Inenge hafu yezviviri zvose zvisingatarisirwi zvinoitika kuvakadzi vanorondedzera kushandiswa kwekudzivirira pamuviri mukati memwedzi wavanotora pamuviri. Kutsvakurudza kwakaratidza ukama pakati pemishonga yekuberekwa kwepiritsi uye uremu - kuti uremu hwomukadzi hunoita kuti kuve nekuperekerwa kwepabonde kunononoka. Kuberekwa kusina kurongeka uye kuneta kunomiririra zvirwere zvinoputika muUnited States. Vakadzi vanofanira kunzwisisa kuti kuneta uye kurema kunogona kuderedza kuberekwa kwepiritsi nekubudirira.
Kunyange zvazvo mapiritsi ekuberekwa ane hutano anowanzova imwe yenzira dzakakurumbira dzekudzivirira kubata pamuviri, kubudirira kwavo kunogona kukanganiswa mumadzimai ane nzara.
Current Status
Kuwedzera kwehuwandu hwekuwedzera kunowedzera pamusoro pemakore 25 apfuura. Ichokwadi, maererano neNational Center for Health Statistics, kuneta kunoramba kuchiva hutano hwehutano hwevanhu muUnited States uye pasi rose. Muna 2005 kusvika muna 2006, vanodarika chikamu chimwe muzvitatu zvevanhu vakuru vekuAmerica (vanopfuura mamiriyoni 72) vakarondedzerwa sevari kuoma. Ichi chidzidzo chakajekesawo kuti 35.3% yevakadzi vanotambura nekuwedzerwa. Pakati pemafungiro akafanana, anenge 34% evanhu vakawanda veUnited States (27.4% yevakadzi) vaizoonekwa sehuwandu. Kuwedzera muviri kunorondedzerwa semutumbi wehuwandu hukuru (BMI) we30 kana mukuru apo munhu ane uremu hwepamusoro ane BMI ye 25 kusvika 29.9. BMI inotarwa kubva paurefu hwemunhu nekukwirira uye inopa chiratidzo chinonzwisisika chemuviri wemafuta uye uremu hutsika hunogona kutungamirira kune zvinetso zveutano.
Background
Pamberi paHolt et al. kudzidza, kwakatendwa kuti uremu hwemuviri hwakanga husina maturo pahutano hwekuberekwa kwepiritsi inobudirira. Iyi mhedziso yainyanya kuvakirwa kubva kuOxford Family Planning Association yekudzidza yakabudiswa muna 2001. Ava vatsvakurudzi vakawana kusawirirana pakati pehutano hwemuviri uye kutapura kwekunamatira kwekudzivirira kubata pamuviri (mushure mekugadzirisa kwezera uye hukama).
Zvisinei, 75 muzana yevakadzi vari muchidzidzo ichi vakanga vachishandisa mapiritsi ekudzivirira kuberekwa aiva nehukuru kupfuura kana akaenzana ne 50 mcg ye estrogen. Migumisiro inobva padzidzo iyi inogona kunge isingashandisi kuzuva ranhasi remuromo wekudzivirira kubvisa pamuviri nekuti (kunze kwemashoma mapiritsi emapiritsi), ruzhinji rwemishonga yekuberekwa kwepiritsi inobata 30 kusvika 35 mcg yeestrogen, uye yakawanda-esterogen (20 mcg) marudzi anowanikwawo.
Ongororo Ichangopfuura
Holt et al. yakanyora hurukuro yakawanda-kudzidzira kudzidza kusvika ikozvino, kuongorora kubatana pakati pehutano uye kukanganisa kwepabonde kwekudzivirira kubata pamuviri . Vakagumisa kuti kune vakadzi vanoshandisa mapiritsi ekuberekwa (sekuenzanisa nevakadzi vane uremu hwakadzika), avo vanowedzera kuwandisa vane 60% inowanzova nepamuviri apo avo vanorema ndevamwe makumi manomwe kubva muzana vanogona kubatwa nekushaya pamuviri. Kunyanya, kubatana pakati pepaundi mapaundi nemapirisi kukundikana kwakatanga kuve pakati pevakadzi vane uwandu hwehuwandu hwevanhu vane BMI vaiva 27.3 kana kupfuura (izvi zvingave zvakaenzana nemukadzi 5-foot, 4-inch woman anorema 160 pounds kana kupfuura). Nokudaro, vakadzi vanogara vachishandisa zvirongwa zvekudzivirira pamuviri uye uyo BMI aive mukuru kune 27.3 aiva nezviitiko zvinokwana 1.58 mukana wekutora pamuviri kana achienzaniswa nevashandisi vasingashandisi vane BMI vakanga vasingapfuuri 27.3.
