ZGT ndi kusamba kwa thupi - kukonzekera mbadwo watsopano: ndemanga, mndandanda

Ndi msinkhu, mlingo wa estrogen mu thupi la mkazi umayamba kuchepa. Zimenezi zimabweretsa zizindikiro zingapo zomwe zimabweretsa mavuto. Uwu ndikutumphuka usiku, kuwonjezeka kwa mafuta ochepa kwambiri, kuthamanga kwa magazi, chiwalo chowopsa cha ziwalo zoberekera, kusamba kwa ubweya. Kupewa chikhalidwe chosasangalatsa choterechi chingathandize m'malo opangira mahomoni (HRT). Mankhwala amatha kuchotsa zizindikiro za kusamba kwa thupi ndikuchepetsa chiopsezo chokhudzana ndi nthawi ya kusamba. Mankhwalawa akuphatikizapo Climonorm, Climadinone, Femoston, Angelique. Modzichepetsa kwambiri, HRT iyenera kuchitidwa panthawi yopuma. Mankhwala a mbadwo watsopano akhoza kuuzidwa kokha ndi gynecologist woyenera.

Fomu ya kumasulidwa kwa mankhwala "Klimonorm"

Mankhwalawa amatanthauza mankhwala oletsa anti-menopausal. Zimapangidwa mwa mawonekedwe a mitundu iwiri. Mtundu woyamba wa dragee ndi wachikasu. Chinthu chachikulu chomwe chimapangidwa ndi isradiol valerate 2 mg. Mtundu wachiwiri wa dragee ndi bulauni. Chigawo chachikulu ndi validate ya estradiol 2 mg ndi levonorgestrel 150 μg. Amathira mankhwala m'mabelters kwa zidutswa 9 kapena 12 payekha.

Pogwiritsa ntchito mankhwalawa, HRT kawirikawiri imachitidwa posakhalitsa. Kukonzekera kwa mbadwo watsopano wa ndemanga nthawi zambiri ndi zabwino. Zotsatirapo sizikula ngati mutatsatira malangizo a dokotala.

Zotsatira za mankhwala "Klimonorm"

"Klimonorm" - mankhwala osankhidwa omwe amaikidwa kuti athetse zizindikiro za kusamba kwa thupi ndipo ali ndi estrogen ndi progestogen. Kulowa m'thupi, chinthu cha validate cha estradiol chimasandulika kukhala estradiol wa chilengedwe. Thupi la levonorgestrel limaphatikizapo mankhwala aakulu ndi kupewa khansa ya endometrial ndi hyperplasia. Chifukwa cha mawonekedwe apaderadera ndi apadera a phwando, ndizotheka pambuyo pa chithandizo chobwezeretsa kusamba kwa amayi omwe ali ndi chiberekero chosadziwika.

Estradiol amapindula kwathunthu estrogen ya thupi m'thupi panthawi yomwe kusamba kwa thupi kumachitika. Amathandizira kuthana ndi mavuto omwe angayambitse panthawi yopuma. N'zotheka kuthetsa kuchedwa kwa mapangidwe a makwinya komanso kuwonjezera khungu la collageni pakhungu pamene HRT ikuchitika panthawi yopuma. Mankhwala amachepetsa kuchepetsa thupi lonse ndi kuchepetsa chiopsezo cha matenda a m'mimba.

Pharmacokinetics

Pogwiritsidwa ntchito pamlomo, mankhwalawa amatengeka m'mimba m'kanthawi kochepa. Mu thupi, mankhwalawa amadziwika ndi mapangidwe a estradiol ndi esitori. Pasanathe maola awiri, ntchito yaikulu ya wothandizira mu plasma imadziwika. Thupi la levonorgestrel liri pafupifupi 100% loyenera ku magazi albumin. Amatulutsa mkodzo komanso pang'ono ndi bile. Ndikofunika kwambiri kuti musankhe mankhwala opangira HRT ndi kusamba. Kukonzekera pa msinkhu woyamba kumayesedwa kuti ndi kotheka ndipo kumatha kusintha kwambiri chikhalidwe cha kugonana kosangalatsa pambuyo pa zaka 40. Mankhwala ochokera ku gululi amatanthauza "Klimonorm".

