Izindlela Zokulawula Inzalo Ezisekelwe Ekuvuthweni Kwamaqanda: Ukwandisa Ukusebenza Kahle

Ubuchwepheshe bokulawulwa kokuzalwa sebuthuthukile, buhlinzeka ngezindlela eziningi zokuvimbela ukukhulelwa okungahlosiwe. Ukuqonda ukuthi izidambisi-zokuzala zibhekisa kanjani ekukhishweni kweqanda elivuthiwe kusiza ekuthatheni izinqumo ezinolwazi. Nakuba kukhona imikhiqizo, iningi lazo lihlose ukuphazamisa ukuvuthwa kweqanda noma ukuchanyuselwa, kuhlanganise nalezo ezigxile ekulawuleni inzalo ngokuvimba ukuvuthwa kweqanda (ovulation). Lo mbono jikelele uchaza umjikelezo wokuzala kowesifazane, izindlela ezitholakalayo, ucwaningo oluqhubekayo, nezinto ezibalulekile okufanele zicatshangelwe.

Indawo Eguqukayo

Ubuchwepheshe sebuthuthuke kakhulu, buhlinzeka ngezindlela eziningi zokuvimbela ukukhulelwa okungahlosiwe. Ukuqonda ukuthi izidambisi-zokuzala zibhekisa kanjani ekukhishweni kweqanda elivuthiwe kusiza ekuthatheni izinqumo ezinolwazi. Nakuba kukhona imikhiqizo, iningi lazo lihlose ukuphazamisa ukuvuthwa kweqanda noma ukuchanyuselwa. Lo mbono jikelele uchaza umjikelezo wokuzala kowesifazane, izindlela ezitholakalayo, ucwaningo oluqhubekayo, nezinto ezibalulekile okufanele zicatshangelwe [1].

Umjikelezo wokuzala uvamise ukuba yizinsuku ezingu-28, nakuba umehluko ungavela ngenxa yezakhi zofuzo, ingcindezi, nempilo. Amahomoni afana ne-follicle-stimulating hormone kanye ne-luteinizing hormone ahlela ukuthuthuka kweqanda. Ngokucindezela le miyalezo, izidambisi-zokuzala zingamisa ukuvuthwa kweqanda. Lezi zindlela seziba ngokwengeziwe zisebenza kahle, njengoba imithi yesimanje ilungisa kokubili izixube zamahomoni namadivayisi.

Izidambisi-zokuzala ezinamahomoni zisebenzisa amahomoni ngamaphilisi, ama-patch, noma imijovo. Zisebenza ngokuguqula imiyalezo phakathi kwe-pituitary gland nama-ovary, okuvimbela ukuvuthwa kweqanda. Izifundo zikhombisa ukuthi zisebenza kahle uma zisetshenziswa ngendlela efanele. Kodwa-ke, abanye abasebenzisi babhekana nobuhlungu bekhanda, isicanucanu, noma ukopha okuncane.

Izindlela Ezinamahomoni

Izixazululo ezingekho namahomoni zisebenza ngezinqubo zomzimba. Izindlela ze-barrier, njengamakhondomu, zivimba isidoda, kanti amadivayisi e-copper intrauterine aphazamisa ukuchanyuselwa ngokukhipha ama-ion athinta ikhono lesidoda lokusinda. Yize zingagxili kakhulu ekuvimbeni ukukhishwa kweqanda, lezi zinketho zilungele labo abafuna umthelela omncane wamahomoni. Ukusetshenziswa ngendlela efanele kubalulekile, ngoba ukungazisebenzisi ngendlela engaguquguquki kunganciphisa ukusebenza kahle.

