Izimpawu zokuthi i-Plan B ayizange isebenze: Uhlolojikelele olubanzi
Imithi yokuvimbela ukukhulelwa yesimo esiphuthumayo (emergency contraception) ingasiza umuntu agweme ukukhulelwa angahlelanga ngemva kokuphazamiseka ekusetshenzisweni kwemithi yokuvimbela ukukhulelwa noma ucansi olungasebenzisi ikhondomu. I-Plan B iqukethe i-levonorgestrel, ezama ukubambezela ukuvuthwa kweqanda ukuze isidoda singahlangani neqanda. Nakuba ingasebenzi kahle uma ithathwa masinyane, kukhona izinto eziningi ezinganciphisa ukusebenza kwayo. Isikhombi somzimba wesisindo (BMI), ukusebenzisana kwemithi, noma isikhathi sokuyithatha konke kungavusa ukukhathazeka ngokuthi ingabe ukukhulelwa sekwenzekile yini. Ukucindezeleka nakho kwenza izinto zibe nzima, ngoba eminye yemiphumela emijwayelekile yokunakekela leli pilisi ifana nezimpawu zokuqala zokukhulelwa. Ukuqonda lezi zinto, nokwazi izimpawu zokuthi i-Plan B ingase ingasebenzanga, kunganciphisa ukungabaza. Lesi sihloko sichaza izinto eziyisisekelo nezimpawu ezingase zibonise ukwehluleka kwe-Plan B.
Indima Yesikhathi
Isikhathi sibalulekile kakhulu. Ukuze imiphumela ibe mihle, ochwepheshe batusa ukuthatha i-Plan B kungakapheli amahora angama-72 ngemuva kocansi olungavikelekile, okungcono kakhulu kube masinyane. I-Levonorgestrel ikakhulu ivimba ukukhishwa kweqanda kodwa ingase ingavinji ukuxubana kwesidoda neqanda uma ukuvuthwa kweqanda sekwenzekile kakade. Njengoba imijikelezo yokuya esikhathini ihlukene, ukulandelela ukuvuthwa kweqanda kungasiza abantu baqonde kangcono iwindi labo lokuzala, ngoba umuntu osuseduze nokuvuthwa kweqanda angaba newindi elincane lokuvikeleka okusebenzayo. Ukubambezeleka nakho kunika iqanda isikhathi lokuphuma, okwehlisa amandla epilisi. Uma ukuthatha ipilisi kubambezeleka kudlule emkhawulweni onconyiwe, umuntu uba nokungaqiniseki okukhulu. Ukuziphendulela ngokushesha, kanye nokuqaphela umehluko wemijikelezo yomzimba ngamunye, kwenza amandla epilisi okugwema ukukhulelwa abe phezulu [1].
Imiphumela Emingcele Engase Ibonakale
I-Plan B ingadala ukusabela okuncane, okudlula masinyane njengezinkantinini (nausea), isiyezi, noma ukukhathala. Ubuhlungu noma ukuzwela ebeleni, kanye nokubambezeleka nokubaba esiswini kungafana nezimpawu zokukhulelwa, kubangele ukukhathazeka. Ukopha okuncane noma ukuya esikhathini kusenesikhathi noma sekwephuzile kungavela, kubonisa ukushintsha kwamahomoni okungazelelwe. Le miphumela, nakuba ingathandeki, yona uqobo ayiqinisekisi ukuthi ipilisi lehlulekile. Imvamisa iyaphela uma amazinga amahomoni esehla. Ukuqaphela noma yiziphi izinguquko eziqhubekayo noma ezinzima kungaba ukuhlakanipha. Noma kunjalo, abantu abaningi bathola ukuthi ukuguquguquka okuncane ekopheni noma esimweni sengqondo kuphela ngokushesha. Ukulindela le miphumela yesikhashana kusiza ukuhlukanisa impendulo ejwayelekile nezinkinga ezijulile mayelana nokungasebenzi kahle kwepilisi.