Zisonyezo ndi zotsutsana

Mankhwalawa angagwiritsidwe ntchito pazifukwa zotsatirazi:

• Mankhwala othandizira odwala opaleshoni;
• Kusintha kwa kusintha kwa khungu ndi mucosa wa dongosolo la genitourinary;
• Kusakwanira kokwanira kwa estrogens pa nthawi ya kusamba;
• Kupewa kwa matenda a mitsempha;
• Kusintha kwa kayendetsedwe kamodzi pamwezi;
• Kuchiza kwa amenorrhea wa mtundu wapamwamba ndi wachiwiri.

Contraindications:

• Kutaya magazi sikukhudzana ndi kusamba;
• Kuyamwitsa;
• Zodalirika zokhudzana ndi mahomoni zowonongeka ndi khansa;
• Khansara ya m'mimba;
• Matenda a chiwindi;
• Kupweteka kwambiri ndi thrombophlebitis;
• Hypersensitivity kwa zigawo zikuluzikulu;
• Kusokoneza;
• Matenda a chiberekero.

Sikuti nthawi zonse amawonetsedwa HRT ndi kusamba. Kukonzekera kwa mbadwo watsopanowu (mndandanda wafotokozedwa pamwambapa) amangolembedwera kokha ngati climacterium ikuphatikizidwa ndi kuwonongeka kwakukulu mu umoyo wa mkazi.

Mlingo

Ngati mwezi ulipo, ndiye kuti chithandizo chiyenera kuyamba tsiku lachisanu. Ndi mankhwalawa amatha kuyambitsa, njira yothandizira ikhoza kuyamba nthawi iliyonse ya pulogalamuyi, kuphatikizapo kutenga mimba. Phukusi limodzi ndi mankhwala "Klimonorm" lakonzedwa kuti likhale phwando la masiku 21. Wothandizira waledzera pazinthu izi:

• Masiku 9 oyambirira mkazi amatenga chikasu dragee;
• Masiku 12 otsatirawa - mapepala a bulauni;

Pambuyo pa chithandizo, pali mwezi uliwonse, kawirikawiri pa tsiku lachiwiri kapena lachitatu mutatha kutenga mlingo womaliza wa mankhwala. Kwa masiku asanu ndi awiri pali kupumula, ndipo ndi koyenera kumwa phukusi lotsatira. Dragee iyenera kutengedwa popanda kutafuna, ndi kutsuka pansi ndi madzi. Ndikofunika kuthandizira panthawi inayake popanda kuwasowa.

Ndiloyenera kuvomereza ndondomeko ya HRT posakhalitsa. Mankhwala osokoneza bongo atsopano angakhale olakwika. Sizingatheke kukwaniritsa zotsatira zomwe mukuzifuna ngati muiwala kutenga mapiritsi nthawi yake.

Ngati mwadodometsa kwambiri, zinthu zosasangalatsa monga kunyalanyaza, kusanza ndi kutuluka magazi zomwe sizigwirizana ndi msambo zikhoza kuchitika. Palibe mankhwala enieni a mankhwala. Ngati mwadodometsa kwambiri, perekani chithandizo chodabwitsa.

Mankhwala "Femoston"

Mankhwala ndi a gulu la antimycotics. Zapangidwa mwa mawonekedwe a mapiritsi awiri. Mu phukusi mungapeze choyera choyera ndi kujambula filimu. Chinthu chachikulu ndi estradiol mu mlingo wa 2 mg. Komanso mtundu woyamba ndiwo mapiritsi a imvi. Zopangidwazo zili ndi estradiol 1 mg ndi dydrogesterone 10 mg. Zosungidwa mankhwala mu mabelters kwa zidutswa 14 pa aliyense. Mtundu wachiwiri umaphatikizapo mapiritsi a pinki, omwe ali ndi estradiol 2 mg.

Mothandizidwa ndi chida ichi nthawi zambiri amachitidwa mankhwala opatsirana. Amasankhidwa mwachindunji, ngati ndi funso la HRT pakuyamba kusamba, mankhwala osokoneza bongo. Mayankho "Femoston" ali ndi zabwino komanso zoipa. Mawu abwino akupitirizabe. Mankhwala osokoneza bongo amatha kuthetsa mawonetseredwe ambiri.

