Izincomo Ezintsha Zithi *Konke* Ukulawulwa Kokuzalwa Kwe-Hormonal Kufanele Kutholakale Ngaphandle Kwekhawunta

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Impi yokwenza ukulawulwa kokuzalwa kwamahomoni kufinyeleleke kabanzi iyaqhubeka.

Ohlelweni luka-Okthoba lwe I-Obstetrics & Gynecology, I-American College of Obstetricians and Gynecologists (ACOG) isikisela lokho konke izinhlobo zokuvimbela inzalo kwamahomoni—okuhlanganisa iphilisi, iringi yesitho sangasese sowesifazane, isivikelo sokuvimbela inzalo, nemijovo yedepho ye-medroxyprogesterone acetate (DMPA)—ziphephe ngokwanele ukufinyelela ekhawuntareni ngaphandle kwemingcele yobudala, ngokombiko wabezindaba okhishwe yikomiti. (Ama-IUDs kusafanele enziwe ehhovisi lakho le-ob-gyn; ngaphezulu kulokho okungezansi.) Lesi yisimo esibuyekeziwe, esinamandla kunezincomo zangaphambilini zango-2012, eziphakamise ukuthi kuphela izindlela zokuvimbela inzalo ezitholakalayo ngaphandle kwe-counter. Okubalulekile, nokho, i-ACOG iphinde ithi ekukhululweni kwayo kwabezindaba ukuthi ukuhlolwa kwaminyaka yonke kwe-ob-gyn kusatuswa, kungakhathaliseki ukuthi ukufinyelela ekulawuleni ukuzalwa.

"Isidingo sokuthola njalo incwadi kadokotela, ukuthola imvume yokugcwalisa kabusha, noma ukuhlela i-aphoyintimenti kungaholela ekusetshenzisweni okungaguquki kwendlela yokulawula inzalo ethandwayo," kusho uMichelle Isley, MD, MPH, owabhala ngokuhlanganyela umbono we-ACOG, esitatimendeni. khulula. Ngokwenza zonke izinhlobo zokuvimbela inzalo ngama-hormone zitholakale ezitolo, abesifazane bazokwazi ukufinyelela ezinhlobonhlobo zezinketho ngaphandle kwalezi zingqinamba ezivamile, echaza.

Esimweni lapho zonke izindlela zokulawula ukuzalwa kwamahomoni yenza ukutholakala ngaphezulu kwekhawunta ngesikhathi esithile, akufanele kube ngenxa yokukhokhela ukuthenga, kungeze ilunga lekomidi le-ACOG, uRebecca H. Allen, MD, M.P.H., ekukhulumeni nabezindaba kwekomidi. Ngamanye amazwi, intengo yale mithi akufanele ikhuphuke ngoba izotholakala kalula. “Ukusatshalaliswa komshwalense nokunye ukwesekwa kwezezimali kokuvikela ukukhulelwa kusamele kusasebenza,” kusho uDkt Allen. (Okuhlobene: Izinganekwane Ezi-7 Zokulawulwa Kokuzalwa Okuvamile, Busted Isazi)

Eqinisweni, kubalulekile ukuthi izindleko zokulawula inzalo zisingathwe uma kucutshungulwa lezi zincomo, uLuu Ireland, M.D., M.P.H., FACOG, umsizi kaprofesa wezokubelethisa kanye nezifo zabesifazane kanye nomgcinimafa we-ACOG's Massachusetts Section, uyatshela. Umumo. “Okwamanje, ukuvimbela inzalo ngama-hormone kuyakhokhelwa mahhala esigulini ngaphansi kwe-Affordable Care Act,” kuchaza uDkt. Ireland. "Lezi zindlela zokuvikela izindleko kufanele zihlale zikhona. Asikwazi ukuhwebelana ngesithiyo esisodwa (isidingo sencwadi kadokotela) sithole esinye (izindleko eziphuma ephaketheni)."

Pho, kungani kuphushwa ukuvimbela inzalo ngaphandle kwe-counter? Ngokwezibalo nangokwesayensi, kumane kunengqondo, kusho uDkt Ireland.

“Cishe ingxenye yabo bonke ukukhulelwa e-United States ayihlelwanga, futhi abesifazane bafanelwe ukuthola kalula izindlela eziphumelelayo zokuvimbela ukukhulelwa,” uyachaza. Ithemba ukuthi izinketho zokulawula ukubeletha ezifinyeleleka kalula zizosho ukukhulelwa okungafuneki okumbalwa, usho kanje. (Futhi, masingakhohlwa ukuthi ukulawulwa kokuzalwa kuvame ukusetshenziselwa ukwelapha izimo zezempilo zabesifazane njenge-polycystic ovary syndrome.)

