Lub tswv yim ntawm kev siv tshuaj hormonal contraceptives:
- hluav taws xob ntawm ovulation. Los ntawm lub tswv yim ntawm kev tawm tswv yim tsis zoo, cov progestogen pob txha quav ua rau cov tshuaj hormones-stimulating thiab luteininizing. Tsis muaj qhov siab ntawm FSH thiab LH excludes ntawm ovulation. Ethinyl estradiol ua ke nrog progestogens suppresses folliculogenesis hauv cov zes qe menyuam;
- ua rau qhov siab ntawm qhov ncauj tsev menyuam. Progestogens pauv cov yam ntxwv xeeb ntawm biochemical thiab hnoos lub ncauj tsev menyuam hnyuv, tsim kom muaj kev tiv thaiv ntawm kev txav ntawm spermatozoa rau hauv lub uterine kab;
- cov kev hloov nyob rau hauv endometrium uas cuam tshuam nrog lub implantation ntawm lub qe. Progestogens inhibit lub proliferation ntawm endometrial hlwb, provoking tus inferior secretory transformation. Txawm hais tias ovulation thiab fertilization tshwm sim, kev xeeb tub tsis tau zoo zuj zus;
- qeeb lub tsiv teb tsaws ntawm qe thiab txo qhov contractility ntawm cov hlab plawv hlab. Progestogens qeeb cov tshuaj peristalsis ntawm cov leeg.
Lub tswv yim ntawm kev siv tshuaj tiv thaiv thaum muaj xwm ceev (Escapel, Postinor):
Xav paub ntau ntxiv txog kev tiv thaiv thaum muaj xwm txheej ceev tuaj yeem nrhiav tau ntawm no.
- inhibition ntawm ovulation, kev tiv thaiv ntawm fertilization;
- Hloov nyob rau hauv endometrium, tiv thaiv lub implantation ntawm ib tug fertilized qe.
Kev faib tawm ntawm hormonal contraceptives:
- Ntawm txoj kev ntawm lub tshuaj qhov kev cuam tshuam rau hauv cov hlab ntsha:
- implantable nyob rau hauv daim tawv nqaij. Cov kua yoojyim (35X2.5 millimeters), tso cov tshuaj hormones uas ua rau cov ntshav, tsim kom muaj qhov sib xyaw;
- ampoules. Cov kev txhaj tshuaj yog ua txhua txhua 45-75 hnub;
- ntsiav tshuaj.
- Kev tsim los ntawm hormonal:
- (ib zaug xwb) (ib zaug hauv lub voj voog (cov hnub nyoog 21 hnub) muaj ntau yam ntawm gestagens thiab estrogens nkag mus rau poj niam lub cev), biphasic (hauv thawj ib nrab ntawm lub voj voog, cov ntsiav tshuaj nrog qis cov ntsiab lus ntawm gestagens yog siv los simulate lub qhov roj oscillation ntawm cov keeb kwm hormonal), peb theem (muaj ntau cov tshuaj hormones rau kev txais tos qhov tshwm sim, uas tso cai rau koj kom yog tseeb rau ntawm tus poj niam cev nqaij daim tawv);
- uncombined ("mini-drank"). Muaj tsuas yog gestagens xwb.
- Rau txhua hnub ntau npaum li cas ntawm cov khoom ua estrogen:
- Microdosed (muaj 20 mg / hnub ethinyl estradiol);
- tsawg-koob (30-35 μg / hnub ethinyl estradiol);
- high-dose (50 mcg / hnub ethinyl estradiol).
Hormonal contraceptives: cov lus qhia siv
Rau cov tshuaj tua kabmob / hormonal tso tawm: cov tshuaj tua kabmob yog tua rau 7 hnub (3 thaj ua rau ib pob).
Rau monophasic COC: 21 ntsiav tshuaj ntawm tib xim nyob rau hauv cov hlwv.
Rau "mini-drank": 21/28 ntsiav tshuaj ntawm tib xim nyob rau hauv cov hlwv.
Rau peb theem: Hloov 21/28 ntawm cov xim sib txawv hauv cov hlwv.
Cov nyhuv tshuaj tiv thaiv tau ua tiav los ntawm kev hloov cov yam ntxwv ntawm lub ncauj tsev menyuam ntawm ncauj tsev menyuam thiab kev tua ntawm cov qoob loo. OK thiab "minipili" raug muab tso rau hauv, txhua txhua hnub ntawm ib lub sijhawm, tom qab qhov kev txiav txim tau teev rau hauv pob. Standard dosage: ntsiav tshuaj ib zaug txhua txhua 24 teev, rau 21 hnub. Cov pob ntawv tom ntej no yuav tsum pib tom qab ib lub lim tiam ib zaug, thaum lub sijhawm tshem tawm los ntshav. Atherosclerosis ntawm txais tos: 3 lub lis piam - txais tos ntawm dragees, 1 lub lim tiam - ib so.