Ntchito

"Femoston" - mankhwala ophatikizapo mankhwala awiri kuti athe kuchiritsidwa pambuyo pake. Zonsezi zimagwirizanitsa ndi mahomoni achikazi a progesterone ndi estradiol. Nthendayi imabweretsanso malo otchedwa estrogen pa nthawi ya kusamba kwa thupi, imachotsa zizindikiro za chilengedwe komanso zowonongeka, zomwe zimalepheretsa kukula kwa matenda a mitsempha.

Dydrogesterone ndi gestagen yomwe imachepetsa chiopsezo chokhala ndi hyperplasia ndi khansa ya uterine. Zinthu izi zili ndi estrogenic, androgenic, anabolic ndi glucocorticoid ntchito. Ngati atayamwa, imangowonjezereka m'mimba ndipo kenako imachepetsa. Ngati HRT ikuwonetsedwa kuti yayamba kusamba, kukonzekera "Femoston" ndi "Klimonorm" kuyenera kugwiritsidwa ntchito poyamba.

Zisonyezo ndi zotsutsana

Mankhwala amagwiritsidwa ntchito pazochitika zotere:

• HRT pakupita kusamba ndi pambuyo pa opaleshoni;
• Kuteteza matenda odwala matenda a m'mimba, omwe akukhudzana ndi kusamba kwa thupi

Contraindications:

• Mimba;
• Lactation;
• Khansara ya m'mimba;
• Kutupa kwa chikhalidwe choipa chomwe chimadalira mahomoni;
• Porphyria;
• Thrombosis ndi thrombophlebitis;
• Hypersensitivity kwa zigawo zikuluzikulu;
• Matenda a shuga;
• Kuthamanga kwa magazi;
• Endometrial hyperplasia;
• Migraine.

Zidzathandiza kusintha umoyo wa HRT ndi kusamba. Zizindikiro za mankhwala osokoneza bongo zimakhala zabwino. Komabe, simungagwiritse ntchito popanda kufunsa dokotala.

Mlingo

Mapiritsi "Femoston" ndi zomwe zili estradiol pa mlingo wa 1 mg amatengedwa kamodzi pa tsiku panthawi yomweyo. Chithandizo chikuchitika malinga ndi dongosolo lapadera. Masiku 14 oyambirira, muyenera kutenga mapiritsi oyera. Masiku 14 otsala - mankhwala a mthunzi wakuda.

Mapiritsi a pinki okhala ndi 2 mg ya estradiol aledzera masiku 14. Azimayi omwe sanamalize kusamba, mankhwala ayenera kuyamba tsiku loyamba la magazi. Odwala omwe ali ndi mankhwala osokoneza bongo amalembedwa pambuyo pa mankhwala a sabata ziwiri ndi Progestagen. Zina zonse ngati mulibe mankhwala amwezi uliwonse mukhoza kuyamba kumwa tsiku lililonse. Ndikofunika kutsatira ndondomeko ya mankhwala kuti mupeze zotsatira zabwino za HRT pokhala ndi kusamba. Kukonzekera kwa mbadwo watsopanowo kumathandiza kuti mkazi azikhala bwino ndikukhalitsa unyamata wake.

Mankhwalawa "Climadinone"

Mankhwalawa amatanthauza njira zowonjezera ubwino pa nthawi ya kusamba. Ali ndi phytotherapeutic. Zapangidwa mwa mawonekedwe a mapiritsi ndi madontho. Mapiritsi ndi pinki ndi mtundu wofiirira. M'bukuli muli zowonjezera za tsimitsifugi 20 mg. Madonthowa ali ndi tsimitsifugi 12 mg. Madontho ali ndi bulauni chofiirira ndi fungo la nkhuni zatsopano.

Zisonyezo:

• Matenda a zamasamba okhudzana ndi zizindikiro za kusamba kwa mimba.

Contraindications:

• Ziphuphu zodalirika ndi mahomoni;
• Kusakanikirana kwa lactose;
• Kumwa mowa;
• Hypersensitivity kukhala zigawo zikuluzikulu.

Ndikofunika kuti muwerenge mosamala malangizowa musanayambe HRT ndi kusamba. Kukonzekera (pulasitala, madontho, mapiritsi) ziyenera kugwiritsidwa ntchito pokhapokha potsutsidwa ndi azimayi.

Mankhwalawa "Climadinone" amalembedwa piritsi limodzi kapena madontho 30 patsiku. Ndikoyenera kuyambitsa chithandizo pa nthawi yomweyo. Njira yothandizira imadalira umunthu wa thupi.