Izinto Ezinciphisa Ukusebenza Kahle
Kunezinto eziningana ezinganciphisa ukusebenza kahle. Labo abanesisindo somzimba esiphezulu kwesinye isikhathi bamunca noma bagaye i-levonorgestrel ngendlela ehlukile. Eminye imithi, kuhlanganisa eminye yemithi yesifo sokuwa, ingashesha ukwephula amahomoni emzimbeni. Ukugabha ngokushesha ngemva kokuthatha ipilisi nakho kwandisa ingozi yokulikhuculula ngaphambi kokuthi lingene egazini. Ukunconywa kabusha kwesilinganiso kuvamile uma lokho kwenzeka kungakapheli amahora amabili. Ukudideka ngemiyalelo efanele noma ukuhlukanisa imithamo ngendlela engalungile nakho kunganciphisa amandla epilisi. Lezi zimo ziveza ukubaluleka kokulandela imihlahlandlela nokubonisana nosokhemisi noma udokotela mayelana nokungase kuhlanganyele imithi. Ukunaka ngokucophelela lezi zinto kusiza ukwandisa amathuba okuthi i-Plan B iphumelele [2].
Umthelela Wengqondo
Ukubhekana nombuzo othi “Ingabe i-Plan B ingahluleka?” kungadala ingcindezi enkulu, eqiniswa ukukhathazeka okungenziwa umphakathi noma okwakho siqu. Ukuqapha kakhulu noma yiziphi izinguquko emzimbeni kungakhulisa imizwa emincane kube izixwayiso ezinkulu. Ukukhathazeka kungaphazamisa impilo yansuku zonke, kwenze kube nzima ukwenza izinqumo ezinengqondo mayelana nokuhlolwa nokulandela ngemva kwalokho. Nakuba abaningi bathola ukuphefumula kalula uma imiphumela yokuhlolwa ikhombisa ukungakhulelwa, isikhathi sokulinda singaba nezinga eliphezulu lengcindezi. Ukwabelana ngezinkathazo nomngane omethembayo noma umeluleki kuvame ukusiza. Ukuqaphela ukuthi i-Plan B ivame ukusebenza kahle kunganciphisa ukwesaba imiphumela emibi kakhulu. Noma kunjalo, ukufuna ukuqinisekiswa kodokotela noma osizo lwezempilo yengqondo kungaba yingxenye ebalulekile yokubhekana nalesi simo esisindayo ngokwengqondo.
Izinkomba Zokungasebenzi Kahle Okungenzeka
Nakuba ukopha okubambezelekile noma okusencane kuphela kuvame ukungabi yinkinga, ukuya esikhathini okungafiki kuze kudlule isonto kungase kubonise ukukhulelwa. Ukuzihlola khona-ke kuba kubalulekile. Ubuhlungu obuqhubekayo nobukhulu bungase bubonise izinkinga, njengokukhulelwa kwe-ectopic, okudinga ukuhlolwa ngokushesha. Izimpawu ezithambile ezifana nesicanucanu esingapheli noma ubuhlungu obungapheli emaqandeni okubeletha obuba bukhulu kancane kancane nazo zingafuna ukunakwa. Njengoba imiphumela emibi ye-Plan B ivamise ukuphela ngokushesha, ubuhlungu noma ukungakhululeki okuqhubekayo noma okwandayo kungase kubonise enye imbangela. Uma ukungabaza kuqhubeka, ithesti yokukhulelwa oyithenga ekhemisi (over-the-counter) ihlinzeka ukuhlolwa kwangaphambili. Ukuqinisekisa imiphumela ngokubonisana nodokotela kusiza ukususa ukungaqiniseki futhi kukusize wenze izinyathelo ezifanele ezilandelayo [3].
Ukudideka Nezimpawu Zokukhulelwa
Izinguquko ezidalwa amahomoni zingafana nezimpawu zokuqala zokukhulelwa, kufaka phakathi ukukhathala nokucasuka okuncane kwesisu. Ukucindezeleka kungenza lokhu kube nzima kakhulu, kushiye umuntu engazi ukuthi uyaphendula ku-Plan B noma ugcwala izimpawu zangempela zokukhulelwa. Ukugwema ukuhumusha ngokushesha kunconywa, ngoba i-human chorionic gonadotropin (hCG) ngokuvamile kumele ikhuphuke cishe amasonto amabili ngaphambi kokuba itholwe. Ukuhlola masinyane kakhulu kungaholela emiphumeleni engacacile. Uma ukusola kuqhubeka, ukuphinda ithesti ngemva kwezinsuku ezimbalwa kungasiza ukuveza umphumela ocacile. Ukuthola impumela ecacile kusiza ukugwema ukuhumusha kabi izimpendulo zesikhashana zomzimba. Ulwazi olunzulu ngomjikelezo wakho ojwayelekile lungasiza futhi ukuhlukanisa ukuguquka okuvamile nezimpawu ezingase zisho ukukhulelwa.
Umbuzo Othi “Ingabe Usengakhulelwa Ngemva Kokuthatha i-Plan B?”
