I-Estrogen kwiipilisi ezininzi zokulawula izilwanyana ziye zancitshiswa
Ingaba yingozi okanye iphumelele kubafazi abangaphezu kwama-40 ukusebenzisa ulawulo lokuzalwa kwe-hormonal? UDkt. Andrew Kaunitz unika i-vignette yecala elilandelayo kwinqaku elipapashwe kwiNew England Journal of Medicine :
Owesifazane onempilo, onamahlombe oneminyaka engama-46 ubudala ongenamdla, ucela iingcebiso malunga nokukhulelwa komzimba. Uphawula ukuba ixesha lakhe lokuya esikhathini aliqhelekanga kunokuba ngaphambili, kwaye uphinda uxela ukuphazamiseka okutshisayo. Ulwalamano olutsha emva kokuqhawula umtshato, kwaye usebenza ngokwesondo. Ubuza ukuba unokuqalisa ukusebenzisa imithi yomlomo . Yintoni oyayicebisa ngayo?
Izinketho zoLawulo lokuzalwa kwabesetyhini kuma-40
Ukuba uneminyaka engama-40 ubudala okanye ngaphezulu, landela! Kuye kwafunyaniswa ukuba ukhetho lwakho olukhoyo lokulawula ukuzalwa luye landa. Akusekho ukhetho lwakho oluthile luncitshiswe kwiikhondom, i- diaphragms , kunye ne- tubal ligation .
UDkt. Kaunitz, ilungu leSebe le-Obstetrics kunye neGynecology kwiYunivesithi yaseFlorida College of Medicine, uphando olushicilelwe kumqulu wama-Matshi 20 we-2008 we- New England Journal of Medicine ohlola ukusetyenziswa kwe-women's hormonal contraception emva kweminyaka engama-40. U-Kaunitz uchaza ukuba ekubeni i-estrogen efunyenwe kwiintlobo ezininzi zamanxeba okulawulwa kokuzalwa kwamhlanje ziye zancitshiswa ngokuphawulekayo, i pilisi ngoku ithathwa njengendlela ekhuselekileyo yokuncinci, abafazi abanempilo abangaphezu kweminyaka engama-40.
Ezinye iiNzuzo zoNyango wokuHlonyelwa kwaBaHoroni kwaBafazi abangaphezu kweminyaka eyi-40
UDkt. Kaunitz uphinde uchaze ukuba abaninzi abafazi banokukhetha ipilisi ngenxa yokuba:
- Ukunciphisa ukuphuma kwindoda ngokungaqhelekanga
- Ukunceda ukulawula ukutshisa
- Uncedo lokunciphisa i-hip fractures
- Ukunciphisa umngcipheko we-ovarian, i-endometrial, kunye nomhlaza ongqambileyo
Ingozi yeCandelo leGazi eliMngcipheko
Khumbula, nangona kunjalo, ukuba umngcipheko weengcipheko zegazi ezinobungozi ukhula ngokukhawuleza kwiminyaka engama-40 yabasetyhini abasebenzisa iipilisi zokulawula ukuzalwa kokuzalwa kwe-estrogen, kunye neziganeko eziqikelelweyo kwiimeko ezingama-100 kubantu abayi-100 000 (xa kuthelekiswa namaqela angama-100 000 abantu abaneminyaka yobudala).
Kwakhona, umngcipheko we-thromboembolism wenyuka phantse kabili phezulu phakathi kwabasetyhini njengabafazi basetyhini abasebenzisa izithintelo zomlomo .
Ukuba unomfazi oneminyaka engama-40 kunye nonyaka onokugqithiseleyo, ukutshaya umsila, uququze iintloko, uxinzelelo lwegazi oluphezulu , okanye isifo sikashukela, uphando lukaDkt. Kaunitz lubonisa ukuba umngcipheko ochaphazelekayo kunye nokusetyenziswa kolawulo lokuzalwa ngokubhekiselele ekusebenziseni ukulawulwa kokuzalwa kuthathwa njengongaphezulu inzuzo. Kodwa, kukho iindaba ezilungileyo. Abesifazane abangaphezu kwama-40 kunye nale mingcipheko ingabakho abaviwa abagqwesileyo kwi- ParaGard IUD , okanye ngeendlela zokukhulelwa kweprogesin kuphela .
Ukusetyenziswa kolawulo lokuzalwa kuBesifazane abaneminyaka engama-40 kunye nabadala
Ukukhulelwa kwe-hormone kusandul 'ukuba kuyimfuneko yokuba abantu abangama-40-banikezelwe ukuba abafazi abaninzi bakhetha ukuyeka ukuzala abantwana kude kube yimva kamva, ngoko ukutshatyalaliswa kwempahla, njengokuba kubakho izibatho eziboshweyo, akunakukukhetha. Okuthakazelisayo, iinani libonisa ukuba abafazi abaneminyaka engama-40 kunye nabasetyhini abanako ukukhetha ukulawula ukuzalwa , kodwa (kunye neentsha), aba bafazi abadala banamazinga aphezulu okukhipha isisu . Nangona kunjalo, uDkt. Kaunitz uthi iingxelo ezingama-40 kunye nabafazi beminyaka yobudala abasebenzisa ukukhulelwa kwezilwanyana "banokusebenzisa imithi yokukhusela ngokuchanekileyo nangokuzimeleyo kunabantwana abaselula.
Ngako oko, abafazi beli qela leminyaka banamazinga aphantsi okuhluleka kokukhulelwa kunokuba bafazi abaselula. "
Ukwandiswa kwe-40 kunye neendlela zokukhulelwa kwabafazi kuza kufumana abaninzi abafazi banandipha ngokuxhamla ubudlelwane bezesondo ngaphandle kokufuna ukukhathazeka ngokukhulelwa.
Umthombo:
Kaunitz, AM (2008, Matshi 20). Ulwaphulo lweHormonal kwi-Women's Age of Reproductive Age. I-New England Journal of Medicine, 358 (12) , 1262-1270.