Vele, isimo sezepolitiki sakamuva esizungeze ukutholakala kokulawulwa kokuzalwa bekushubile — ukusibeka kalula. UMongameli uTrump phambilini ubeke umbono wakhe ekubuyiseni imali iPlanned Parenthood, umhlinzeki omkhulu wezempilo yabesifazane nezinsizakalo zokuzala e-US. Futhi, amaRephabliki eSenate aphokophele ephindelela umthetho ozonciphisa ikhono lePlanned Parenthood lokuhlinzeka ngezinsizakalo ezifana nokuhlolwa komzimba, ukuhlolwa komdlavuza nokunakekelwa kokuvimbela inzalo. Konke lokhu kwenza ukufinyelela kokulawula inzalo kubaluleke nakakhulu.

Akunasayensi futhi ephakamisa ukuthi kufanele wenze ukuvakashelwa kwe-ob-gyn ukuthola ukulawulwa kokuzalwa, kungeza uDkt Ireland. Esikhundleni salokho, ukuvakashelwa ngudokotela kanye nesidingo sencwadi kadokotela kuvame "ukuletha izithiyo zangempela kwabesifazane ekufinyeleleni inzalo abayifunayo," uyachaza. Lezi zithiyo zifaka phakathi odokotela abangaqondi ukuthi ezinye izindlela zokuvimbela inzalo zisebenza kanjani, imibono engeyona mayelana nemithi, nokukhathazeka okweqile ngokuphepha, ngokusho kombono wango-2015 oshicilelwe yi-ACOG.

Kodwa ngenxa yokuthi akufanele unayo ukuya ku-ob-gyn ukuze uthole ukulawulwa kokuzalwa kwama-hormone, akusho ukuthi akufanele uwabone nhlobo. Ukuvakasha kwaminyaka yonke nokuhlolwa kusadingeka ekunakekelweni kwezempilo okuvimbelayo (cabanga: ama-pap smear, ukuhlolelwa izifo ezithathelwana ngocansi nezifo, ukugonywa, ukuhlolwa kwebele, ne-pelvic, njll.), kusho uDkt. Ireland. Ukuvakasha kodokotela nakho kukunikeza ithuba lokuxoxa nganoma yikuphi ukukhathazeka ongase ube nakho mayelana nomjikelezo wakho wokuya esikhathini, ukusebenza kocansi, noma impilo yesitho sangasese sowesifazane ngokuvamile, uyanezela. Qaphela: Labo abakhetha ukufakelwa i-IUD noma izinto zokuvimbela inzalo nabo kusazodingeka benze i-aphoyintimenti nodokotela wabo ukuze ifakwe okokuqala le divayisi, kuchaza uDkt Ireland. (Kuhlobene: I-Op-Ed kaLena Dunham Iyisikhumbuzo Sokuthi Ukulawula Ukuzalwa Kungaphezulu Kakhulu Kunokuvimbela Ukukhulelwa)

Ngokuqondene nalabo okungenzeka ukuthi bafuna ukuzama ukuvimbela inzalo okokuqala ngqa, i-ob-gyn isazohlala iyinsiza ebalulekile ekusizeni wena ukuthi ukhethe ukuthi iyiphi indlela elungele umzimba wakho, kusho uDkt Ireland. Kepha i-FWIW, "izifundo zocwaningo ezisezingeni eliphakeme" eziningi zikhombisile ukuthi abesifazane bayakwazi ukuzihlola ngokuphepha futhi banqume ukuthi bangabaqokelwa ukulawulwa kokuzalwa kwamahomoni noma cha, uyanezela. Futhi, uma ukulawula inzalo zazikhona ukuze itholakale esitolo, ukulebula komuthi kuzosebenza njengomhlahlandlela owengeziwe wokuthi usetshenziswa kanjani, futhi unikeze noma yiziphi izexwayiso/ukukhathazeka abasebenzisi okufanele bakuqaphele, uyachaza.

Uma umbono wokulawulwa kokuzalwa kuka-the-counter uzwakala umuhle kakhulu ukuthi ungaba yiqiniso, kungenxa yokuthi, njengamanje, kunjalo. (Bheka: Lokho Ukukhethwa KukaDonald Trump Kungasho Ukuthi Ikusasa Lezempilo Yabesifazane)

Okubalulekile: Ungakhanseli i-aphoyintimenti yakho ye-ob-gyn okwamanje. Lezi zitatimende ezivela ku-ACOG, njengamanje, izincomo ezijwayelekile. Izinqubomgomo azikashintshi, futhi ukulawulwa kokuzalwa kwamahomoni kusatholakala kuphela ngomuthi waseMelika.

“Lezi zinguquko ngeke zenzeke ngokushesha,” kusho uDkt. "Kunenqubo okumele yenzeke nge-US Food and Drug Administration (FDA) [ngaphambi kokuba] kutholakale isimo sokutholakala ekhawuntaleni."

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