uqonda ukuthi umzimba wakho udinga isikhathi sokujwayela ukukhishwa kwamahomoni endaweni ethile:

• Ukuphuma kwegazi okungajwayelekile noma ukubonakala, ikakhulukazi ezinyangeni zokuqala eziyi-3-6
• Izikhathi ezilula noma ukungabikho ngokuphelele kwezikhathi ngokuhamba kwesikhathi
• Ukugcwala okuncane noma ukungakhululeki kwe-pelvic, ikakhulukazi emasontweni ambalwa okuqala
• Ukuba nobumnene bebele noma izinguquko zemizwa
• Ukuba nobuhlungu bekhanda noma isicanucanu
• Ukuvela kwamabala noma izinguquko zesikhumba
• Ushintsho lwesibalo somzimba (noma ngabe ukuzuza isisindo esikhulu akuvamile)

Le miphumela ejwayelekile ivamise ukuzinza njengoba umzimba wakho ujwayela le divayisi. Abesifazane abaningi bathola ukuthi noma yiziphi izindlela zokuphuma kwegazi ezingajwayelekile zithuthuka kakhulu ngemuva kwezinyanga ezimbalwa zokuqala.

Noma kungavamile, eminye imiphumela emibi engathi sína ingenzeka edinga ukunakekelwa kwezokwelapha ngokushesha. Lezi zinkinga ezingavamile kodwa ezibalulekile zihlanganisa:

• Isifo sokuvuvukala kwamathambo e-pelvic (PID), ikakhulukazi ezinsukwini zokuqala ezingama-20 ngemuva kokufakwa
• Ukuphuma kwedivayisi, lapho i-IUD iphuma ingxenye noma ngokuphelele
• Ukugwazwa kodonga lwesibeletho ngesikhathi sokufakwa (akuvamile kakhulu)
• Ama-ovarian cysts, avame ukuzixazulula ngokwawo
• Ukuphendula okukhulu komzimba ezintweni zedivayisi

Uma uhlangabezana nobuhlungu obukhulu be-pelvic, ukuphuma kwegazi okuningi, umkhuhlane, noma ungazizwa izintambo zedivayisi ngesikhathi sokuhlolwa kwakho kwanyanga zonke, xhumana nomhlinzeki wakho wezempilo ngokushesha ukuze uhlolwe.

Ubani Ongafanele Athole i-Levonorgestrel Intrauterine Route?

Ngenkathi ama-IUD e-levonorgestrel ephephile kwabesifazane abaningi, izimo ezithile zezokwelapha noma izimo zenza le ndlela yokuvimbela inzalo inganconwa. Umhlinzeki wakho wezempilo uzobuyekeza ngokucophelela umlando wakho wezokwelapha ukuze aqinisekise ukuthi le divayisi ilungele wena.

Akufanele usebenzise i-IUD ye-levonorgestrel uma unezimo ezilandelayo, ngoba zingakhuphula ingozi yakho yezinkinga:

• Ukukhulelwa kwamanje noma okusolwayo
• Isifo sokuvuvukala kwamathambo e-pelvic esisebenzayo noma ukutheleleka kwamuva kwe-pelvic
• Ukuphuma kwegazi okungachazeki kwesitho sangasese sowesifazane
• Umtholampilo womlomo wesibeletho noma wesibeletho
• Umtholampilo wamabele noma umlando womtholampilo wamabele
• Amathumba esibindi noma isifo sesibindi esibi
• Ukuwohloka kwesibeletho okungavimbela ukubekwa kwedivayisi okufanele

Lezi zinto ezingavunyelwe ngokuphelele zisho ukuthi idivayisi ibeka ingozi enkulu futhi akufanele isetshenziswe ngaphansi kwalezi zimo.