Enye inketho enezinga lamahomoni yindandatho yesitho sangasese sowesifazane (vaginal ring), abayifaka ngokuvamile amasonto amathathu ngesikhathi ngaphambi kokuthatha ikhefu. Ikhipha amazinga aphansi e-estrogen ne-progestin, afana nalawo amaphilisi okubelethisa axubile, ngaleyo ndlela ivimbele ukuvuthwa kweqanda. Ngokuthi indandatho ihlale endaweni amasonto ambalwa, ingaba lula kakhulu kunamaphilisi okufanele athathwe nsuku zonke. Kodwa-ke, abantu kufanele baqaphele imiphumela engemihle engase yenzeke, njengokucasuka esithweni sangasese sowesifazane noma ukwanda kokukhipha uketshezi [2].

Ezinye Izinketho

Umjovo wokubelethisa ungomunye umqondo osetshenziswa kabanzi. Ufakwa njalo emva kwezinyanga ezintathu, uqukethe ihomoni ye-progestin ecindezela ukuvuthwa kweqanda futhi inganciphisa ukopha ngokuhamba kwesikhathi. Ngenkathi abaningi bewuthokozela umqondo wokuthola umjovo njalo ngekota yonyaka, le ndlela ingabambezela ukubuyela emandleni okukhulelwa izinyanga ezimbalwa ngemuva kokuwuyeka. Lokhu kubonisa ukubaluleka kokubheka izinhlelo zomndeni wesikhathi esizayo nezinhlelo zomuntu siqu ngaphambi kokukhetha umjovo wokuvimbela inzalo. Kokubili indandatho nomjovo sekuhlolwe kabanzi ezivivinyweni zezokwelapha, okugqamisa ukusebenza kwazo uma zisetshenziswa njalo ngokulandela imihlahlandlela.

Enye indlela ifaka i-implant encane ngaphansi kwesikhumba sengalo engenhla. Lona ukhupha kancane amahomoni enziwe esikhungweni (synthetic) ukuvimba ukuthuthuka kweqanda. Labo abazibuza ukuthi bangayimisa kanjani i-ovulation ngaphandle kwamaphilisi ansuku zonke bangathola le ndlela ithokozisa. Abasebenzisi kufanele baqaphele izinguquko esimweni sengqondo noma ukuguquka kwemijikelezo yokopha. Idatha yezokwelapha iphakamisa ukuthi ama-implant anciphisa amaphutha omsebenzisi uma kuqhathaniswa nezindlela ezidinga ukunamathela nsuku zonke [3].

Ososayensi bahlola imolekyuli ezintsha ukunciphisa imiphumela emibi, ukwehlisa imithamo, nokwenyusa ubulula bokusebenzisa. Abanye abacwaningi bahlolisise ama-implant aqhunyiswa emzimbeni (biodegradable) akhipha imithi kancane kancane, okwenza kungadingeki ukuwasusa. Lezi zinto ezintsha zibonisa ushintsho olubanzi oluya kwezidambisi-zokuzala ezenzelwe umuntu ngamunye futhi ezisebenza kangcono.

Izinto Zomuntu Siqu

Ukwakhetha isidambisi-zokuzala kubandakanya ukukala umlando wezempilo, indlela yokuphila, nezici zobungozi. Ezinye izimo zezempilo zingavimbela ukusetshenziswa kwezinye izindlela. Abantu abanezinkinga zokugqama kwegazi, umfutho wegazi ophakeme, noma izinhlobo ezithile zemigraine kufanele baxhumane nochwepheshe bezempilo. Izinto ezifana ne-body mass index zingathinta ukusebenza kahle, okuveza ukubaluleka kokuholwa uchwepheshe.

Izindleko nendlela yokufinyelela zidlala indima enkulu ekukhetheni izidambisi-zokuzala. Nakuba umshuwalense wezempilo uvame ukumboza izindlela eziningi, ezinye izifunda zinomkhawulo ngezinketho ezikhona. Ama-implant noma amadivayisi e-intrauterine angadinga izikhathi eziningi zokuvakashela odokotela, okwenza kube nzima kulabo abanezinsiza zempilo ezilinganiselwe. Ukusesha online noma ukuvakashela izikhungo zezempilo zomphakathi kungaveza izinhlelo ezibiza kancane, okusiza abantu bathole izixazululo ezingabizi kakhulu [4].

