I-Mirena IUD yoNyango lweeMviwo eziPhezulu
Ukuba ucinga nge-IUD yolawulo lokuzalwa kunye nexesha elinzima, ngaba i-Mirena IUD inokukhetha okulungileyo? Oku kuqhathaniswa njani kunye nemilenze yomlomo kunye neendlela zokugonywa (ezifana ne-endometrial ablation kunye ne-hysterectomy) yokulawula ukuphuma kwegazi elikhulu?
Yintoni iMirena IUD?
I-Mirena IUD enye ifomu ye- IUD (i-intrauterine device) esetyenziselwa ulawulo lokuzalwa.
Isixhobo se- hormonal sinokuthintela ukukhulelwa iminyaka emihlanu-ngokunciphisa ukukhulula i- progestin , i-levonorgestrel, ngeli xesha. Ukuba ukhetha i-Mirena yokulawulwa kokuzalwa, unokukwazi ukufumana inzuzo kwezinye izinto ezingezizo zokukhusela ezifana nokukhutshwa kwezikhathi ezinzima.
I-Mirena yokukhupha okukhulu:
I-FDA ivume iMirena ngo-2009 ukukunceda ukuphaphaza kakhulu igazi . Okwangoku kuphela uhlobo lolawulo lokuzalwa oluvunywe ukunceda ukulawula ukuphuma kwexesha elidlulileyo. I-Mirena yile ndlela kuphela yokukhetha unyango olungelona unyango xa ufumana ixesha elibi.
Bangaphi Abasetyhini Abahluphekayo Ngokuxhatshazwa Okukhulu?
Kulinganiselwa ukuba phakathi kwama-9 no-14 ekhulwini kwabasetyhini abasempilweni banokuchaphazeleka ngamaxesha amaninzi. Abasetyhini abanamaxesha amaninzi baya kulahleka malunga neetlanu ezilishumi / ezintandathu zezipuni zegazi (ezingama-80 mL okanye ngaphezulu) kwisigidi esisodwa. (Abafazi abanamaxesha aphakathi nje balahlekelwa iipaspuni ezi-4 ukuya kwe-12 zegazi (20-60 mL) ngexesha lawo.)
Amaxesha amaninzi anakho ekukhokelela ekudiseni i-anemia kunye nezinye iingxaki, kungekhona ukuthetha ngemicimbi yokuphila yokuphila ngamaxesha amaninzi.
Ungazi njani Ukuba Unamaxesha Aphakamileyo?
Kungaba nzima ukuxelela ukuba ungaphi na igazi ebudeni bakho, kwaye abambalwa abafazi baya kuba nako ukuqikelela inani leetaspuni okanye iipunipoli zegazi ezilahlekileyo.
Ngenxa yoko, oogqirha bacetyisa ukuba unokubanjelwa egazini elikhulu xa wena:
- Gcoba nge-pad okanye i-tampon zonke iiyure ezi-2 ukuya kwezi-3
- Ngaba uye wakhahla iingubo zakho okanye iibhedi ngenxa yokuphuma kwegazi
- Ufanele uvuke phakathi kobusuku ukutshintsha i-tampon okanye ipasti yakho
- Gqoka zombini i-tampon kunye nepedi (ukukhuselwa kabini)
Ukusebenzisa i-Mirena yokukhupha ngamandla: Uphando lusitshele ntoni?
Kukho uphando olunzulu olwenziwe ukuba lubone ukuba i-Mirena yonyango olusebenzayo lwexesha elibi, zombini yodwa, xa kuthelekiswa nemithi yomlomo, kwaye xa kuthelekiswa neenkqubo zokuhlinzwa ezifana ne-endometrial ablation kunye ne-hysterectomy. Nantsi isishwankathelo sezinye zophando:
- Kwisifundo esithile sabasetyhini abaye baphelelwa yigazi elininzi, uMirena unciphise inani lokuphuma kwindoda ekuphumeni kwakhe ngamaphesenti angama-80 emva kweenyanga ezintathu zokusetyenziswa. Emva kweenyanga ezintandathu, ukuphuma kwegazi kwanciphisa ngamaphesenti angama-90.
- Olunye uhlolisiso lwabheka abafazi abangama-50 ababeceba ukuhlinzwa ukuze baphathe ixesha elibi kodwa bavuma ukuba iMirena ifakwe endaweni. Abamashumi amabini anesibhozo kwabesifazane babika ukuba baqaphela inani elincinci lokulahleka kwegazi emva kweenyanga ezintathu zokusetyenziswa kweMirena. Le nani inyuke kwi-41 emva kweenyanga ezili-9 zokusetyenziswa. Abangamashumi mane-nye kwala mabhinqa banquma ukuqhubeka besebenzisa iMirena endaweni yokuhlinzwa ukuze baphathe ukuphuma kwegazi.
- Xa kuthelekiswa kunye neepilini kuphela zokulawula iipilisi kunye neDepo-Provera, i-Mirena ifumaneke ukuba iphumelele ekulawuleni ukuphuma kwegazi.
- Ukuphononongwa kweengcaphephe zophando ezi-6 kuboniswe ukuba, xa kuthelekiswa nokuqheliswa kwe-endometri (inkqubo yokucoca ekhupha umgca wesisu), i-Mirena yafunyanwa ukuba iphumelele ekunciphiseni ukulahleka kwegazi kwenyanga. I-Mirena yafunyanwa ibe yinto efanelekileyo yokuphuphuma kwe-endometrial kuba kukho imiphumo embalwa kunye ne-Mirena ayikuchaphazeli ukuzala kwakho kwexesha elizayo (ngokubhekiselele kwi-endometrial ablation engenza kube nzima ukukhulelwa).