Ngaphezu kwalokho, ezinye izimo zidinga ukuqapha okwengeziwe nokucatshangelwa ngokucophelela, yize zingayikhiphi ngokuzenzakalela idivayisi. Udokotela wakho uzohlola izinzuzo nezingozi uma une:

• Umlando wokukhulelwa okungaphandle kwesibeletho
• Ukuphazamiseka kokopha noma ukuthatha ama-blood thinners
• Izinkinga ze-valve yenhliziyo ezikhuphula ingozi yokutheleleka
• Ama-migraines amakhulu ane-aura
• Ukutheleleka ngocansi kwamuva
• Ozakwethu abaningi bezocansi (ingozi ephezulu ye-STI)

Umhlinzeki wakho wezempilo uzoxoxa lezi zinto nawe futhi angase ancome izinyathelo zokuphepha ezengeziwe noma ezinye izindlela zokuvimbela ukukhulelwa uma kudingeka.

Amagama Emikhiqizo Yendlela Yokufaka I-Levonorgestrel Intrauterine

Izinkampani eziningi zemithi zikhiqiza ama-IUD akhulula i-levonorgestrel, ngalinye linokucaciswa okuhlukile kanye nobude bokusebenza. Imikhiqizo evame kakhulu etholakalayo ihlanganisa i-Mirena, Skyla, Liletta, kanye ne-Kyleena.

I-Mirena yiyona IUD yokuqala ye-levonorgestrel eyavunywa futhi ikhipha ama-micrograms angu-20 e-hormone nsuku zonke ekuqaleni, ihlala isebenza iminyaka engu-8. I-Skyla incane futhi ikhipha ama-micrograms angu-14 nsuku zonke, yakhelwe ukusetshenziswa iminyaka emi-3, okuyenza ibe yindlela enhle yabesifazane abangakabi nabantwana.

I-Liletta ikhipha ama-micrograms angu-18.6 nsuku zonke futhi ivunyelwe iminyaka engu-8, kuyilapho i-Kyleena ikhipha ama-micrograms angu-17.5 nsuku zonke futhi ihlala iminyaka emi-5. Umhlinzeki wakho wezempilo uzokusiza ukhethe inketho efanele kakhulu ngokusekelwe ezidingweni zakho, i-anatomy, kanye nezintandokazi.

Yonke le mikhiqizo isebenza ngendlela efanayo kodwa ingase ibe nomehluko omncane ngosayizi, amazinga okukhishwa kwe-hormone, kanye nobude bokusebenza. Ukumbozwa komshuwalense kungase futhi kuhluke phakathi kwemikhiqizo, ngakho-ke kufanelekile ukuxoxa ngezindleko nomhlinzeki wakho.

Ezinye Izindlela Zokufaka I-Levonorgestrel Intrauterine

Uma i-IUD ye-levonorgestrel ingakulungele, ezinye izinketho zokuvimbela ukukhulelwa eziphumelela kakhulu zingahlinzeka ngokuqeda ukukhulelwa isikhathi eside. I-copper IUD (ParaGard) inikeza ukuvimbela ukukhulelwa okungenayo i-hormone iminyaka engu-10, nakuba ingase ikhulise ukuphuma kwegazi emini.

Ezinye izindlela ze-hormonal zihlanganisa i-contraceptive implant (Nexplanon), ekhulula i-hormone ehlukile ye-progestin ngaphansi kwesikhumba sakho iminyaka emi-3. Imithombo yokulawula ukuzala (Depo-Provera) inikeza izinyanga ezi-3 zokuvikela ngomjovo ngamunye, kuyilapho amaphilisi okulawula ukuzala, iziqeshana, kanye nezindandatho zinikeza ukuvimbela ukukhulelwa kwe-hormonal kwesikhathi esifushane.

Kwabesifazane abafuna ukukhululeka ekopheni eliningi kunokuvimbela inzalo, ezinye izindlela zihlanganisa amaphilisi e-tranexamic acid, amaphilisi okulawula inzalo anamahomoni, noma izinqubo ezinjenge-endometrial ablation. Udokotela wakho angase futhi acabange ukwelapha izimo ezingaphansi njengama-fibroids noma i-endometriosis ngokuqondile.