Uyezve, mukadzi anonyanya kuwandisa anowanzova nekutapukira kwepabonde kana akanganwa mapiritsi ake ezuva nezuva. Zvakakosha kuziva, zvisinei, zviitiko zvinosanganisira kureba, kuyerwa, kutevedza purogiramu yekudzivirira kuberekwa, uye kukanganisa kwepabonde kwaive kuzvitaurira munyaya ino. Izvi zvinoreva kuti mhedzisiro inaccuracies inogona kuitika nekuda kwekunyora kwekutaura.
Mutsvakurudzo wekutsvakurudza kwakaitwa muna 2007 naBrunner, Huber, uye Toth inoratidzira utera husina simba, kunyange husingarevi, hukama pakati pekuneta nekuzvarwa kwepiritsi kusakundikana. Migumisiro yakaratidza kuti vakadzi vakawandisa (BMI ≥ 30) vaiva nehuwandu hwekuita pamuviri.
Asi, mushure mokunge vatsvakurudzi vakashandura kune zera, dzinza / dzinza, uye hukama hwevakadzi, vakagumisa kuti kwakanga kusina kuwirirana pakati pekuremera uye kukanganiswa kwepabonde kwekudzivirira kubata pamuviri. Vatsvakurudzi vakarayira kuti kudzidza kwavo kunogona kunge kwakaguma nemigumisiro yakaipa nokuti panzvimbo yekuyera uye kuenzanisa kutsvakurudza kunobatanidzwa, zvigumisiro zvaive zvakavakirwa pamadzimai ekuzvitsanangurira kwehurefu hwavo uye uremu. Zvichipa kuti vakadzi vanowanzova-vanodzokorora hurefu hwavo uye vari pasi-vanodzokorora uremu hwavo nemaundi mashoma, BMI inogona kunge isina kururama. Pakupedzisira, vatsvakurudzi vakanga vasina ruzivo pamusoro pehuwandu hwepabonde kana kuti kwete vakadzi vacho vaigara vachitora mapiritsi avo; kushayikwa kwekubatanidzwa kwezviitiko izvi kunogona kuve nehanya nemigumisiro yekudzidza uku, uye vatsvakurudzi vakagumisa kuti zvikuru, zvakanyatsodzidza zvidzidzo zvinodiwa kuti ave nemhinduro yakajeka yekuti kana kuora mwoyo kunobatsira here pakunamatira kunobatsira kunobata pamuviri.
Chikonzero Nei Piritsi Isinganyanyi Kubudirira
Zvinosuruvarisa, chikonzero chaiicho chekuti sei kuwandisa kwepamusoro uye / kana kupfurikidza vakadzi vari pangozi yakawanda yekushayikwa kwepabonde kunenge kusati yazivikanwa zvachose. Zvisinei, zvinyorwa zvakawanda zvinongororwa zvinyorwa zvinongotaura nezvezvinhu zvipenyu izvo zvingaverengera njodzi yakawanda:
- Hormone Levels: Mazuva ano mapiritsi ekuberekwa ane zvirwere zvakanyanya pasi (zvichifananidzwa neavo vatangotanga makumi emakore apfuura). Zvirongwa zvekuvhara mishonga dzemumuromo zvakagadzirisa maitiro ehomoni mukutedza kuderedza migwagwa isina kudiwa, yakadai sedambudziko rekuvhara ropa, kuwedzera kwemahombe, uye musoro. Kuti zvive zvinobudirira, mahomoni ari piritsi inoda kupararira kuburikidza neropa remukadzi. Kana mukadzi ane hukuru hukuru hwemutumbi, zvinogona kuva zvakaoma kuti kuparadzirwa kwakakwana kuitike, kunyanya kupa hutachiona hwemahomoni anowanikwa mune dzakawanda dzemapiritsi emazuva ano.
- Metabolism: Kazhinji, vakadzi vane nzara vane yepamusoro yemetabolism, saka mapirmoni emupiritsi angangodhindiswa zvakanyanya. Saka, kunyanya mukadzi ari kuyera, yakasimudza nheyo yaro yemagetsi; izvi zvinogona kupfupisa nguva yehupiritsi inoshanda.
- Liver Enzymes: Vakadzi vanoremekedzwa vanogona kuve ne-up-mutemo wehuputi hwemagetsi; idzi dzakakwirira masero enzymes dzinogona kubatsira kuputsa mahomoni mumuromo wekudzivirira pamuviri. Vakadzi vane nzara vanowanzova nekupararira kwehuwandu hwemuviri uye muviri. Zvichipa kuti pane mamwe mavara ayo ropa rinofanira kupararira uye mukana wekuti ma enzymes achaputsa mahomoni nokukurumidza, mazinga ekupararira mahomoni angaderedzwa.
- Hormone Storage: Mahomoni, estrogen uye progestin , inowanikwa mumapiritsi ekuberekwa anochengetwa inochengetwa mumuviri wemuviri. Nokudaro, mamwe masero akawanda ane mukadzi, iyo inowedzera mikana yemapirmoni yemapiritsi ichibatanidzwa mumafuta panzvimbo yekuyerera kuburikidza neropa rake.