- Olunye uphando lubhekise eMirena njengonyango lokuphuma kwegazi elinomnyaka omnye. I-Mirena yabonwa ukuba yinkqubo efanelekileyo yonyango kwabafazi abathathu kwabasetyhini abanegazi elinamandla-amaphesenti angama-79.5 kwabesetyhini baceba ukuqhubeka besebenzisa iMirena. Olu pho nonongo lubonisa ukuba i- hemoglobin (iqela eliphambili kwiiseli ezibomvu zegazi) linyuka kwiinyanga ezi-3 nakwi-12 kubafazi abasebenzisa iMirena. Oku kubalulekile kuba ukuphuma kwegazi kunakhokelela kumanqanaba angaphantsi kwe-hemoglobin-kwaye oku kunokukubeka engozini yokuba yindalo (xa umzimba wakho ungenayo iiselundi zegazi ezibomvu ezaneleyo).
- Uvavanyo lwango-2017 luhlolisise ukungafani phakathi kweMirena, i-hysterectomy, kunye ne-endometrial ablation yokuphuma kwegazi. I-Mirena ibekwe ngokubhekiselele kwinani lomgangatho wobomi, ilandelwa yi-hysterectomy, elandelwa yi-endometrial ablation. Iimiphumo ezimbi zixhomekeke ngakumbi kwiMirena kunokuba kuphuculwe i-endometrial, kodwa i-Mirena yindleko ephezulu xa kuthelekiswa.
I-Mirena Iyanciphisa Ukunyuka Kwemini?
Ngokubanzi, kubonakala sengathi i-Mirena inokukunceda ukuphatha igazi elininzi ngeendlela ezimbini:
- I-Mirena inganciphisa inani lokuphuma kwegazi unyanga nganye.
- Ukulahleka kwegazi lakho kumjikelezo ngamnye kunganciphisa ngokuqhubekayo nokusetyenziswa kweMirena.
Emva kokuba i-Mirena IUD ingeniswe kwisibeletho sakho iprogesin ikhutshwe kunceda ukunciphisa ukunyuka kwimbumba yesisu sakho (okwenzeka ngenyanga nganye). Oku kwenza ukuba ibhande lincinci, ngoko ke kuncinci ukucinywa ngexesha lexesha. Oku kufana nokuphuma kweenyanga ngaphantsi.
Kuthatha ixesha elingakanani iMirena yokunciphisa ukuhlamba?
I-Mirena inokunciphisa ukuphuma kwegazi kwinyanga ezimbini kubini abasetyhini abanamaxesha aphakathi okanye anzima. Uninzi lwabasetyhini abasebenzisa iMirena baya kuba nokunciphisa ukulahleka kwegazi emva kweenyanga ezi-3 ukuya kwezi-6 zokusetyenziswa. Kubonakala ngathi u-85% weepesenti wehla ekujikelezeni kwegazi emva kweenyanga ezintathu emva kokufakela ukuba unayo igazi okanye uphepha. Emva konyaka wokusetyenziswa, ngaphezu kwama-95 ekhulwini abantu bancitshiswa ekuphumeni kwegazi.
Emva kweenyanga ezili-6 zokusetyenziswa, malunga nama-20 ekhulwini kwabasetyhini abasebenzisa iMirena abayi kuzuza ixesha. Eli nani likhuphuka lifikelela kuma-50 ekhulwini emva kokusebenzisa iMirena iminyaka emi-5.
Ukusasazwa kweeMeyi kungenwe ekuqaleni ngeMirena
Abanye besifazane besaba ukuba iMirena ayinakukunceda kwangethuba, njengoko bebona ukuba banamabala amaninzi kunokuba bangaphantsi. Kubalulekile ukubonisa ukuba le ndawo yokuqala (iintsuku ezingakumbi zokuphaphaza okanye ukuphaphazeka ngokungavumelekanga) kuyinto evamile emva kokuba iMirena ifakiwe, kodwa ngokuqhelekileyo iyancipha emva kweenyanga ezimbalwa zokusetyenziswa.
Ngaphantsi kwindlela yokusebenzisa i-Mirena IUD yokunyuka okukhulu kokuya esikhathini
I-Mirena IUD inokunciphisa kakhulu ukuphuma kwindoda ngenxa yobuninzi babantu abane-IUD efakwe. Oku kunokukunceda kuphela ngemicimbi yokuphila kunye nokukwazi ukufumana i-anemia kodwa kungenasiphelo esingaphantsi kwezinye iinkqubo zokugonywa ezisetyenziselwa ukunciphisa ukuphuma kwegazi. Kwakhona kunenzuzo yokulondoloza kangcono ukuzala kwakho ukuba ucinga ukuba nomntwana okanye omnye umntwana kwixesha elizayo.
Naliphi na indlela yokunciphisa ukuphuma kwimizi ingaba nemiphumo emibi, kwaye kubalulekile ukuba ube nengxoxo ngokucokisekileyo kunye nogqirha wakho malunga nento efanelekileyo kuwe.
> Imithombo:
> Lethaby, A., Hussain, M., Rishworth, J., noM. Rees. Iprogesterone okanye iProgesterone-Ukukhupha iiNkqubo zeTytrauterine zokuKhusela kwexesha elikhulu. I-Cochrane Database yeeNkqubo eziPhezulu. 2015. 30 (4): CD002126.
> Marjoribanks, J., Lethaby, A., kunye noCarquhar. Ugqirha Olwachasene noTyango lwezoNyango zokuSilalisa ngokunyanga. I-Cochrane Database yeeNkqubo eziPhezulu . 2016. (1): CD003855.