Izinketho zokuvimbela inzalo unomphela njenge-tubal ligation zinikeza ukuvimbela inzalo okuqinisekile uma uqiniseka ukuthi awufuni ukukhulelwa esikhathini esizayo. Umhlinzeki wakho wezempilo angakusiza uqhathanise zonke lezi zinketho ngokusekelwe empilweni yakho, indlela yokuphila, kanye nemigomo yokuzala.

Ingabe i-Levonorgestrel Intrauterine Route Ingcono Kunephilisi Lokulawula Inzalo?

Ama-IUD e-Levonorgestrel anikeza izinzuzo eziningi ngaphezu kwamaphilisi okulawula inzalo, nakuba ukukhetha okuthi "kungcono" kuncike ezidingweni zakho kanye nezintandokazi zakho. I-IUD inikeza amazinga amahomoni aqhubekayo kanye namanani okusebenza kahle aphezulu ngoba akukho ngozi yokukhohlwa ukuthatha imithi yansuku zonke.

Ngamaphilisi okulawula inzalo, udinga ukukhumbula ukuwathatha ngesikhathi esifanayo nsuku zonke, futhi ukusebenza kahle kungancipha uma uphuthelwa imithamo, uhlanza, noma uthatha imithi ethile. I-IUD isebenza ngokuqhubekayo ngaphandle kwesinyathelo esidingekayo kuwe, okwenza kube lula kwabesifazane abaningi.

Amaphilisi okulawula inzalo embula umzimba wakho wonke kumahomoni, kuyilapho i-IUD iletha amahomoni ikakhulukazi emgqeni wakho wesibeletho. Lokhu kulethwa kwendawo ngokuvamile kusho imiphumela emincane yohlelo njengamagazi, nakuba izimpendulo zomuntu ngamunye ziyahlukahluka.

Nokho, amaphilisi okulawula inzalo anikeza ukulawula okwengeziwe ekuvikeleni kwakho inzalo - ungayeka ukuwathatha nganoma yisiphi isikhathi ngaphandle kwenqubo yezokwelapha. Amaphilisi futhi akuvumela ukuthi weqe izikhathi ngendlela ebonakalayo uma ufisa, futhi ezinye izindlela zokwakheka zingasiza nge-acne noma ezinye izinkinga zamahomoni.

Ukuqhathaniswa kwezindleko kukhetha ama-IUD ngokuhamba kwesikhathi, njengoba idivayisi eyodwa ihlala iminyaka eminingi uma iqhathaniswa nemiyalelo yamaphilisi yanyanga zonke. Umhlinzeki wakho wezempilo angakusiza ukuthi ulinganise lezi zinto ngokusekelwe emlandweni wakho wezempilo, indlela yokuphila, kanye nezintandokazi zakho.

Imibuzo Evame Ukubuzwa Mayelana ne-Levonorgestrel Intrauterine Route

Ingabe i-levonorgestrel intrauterine route iphephile kwabesifazane abanesifo sikashukela?

Yebo, ama-IUD e-levonorgestrel ngokuvamile aphephile kwabesifazane abanesifo sikashukela futhi angase akhethwe ngaphezu kwamanye ama-contraceptives e-hormonal. Ukulethwa kwe-hormone okwendawo kusho ukuthi akukho okuningi okuthinta amazinga kashukela egazini uma kuqhathaniswa namaphilisi okulawula ukuzala.

Kodwa-ke, udokotela wakho uzofuna ukuqapha ushukela wakho wegazi eduze ngemva kokufakwa, njengoba abanye besifazane bengase babe nezinguquko ezincane ekusebenzeni kwe-glucose. Izinzuzo zokuvimbela ukukhulelwa okuphumelelayo ngokuvamile zidlula lezi zingozi ezincane, ikakhulu njengoba ukukhulelwa okungahleliwe kungase kube nzima ukuphatha isifo sikashukela kakhulu.

Ngingenzani uma ngisebenzisa i-levonorgestrel intrauterine route eningi ngengozi?