Yebo. Njengoba kungekho ndlela yokuvimbela ukukhulelwa ephelele ngo-100%, kukhona ithuba elincane elisele, ikakhulukazi uma ukuvuthwa kweqanda bekuseduze noma kwaba nocansi olusha ngokushesha ngemva kwalokho. Ipilisi alinazo izinga lokuvikela elihlala njalo ngale fensela elincane. Uma isidoda sihlangana neqanda kamuva, ukukhulelwa kusenezinga lokwenzeka. Isisindo somzimba, imithi ethile, noma ukugabha nakho kunganciphisa amandla alo. Kulezi zimo, ukuqinisekisa ukuthi liphumelele noma lehlulekile kusekutheni uqapha izinguquko zokuya esikhathini futhi uzihlolisisise ukhulelwe yini. Nakuba i-Plan B ingaba yisivikelo esibalulekile esimeni esiphuthumayo, ayifanele neze isetshenziswe esikhundleni semithi ejwayelekile yokuvimbela ukukhulelwa. Ukuba nokulindela okunengqondo kusiza ukuphatha ukukhathazeka mayelana nokuvikeleka okuqhubekayo.
Ukuhlolwa Ukuze Uthole Ukucaca
Ithesti yomchamo oyithenga ekhemisi ithola i-hCG kuphela uma seyakhuphuka yafinyelela ezingeni elilinganekayo. Ukuwusebenzisa masinyane kakhulu kubeka ithuba lokungaqondi kahle. Abaningi bakhetha ukulinda okungenani isonto ngemuva kokungafiki kokuya esikhathini ukuze bathole imiphumela ethembekile. Uma ithesti ikhombisa ukuthi awukhulelwe kodwa ukungabaza kuqhubeka, ukuyiphinda ngemva kwezinsuku ezimbalwa kungakunika ukucaca okwengeziwe. Ama-test egazi enziwa umhlinzeki wezempilo awazwisiseka kakhulu futhi angathola ukukhulelwa masinyane. Kulabo abasajabha bengaqiniseki, udokotela angasikisela ukuhlolwa kwegazi noma i-ultrasound ukuqinisekisa noma ukuchitha ukukhulelwa. Ukunaka kusenesikhathi izimpawu ezikhathazayo kuletha ukuthula kwengqondo [4].
Ukubuyekeza Izindlela Zesikhathi Eside Zokuvimbela Ukukhulelwa
Ukuncika njalo kumapilisi ezimo eziphuthumayo kungadala ukwesaba okuqhubekayo. Ngemva kokwesaba okukodwa okukhulu, abantu bavame ukubheka izindlela zokuvimbela ukukhulelwa ezizinzile zesikhathi eside. Kunezinketho ezihlukene, kusukela kumapilisi okuvimbela ukukhulelwa ahlanganisiwe (combined oral contraceptives) kuya kuma-intrauterine devices (IUD) noma ama-implants. Ukubonisana nochwepheshe bezokwelapha kusiza ukuhlola indlela yokuphila, imiphumela emibi engase ivele, nezindleko. Uma kusetshenziswa kahle, imithi ejwayelekile yokuvimbela ukukhulelwa yehlisa amathuba ezimo eziphuthumayo eziphindaphindayo. Ukwelulekwa nangokusebenzisa amakhondomu noma ukuvikelwa okuphindwe kabili kusiza ukuvikela kokubili ukukhulelwa nezinye izifo ezithathelwana ngocansi. Ukuhlelela kusenesikhathi kungasusa ukungaqiniseki nokukhathazeka okuhlobene nokuncika kuphela emithini yesimo esiphuthumayo, kube nokuvikelwa okuzinzile nokuzethemba okukhulu ngokuhamba kwesikhathi.