Kukonzekera "Angelica"

Amagwiritsa ntchito mankhwala omwe amagwiritsidwa ntchito pofuna kuthetsa kusamba. Zapangidwa mwa mawonekedwe a mapiritsi a mtundu wofiira-pinki. Momwe mankhwalawa akuphatikizapo estradiol 1 mg ndi drospirenone 2 mg. Zosungunuka mankhwala mu mabelters, zidutswa 28 pazidutswa. Katswiriyu adzakuuzani momwe mungagwiritsire ntchito HRT ndi kusamba. Kukonzekera kwa m'badwo watsopanowu sikungagwiritsidwe ntchito popanda kuyankhulana. Thanzi la mahomoni likhoza kupindula ndi kuvulaza.

Mankhwala ali ndi zizindikiro zotsatirazi:

• Mankhwala othandizira odwala opaleshoni;
• Kuteteza matenda a mitsempha ndi kusamba.

Contraindications:

• Kutsegula kuchokera kumaliseche ya chidziwitso chosadziwika;
• Khansara ya m'mimba;
• Matenda a shuga;
• Kuthamanga kwa magazi;
• Thrombosis.

Pa nthawi ya kusamba kwa thupi, akatswiri a amai ambiri amavomereza kuti HRT iyenera kuchitidwa panthawi yopuma. Kukonzekera kwa mbadwo watsopanowu ndi njira yabwino kwambiri kwa amai pambuyo pa zaka 45.

Mlingo wa mankhwala "Angelica"

Phukusi limodzi lakonzedwa kuti lilowe masiku 28. Tsiku lililonse, tenga piritsi limodzi. Imwani mankhwala abwino nthawi yomweyo, osasaka ndi kusamba ndi madzi. Ndikofunika kuchita chithandizo chopanda malire. Kunyalanyaza malangizowo sikuti kungabweretse zotsatira zabwino, koma kungachititse kuti magazi azikhala ndi magazi. Kumvera kokha ndondomekoyi kumathandiza kuti nthawi zonse azichita msinkhu kumapeto kwa HRT posachedwa.

Kukonzekera kwa mbadwo watsopanowu ("Angelique", "Klimonorm", "Klimadinon", "Femoston") uli ndi mawonekedwe apaderadera, chifukwa choti n'zotheka kubwezeretsa kusamvana kwa mahomoni azimayi .

Klimara plaster

Mankhwalawa amapezeka ngati mawonekedwe a 3.8 mg a estradiol. Mawonekedwe ofiira amamangiriridwa kumalo a khungu obisika pansi pa zovala. Pogwiritsira ntchito chigambacho, chogwiritsira ntchito chikumasulidwa, kusintha mkhalidwe wa mkaziyo. Pambuyo masiku asanu ndi awiri, mankhwalawa ayenera kuchotsedwa ndikugwiritsidwa ntchito kumalo atsopano.

Zovuta zochitika pogwiritsa ntchito chigamba ndizosawerengeka. Ngakhale izi, mankhwala a mahomoni ayenera kugwiritsidwa ntchito pokhapokha atakambirana ndi dokotala.

Kufufuza za njira za HRT

Mankhwala a chibadwidwe chatsopano omwe amagwiritsidwa ntchito mu mankhwala othandizira ena, akhoza kubwezeretsa thanzi la amayi pa nthawi ya kusamba. Iwo ali ndi ndemanga zabwino kuchokera kwa amayi oposa zaka 45. Mankhwala kwa kanthawi amathandiza odwala kuti asamakhale ndi nkhawa komanso amadzimva bwino, komanso amathanso kudwala matenda odwala matenda a m'mimba. Ndalama zonse zimalekerera ndipo sichimwa.

Akatswiri amanena kuti pambuyo pa chithandizo, kusamba kumakhala kosavuta, khungu limakhala ndi mthunzi wathanzi ndipo imakhala yosalala komanso yosavuta. M'magazi, mlingo wa cholesterol umachepa. Pamaso a makwinya ang'onoang'ono amasungunuka, odwala amakhala ndi maganizo abwino komanso mphamvu. Mapiritsi ndi mapiritsi ndi osavuta kutenga, malinga ndi ndondomekoyi. Zonsezi zimakhala ndi zokutira, zomwe sizimapweteketsa chapamimba mucosa. Chigamba cha mahomoni chimatchuka.