Hormonal contraception: kev contraindications
- arterial hypertension, muaj feem xyuam rau cov kab mob plawv, valve apparatus abnormalities, keeb kwm ntawm lub plawv nres;
- tus kab mob thromboembolic, cov kab mob cerebrovascular, thrombophlebitis;
- cuam tshuam ntawm cerebral ncig, migraine;
- kev pab cuam nrog kev tiv thaiv tsis ntev;
- mob ntshav qab zib, mob kab mob siab, mob tawv nqaij tawv;
- daim siab qog nqaij hlav (benign / malignant), decompensated siab daim siab mob ntsws;
- Kev haus luam yeeb (15 lossis ntau tshaj ib hnub twg) thaum muaj hnub nyoog 35 xyoo thiab laus dua;
- lactation, cev xeeb tub, deformation ntawm lub uterine kab noj hniav, ntev cem quav, prolapse ntawm uterus;
- mob kab mob ntawm pelvic plab hnyuv siab raum ntawm cov mob nyhav;
- muaj roj ntsha / hormone-dependent neoplasms ntawm qhov kev ua me nyuam;
- uterine los ntshav ntawm kev paub tsis meej etiology.
Cov kev mob tshwm sim ntawm hormonal contraceptive:
- tsis muaj zog ntawm tshuaj (estrogen): meager menstruation, intermenstrual bleeding, amenorrhea, hypoplasia ntawm uterus, kraurosis ntawm vulva, "kub flashes", irritability;
- Hnyav dhau heev lawm: cov kua dej hauv lub cev, xeev siab, mob khaub thuas, hnyav mob khaub thuas, hnyav hauv mammary qog, mob ntshav siab, mob nqaij ntshiv, mob taub hau, latent diabetes Syndrome;
- Progesterone deficiency: amenorrhea, ntshav nthe ntsis, ua kom menyuam mos;
- tus mob progesterone: kev nyuaj siab, mob taub hau, mob alopecia, oily tawv, pob txuv, amenorrhea, hnyav nce / noj tsis qab, tsis muaj libido.
Lub algorithm rau xaiv ib yam tshuaj tiv thaiv hormonal:
- Kom dhau los yog coj qhov chaw tshuaj xyuas kom tsis txhob muaj qhov tsis haum rau kev txais tos cov tshuaj hormones;
- cov tshuaj ntawm qhov kev xaiv thawj zaug yog monophasic OK nrog tsawg androgenic gestagen thiab cov ntsiab lus ntawm ethinylestradiol tsis ntau tshaj 35 μg / hnub ( Regulon , Janine );
- yeeb tshuaj rau kev xaiv rau cov neeg mob uas muaj mob tsis txaus estrogen - 3-theem OK (Diane-35, Tri-Mercy);
- nyob rau hauv lub xub ntiag ntawm pob txuv, hyperandrogenia monophasic ntsiav tshuaj nrog antiandrogenic kev ua yog qhia (Lindineth, Yarina , Logest);
- nrog dysfunctional uterine los ntshav, dysmenorrhea qhia cov ntsiav tshuaj nrog ib feem ntawm tus mob progestogen (Jeanine, Claira );
- nyob rau hauv muaj qhov kev ntsuas endometriosis qhov kev xaiv zoo tshaj plaws yog monophasic contraceptives nrog dienogest, gestodene (Jeanine, Lindineth);
- rau cov neeg haus luam yeeb ntawm cov poj niam muaj hnub nyoog 35 xyoos muaj kev tiv thaiv, muaj txog li 35 xyoos tau pom cov ncauj lus tsis haum xeeb nrog cov ntsiab lus ntawm ethinyl estradiol ( Jess , Lindineth).
Qhov zoo tshaj plaws hormonal contraceptives
Cov tshuaj hormons muaj ib qho kev mob, muaj ntau yam ntawm lub cev, uas tsis tuaj yeem ua tus xeeb ceem nyob hauv ib lo lus. OK ua haujlwm tsis yog los tiv thaiv kev xeeb tub xwb, tab sis kuj yog rau cov hom phiaj kho mob. Tib cov ntsiav tshuaj yuav ua rau muaj teeb meem loj hauv qee tus poj niam, lwm tus tsis ua rau muaj kev tsis zoo. Lub hormonal contraceptive yuav tsum tau xaiv ib tus zuj zus, siv los saib tus ginecological thiab somatic xwm txheej, tsev neeg thiab keeb kwm ntawm cov keeb kwm. Kev xaiv cov tshuaj tiv thaiv hormonal yog ib qho kev tiv thaiv txhim khu kev tiv thaiv tsis tau xav txog kev xeeb tub thiab txoj hauv kev zoo los tswj cov poj niam txoj kev noj qab haus huv.