Izvi Zvose Zvinorevei?
Tinofanira kududzira kutsvakurudza kunoreva here kuti vakadzi vanoremekedzwa havafaniri kushandisa kushandiswa kwemishonga yekuberekwa? Izvi hazvirevi kuti ndiyo mhinduro. Kutaura zvazviri, kubudirira kwemashandisirwo emishonga kana kubvisa pamuviri (kunyangwe mumadzimai ane simba zvakanyanya) ingadai ichiri kuramba yakakwirira. Pakati pevakadzikadzi vanotora mishonga yokudzivirira vana mumuromo gore rimwe chete, Holt et al.'s (2005) chidzidzo chinoratidza kuti vamwe vakadzi vaviri kana mana vachabatwa pamuviri nekuda kwekuwedzererwa kana kuwandisa. Zvisinei, izvi zvinowedzera mungozi yekuzvitora zvinogonawo kuenzanisa nehuwandu hwakawanda hwehutano hwehutano hwehutano, hunogona kusanganisira gestational chirwere cheshuga, huwandu hwehutano hwepamusoro , uye kutengeswa kweCesarea.
Kwainoenda
Vakawanda vanopa utano hwehutano vari kusarudza kurwisa kuderera kwehupiritsi kubudirira kuburikidza nekuisa vakadzi vane uremu hwepamusoro uye vanorema pamapiritsi ekudzivirira kuberekwa kwepamusoro-soro pane kunyorera mazai emudzimai kuti vabatsire kuti pane mahomoni akakwana okudzivirira kuvhara.
Kana iwe ukazviwana uri mumamiriro ezvinhu aya, zvakakosha kuti ukurukure zvose zvaunogona kuita uye zvipingamupinyi zvinhu nechiremba wako. Sezvo vakadzi vane uremu hwepamusoro vangave vane hutano hwehutano hwehutano hunokonzerwa nehutachiona hunorema-vakadzi, huwandu hwepamusoro hwekudzivirira pamuviri hungawedzera huwandu hwehutano hwemwoyo zvakanyanya. Semuenzaniso, kutsvakurudza kwakaratidza ikoko kuti kune ngozi yakawanda yehutano thromboembolism (blood clots) pakati pevakadzi vanopfurikidza vanoshandisa mapiritsi ekuberekwa. Nokudaro, chiremba angada kufarira mukadzi ane uwandu hwepamusoro pane imwe nguva-mazai ekuberekwa kwepiritsi nemirayiridzo yekushandisa nzira yekuchengetedza kuberekwa kwekuberekwa kubatsira kubatsira kukudzivirira kubata pamuviri. Muchiitiko ichi, nzira dzokudzivirira dzakadai semakondomu evanhu kana vakadzi , chipanje , kana spermicide inogona kushandiswa pamwe chete nemapiritsi. Pakupedzisira, kana mukadzi ane uremu hwepamusoro akasarudza kuti haachadi kuva nevana zvakare, chimiro chekusingaperi chekudzivirira pamuviri chakadai se tubal ligation kana hysteroscopic (pasina-chirurgic), iyo inonzi Essure .
The Bottom Line
Tichifunga kuti kune ukama huri pakati pehupamhi hwepamusoro uye hutano hwekuberekwa hunobudirira , zvinokosha kuti ukurukure izvi pamwe nemupi wako wehutano. Uyewo, kubva pakutanga pawakanyorerwa mapiritsi, kana ukacherechedza kuti uremu hwako hwave hwakasimuka (zvichida, zvichida masimiro maviri emapfekete), iva nechokwadi chekuudza mutapi wako wehutano kuti ave nechokwadi chokuti nzira iyi ichiri yakanyanya uye yakachengeteka chirongwa chekudzivirira pamuviri iwe.
> Sources:
> Brunner Huber, LR & Toth, JL (2007). Kuwedzera kwehupombwe uye kukanganiswa kwemuviri kwepabonde Kunowanikwa: Zvakawanikwa Kubva ku2009 National Survey of Growing Family. American Journal of Epidemiology, 166 (11), 1306-1311.
> Holt et al. (2005). Mutumbi Misa Index, Weight, uye Kusakanganiswa Kwemuromo Kunopera Njodzi. Zvipfeko uye Gynecology, 105 (1), 46-52.
> Ogden, CL, Carroll, MD, McDowell, MA, & Flegal, KM (2007). Kuwedzerwa kwehupakati pakati pevakuru muUnited States - Hapana kuchinja kwechiitiko kunokosha kubva muna 2003-2004 .
> Vessey, M (2001). Kukanganiswa kwemuviri kunobata uye Muviri Weight: Zviwanikwa muChidzidzo cheGuru reKohort. Nyaya Yekugadzirisa Mhuri uye Utano Hwekuberekwa, 27 (2), 90-91.