Ukusekelwa Ngokomzwelo Nokubhekana Nesimo
Ukukhathazeka ngokushesha ngenxa yokukhulelwa ongakuhlelanga kungafihla ukunakekelwa kwakho. Imizwa yokuzizwa unecala noma unamahloni kwesinye isikhathi ivimba abantu ekufuneni usizo. Khumbula ukuthi odokotela nabahlinzeki bezempilo bavame ukubhekana nezinkinga ezihlobene nemithi yokuvimbela ukukhulelwa yesimo esiphuthumayo, futhi banikeza izindawo eziphephile, ezinobungcweti nenhlonipho. Ukwethemba abangani noma umeluleki kuvame ukunciphisa ingcindezi yangaphakathi, kanti imiphakathi eku-inthanethi inganikeza ukwesekwa okwengeziwe kozakwenu. Noma kunjalo, ukuhola kochwepheshe kubalulekile ukuze uthole ulwazi oluqinisekisiwe lwezokwelapha. Ukulandisa ngendlela ecacile okwenzekile nezimpawu ohlangabezane nazo kungasiza ukucacisa izinyathelo ezilandelayo. Ukulinganisa inhlalakahle yokomzwelo nolwazi olusemqoka kuqinisekisa indlela enempilo yokubhekana nemiphumela engase ivele. Izinqumo ezenziwe ngolwazi lunciphisa ukwethuka futhi ziholele esixazululweni esingcono.
Izinkolelo Ezingamanga Nokuqonda Okungalungile
Abanye bakholelwa ukuthi i-Plan B iyipilisi yokukhipha isisu. Nokho, umsebenzi wayo omkhulu ukuvimba ukuvuthwa kweqanda, hhayi ukuphazamisa ukukhulelwa okusele kukhona. Enye inkolelo-mbumbulu ithi ingasetshenziswa kaningi ngaphandle kwemiphumela emibi. Nakuba imithamo eminingi kwesinye isikhathi ithathwa ezimeni ezahlukene eziphuthumayo, ukuncika njalo kuyo kungadala ukungajwayeleki komjikelezo wokuya esikhathini kanye nokukhathazeka. Abanye bacabanga ukuthi ivikela nangezinye izikhathi zocansi ngemuva kwesehlakalo sokuqala; empeleni, ayinawo umphumela wokuvikela wesikhathi eside. Ukwazi lezi zinto kugcina okulindelwe kuhambisana namandla ayo angempela. Ulwazi olungelona iqiniso lungandisa ukwesaba noma luholele ekusebenziseni okungalungile, okugqamisa ukubaluleka kwezeluleko zezokwelapha eziqinisekisiwe [5].
Ongakuqaphela Ngemva Kokuyisebenzisa
Abantu kwesinye isikhathi bakhohlwa ukuthi imiphumela emibi ivamise ukuphela ngokushesha. Uma ukungakhululeki kukhula noma kuqhubeka, ikakhulukazi uma kunezintlungu ezibukhali, ukuhlolwa ngokushesha kuhlakaniphe kakhulu. Ukopha okuningi okuqhubekayo, ukulahlekelwa umoya, noma umkhuhlane kuyizimpawu ezingase zibe yingozi. Nakuba kungavamile, lezi zinto zingabonisa izinkinga. Ngokufanayo, izimpawu ezifanayo nezokukhulelwa eziqhubekayo noma eziba zimbi zidinga umbono kochwepheshe. Ukulandela izinguquko emzimbeni nokubhala phansi izinsuku kusiza ekuxhumaneni okunembile nochwepheshe bezempilo. Ukuthola izimpawu ezingajwayelekile kusenesikhathi kuthuthukisa imiphumela. Ukulungele ukufuna usizo ngokushesha kwenza kungabi lula ukuthi izimo ezinzima zingabonwa noma zingelashwa.
Ukunciphisa Izingcuphe Zesikhathi Esizayo
Ngemva kokuhlangabezana nokungaqiniseki, abaningi babuyekeza imikhuba yabo. Ukuhlela ucansi ngezindlela ezivamile zokuvimbela ukukhulelwa kwehlisa ukuncika ezimeni eziphuthumayo. Ukufuna iresiphi yemithi ethembekile yokuvimbela ukukhulelwa kunciphisa ukungaqiniseki okukwenza ulindele imiphumela. Ngaphezu kwalokho, ukwazi kahle iwindi lakho lokuzala nokuguquguquka komjikelezo kungasiza umuntu alinganisise izingozi ezingase zibe khona, ikakhulukazi ngemva kwezigameko zocansi olungavikelekile. Ukunciphisa utshwala noma izidakamizwa ngesikhathi socansi nakho kunganciphisa amaphutha okunganaki. Kulabo abasakhathazekile, ukuxoxa ngezinkathazo nodokotela kusiza ukuhlelela izindlela ezisebenzayo. Ekugcineni, ukuhlanganisa ulwazi namasu okuziphatha ngokuzibophezela kwehlisa izigameko “zokusinda kancane”, kuthuthukise inhlalakahle engokwengqondo neyomzimba.