Kulabo abafuna ukuqonda izindlela ezingcono kakhulu zokuthi bahlele ukulawulwa kokuzalwa, le ndatshana ichaza amasu aphezulu nezinto okufanele zicatshangelwe lapho kukhethwa uhlobo lokuvimbela inzalo olusebenzayo kakhulu.

Ukuqwashisa Komphakathi

Ukukhula kokuqwashisa ngezinkinga zokuzala kuholele ezingxoxweni ezivulekile kakhulu. Abaningi bamemezela imfundo ephelele ngemikhiqizo ehlukahlukene yokuvimbela inzalo, kuhlanganise nokuqeqeshwa okusebenzayo ngezindlela ze-barrier kanye nolwazi olungenakhethi ngezixazululo ezisebenza isikhathi eside. Lokhu kugxila kuhloswe ngakho ukunciphisa ukukhulelwa okungahlosiwe ngokukhuthaza izinqumo ezinolwazi ezifanele izigaba ezahlukene zempilo.

Izinto zempilo yengqondo sezithole ukunakwa futhi, njengoba abanye abasebenzisi bebona izinguquko esimweni sengqondo ngezindlela ezinamahomoni. Ucwaningo luyaqhubeka ukuhlola ukuthi lezi zinguquko zihlotshaniswa yini nemithi uqobo noma nezinto zangaphandle. Odokotela bempilo bagqugquzela ingxoxo evulekile phakathi kweziguli nabahlinzeki bezempilo ukuze kutholwe indlela efanele kakhulu.

Kubantu abazibuza ngiziphi izimpawu zokuqala zokukhulelwa usebenzisa izidambisi-zokuzala, le ndatshana ingena kabanzi ezimpawini ezivamile futhi iphendule imibuzo ebalulekile ehlobene nokukhulelwa ngesikhathi kusetshenziswa izidambisi-zokuzala.

Okufanele Kukalwe Ekugcineni

Ekugcineni, noma iyiphi inketho ekhethwayo, ukulawulwa kokuzala ngokuvimbela ukuvuthwa kweqanda (ovulation birth control) kubonisa inqubekelaphambili yezempilo yesimanje ekukhuthazeni inkululeko yokuzala nasekuthathelweni izifiso ezihlukahlukene zabantu.

Ekuphetheni, ukuqonda kahle ukukhishwa kweqanda nezingozi ezingaba khona kungahola abantu ekukhetheni indlela efanele kakhulu izidingo zabo. Izinketho ziyahlukahluka ezinzuzweni nasezingxenyeni ezimbi, kanti nezimo zomuntu zingashintsha ngokuhamba kwesikhathi.

Izinkomba

1. Petitti DB, Sidney S. Four decades of research on hormonal contraception. Perm J. 2005 Winter;9(1):29-34. doi: 10.7812/TPP/04-129. PMID: 21687478; PMCID: PMC3108408.
2. Feldblum PJ, Morrison CS, Roddy RE, Cates W Jr. The effectiveness of barrier methods of contraception in preventing the spread of HIV. AIDS. 1995;9 Suppl A:S85-93. PMID: 8819574.
3. National Research Council (US) Committee on Population. Contraception and Reproduction: Health Consequences for Women and Children in the Developing World. Washington (DC): National Academies Press (US); 1989. 4, Contraceptive Benefits and Risks. Kutholakala ku- https://www.ncbi.nlm.nih.gov/books/NBK235069/
4. Mercuri ND, Cox BJ. The need for more research into reproductive health and disease. Elife. 2022 Dec 13;11:e75061. doi: 10.7554/eLife.75061. PMID: 36511240; PMCID: PMC9771341.