Awukwazi ukuthi "udlule" ku-IUD ye-levonorgestrel ngomqondo wendabuko, njengoba idivayisi yakhelwe ukukhulula inani elithile le-hormone ngokuhamba kwesikhathi. Idivayisi ilawula ukukhishwa kwe-hormone ngokuzenzakalelayo, ngakho-ke akukho ndlela ongathola ngayo imithi eningi ngengozi.

Uma ukhathazekile ngamazinga e-hormone noma uhlangabezana nezimpawu ezingavamile, xhumana nomhlinzeki wakho wezempilo ukuze uhlolwe. Bangahlola ukuthi idivayisi yakho ibekwe ngendlela efanele futhi bahlole ukuthi izimpawu zakho zihlobene ne-IUD noma ezinye izinto.

Ngingenzani uma ngiphuthelwa umthamo we-levonorgestrel intrauterine route?

Lo mbuzo awusebenzi kuma-IUD e-levonorgestrel ngoba asebenza ngokuqhubekayo ngaphandle kokudinga noma yisiphi isenzo kuwe. Ngokungafani namaphilisi okulawula ukuzala, awudingi ukukhumbula ukuthatha imithamo yansuku zonke - idivayisi ikhipha ama-hormone ngokuzenzakalelayo.

Noma kunjalo, kufanele uhlole njalo ngenyanga ukuthi usakwazi yini ukuzwa izintambo zokususa esithweni sakho sangasese, okukhombisa ukuthi le divayisi isakhona. Uma ungazizwa izintambo noma zibonakala zinde noma zimfushane kunokujwayelekile, xhumana nomhlinzeki wakho wezempilo ukuze uqinisekise ukuthi le divayisi ayishintshanga indawo noma ixoshiwe.

Ngingayeka nini ukuthatha i-levonorgestrel intrauterine route?

Ungakwazi ukususa i-levonorgestrel IUD yakho nganoma yisiphi isikhathi ngumhlinzeki wezempilo oqeqeshiwe, kungakhathaliseki ukuthi usuyithathe isikhathi esingakanani. Inqubo yokususwa ngokuvamile ishesha futhi ayinazweli kunokufakwa.

Ukwanda kwakho ngokuvamile kubuya ngokushesha ngemva kokususwa, ngokuvamile phakathi nezinyanga ezimbalwa. Uma ususa le divayisi ngoba ufuna ukukhulelwa, ungase ukhulelwe ngokushesha ngemva kokususwa, ngakho-ke lungela leli thuba.

Abanye besifazane bakhetha ukususa le divayisi yabo bese beyifaka enye entsha ngokushesha lapho iphelelwa yisikhathi, kanti abanye bashintshela kwezinye izindlela zokuvimbela inzalo noma baphumule ekusebenziseni izindlela zokuvimbela inzalo ngamaphilisi ngokuphelele.

Ngingakhulelwa ngokushesha ngemva kokususwa kwe-levonorgestrel IUD?

Yebo, ukukhulelwa kungenzeka ngokushesha ngemva kokususwa kwe-IUD, nakuba ukubuya kokuzala kuhluka phakathi kwabantu ngabanye. Abesifazane abaningi bakhulelwa phakathi namasonto ambalwa kuya ezinyangeni ngemva kokususwa, futhi ukukhulelwa kungenzeka ngesikhathi somjikelezo wakho wokuqala.

Uma uhlela ukuzama ukukhulelwa, cabangela ukuqala amavithamini e-prenatal ngaphambi kokususwa futhi ugcine imikhuba yokuphila enempilo. Uma ungalungile ukukhulelwa, xoxa ngezindlela zokuvimbela inzalo ezingezinye nomhlinzeki wakho wezempilo ngaphambi kokususwa ukuze uqinisekise ukuvikelwa okuqhubekayo.

Ukusetshenziswa kwangaphambilini kwe-levonorgestrel IUD akubonakali kuthinta ukuzala kwesikhathi esizayo noma imiphumela yokukhulelwa, ngakho-ke ungaqiniseka ukuthi le ndlela yokuvimbela inzalo ngeke ithinte ikhono lakho lokukhulelwa uma usulungele.