Isifinyezo Esiyinhloko
Izimpawu zokuthi i-Plan B ayisebenzi zivame ukuhambisana nokubambezeleka okukhulu kokuya esikhathini, izikhalo zomzimba eziqhubekayo, noma imiphumela engacacile yama-test asekhaya. Nakuba i-levonorgestrel inikeza usizo olubalulekile njengendlela yokuvimbela ukukhulelwa esimeni esiphuthumayo, ayiphelele futhi ingahluleka ngaphansi kwezimo ezithile. Ukuhlala uqaphile, ukufuna ukuhlolwa okufanele, nokubonisana nochwepheshe uma kukhona ukungabaza, konke kubalulekile ekuvikeleni impilo yokuzala. Ngokwazi isikhathi esifanele, ukusebenzisa izilinganiso zokulandelela eziphakanyisiwe, nokuthola ukwesekwa ngokomzwelo, umuntu anganciphisa ukudideka futhi athole izimpendulo eziqondile. Ukuqonda imingcele yaleli pilisi—futhi wamukele imithi ejwayelekile yokuvimbela ukukhulelwa—ekugcineni kuletha ukuzethemba okukhulu nokulawula ohambweni lwakho lokukhiqiza.
Ngaphezu kwalokho, ukubhekana nombuzo othi ingabe usengakhulelwa ngemva kokuthatha i-Plan B kubalulekile. Njengoba kungekho muthi ophelele, ithuba elincane kodwa elikhona lokukhulelwa lisekhona ngaphansi kwezimo ezithile. Ukuqhubeka uqaphela kuqinisekisa ukunakwa okusheshayo emiphumeleni, kugweme izimpawu ezinganakwa futhi kuvikele inhlalakahle yakho yonke.
Ekugcineni, ukuthatha izinyathelo ezisebenzayo kukuvikela ekubanjweni ungakulindelanga. Nakuba lesi sihloko sichaza izenzakalo ezivamile nezimpawu eziyizexwayiso, khumbula ukuthi izimo zomuntu ngamunye ziyehluka. Ukuxhumana okuvamile nochwepheshe bezokwelapha kungakunikeza ukuthula kwengqondo, uma uhlangabezana nezidingo eziphuthumayo eziphindaphindiwe. Ulwazi luletha amandla, lukusize uhlale uzolile futhi wenze izinqumo ezicacile uma kuvela izigameko ezingalindelekile.
Izinkomba
- Nitz U, Gluz O, Clemens M, Malter W, Reimer T, Nuding B, Aktas B, Stefek A, Pollmanns A, Lorenz-Salehi F, Uleer C, Krabisch P, Kuemmel S, Liedtke C, Shak S, Wuerstlein R, Christgen M, Kates RE, Kreipe HH, Harbeck N; West German Study Group PlanB Investigators. West German Study PlanB Trial: Adjuvant Four Cycles of Epirubicin and Cyclophosphamide Plus Docetaxel Versus Six Cycles of Docetaxel and Cyclophosphamide in HER2-Negative Early Breast Cancer. J Clin Oncol. 2019 Apr 1;37(10):799-808. doi: 10.1200/JCO.18.00028. Epub 2019 Feb 20. PMID: 30785826.
- Cleland K, Raymond EG, Westley E, Trussell J. Emergency contraception review: evidence-based recommendations for clinicians. Clin Obstet Gynecol. 2014 Dec;57(4):741-50. doi: 10.1097/GRF.0000000000000056. PMID: 25254919; PMCID: PMC4216625.
- De Santis M, Cavaliere AF, Straface G, Carducci B, Caruso A. Failure of the emergency contraceptive levonorgestrel and the risk of adverse effects in pregnancy and on fetal development: an observational cohort study. Fertil Steril. 2005 Aug;84(2):296-9. doi: 10.1016/j.fertnstert.2005.01.136. PMID: 16084867.
- Zhang L, Chen J, Wang Y, Ren F, Yu W, Cheng L. Pregnancy outcome after levonorgestrel-only emergency contraception failure: a prospective cohort study. Hum Reprod. 2009 Jul;24(7):1605-11. doi: 10.1093/humrep/dep076. Epub 2009 Mar 31. PMID: 19336440.
- Noé G, Croxatto HB, Salvatierra AM, Reyes V, Villarroel C, Muñoz C, Morales G, Retamales A. Contraceptive efficacy of emergency contraception with levonorgestrel given before or after ovulation. Contraception. 2011 Nov;84(5):486-92. doi: 10.1016/j.contraception.2011.03.006. Epub 2011 Apr 27. PMID: 22018122.
