Pafupifupi amuna 60% lero akuti ali okonzeka kugwiritsa ntchito njira zolerera. Komabe, kuchuluka kwa njira zakulera za abambo kumakhalabe kochepa pakadali pano ndipo njira zina zachizolowezi sizothandiza kwenikweni. M'malo mwake, kupewa kukhala ndi pakati kumakhalabe, makamaka, kwa mkaziyo. Kodi njira zodziwika bwino kwambiri zolerera amuna masiku ano ndi ziti? Kodi njira yolelera yodalirika kwambiri ndi yotani? Chidule.

Kondomu ya amuna ndiyo njira yolera yogwiritsira ntchito kwambiri: 21% ya maanja amagwiritsa ntchito padziko lonse lapansi.

Kondomu ya abambo ndi chiyani?

Kondomu ya abambo ndi imodzi mwazomwe zimatchedwa "zotchinga" njira zolerera zosinthira ndipo imakhala ndi kakhungu kocheperako, kamene kamapangidwa ndi latex, koti kayike pa mbolo musanagonane, kuti tipewe umuna kumaliseche. Kondomu yamphongo imalimbikitsidwa, malinga ndi Haute Autorité de Santé, "pakakhala kuti palibe mnzanu wokhazikika kapena ngati njira ina yosinthira yomwe ingapezeke ngati zingatheke kapena kulephera kutsatira njira ya mahomoni".

Kodi kondomu ndi yothandiza?

Kondomu ya abambo imawerengedwa kuti ndi njira yolerera yothandiza. Zowonadi zake, Pearl index, yomwe imalola kuyesa kuchuluka kwa mimba "mwangozi" yoposa chaka chimodzi kuti igwiritsidwe ntchito moyenera, ndiyedi 2. Koma kwenikweni, kondomu siyotsimikizika kwambiri popewa kutenga pakati. osafunika ndikulephera pafupifupi 15% chifukwa chazomwe amagwiritsira ntchito. Kulephera kumeneku kumachitika makamaka chifukwa chophwanya kondomu, komanso chifukwa chogwiritsa ntchito mosasamala, kapena ngakhale kusiya kwake panthawi yogonana.

Ubwino ndi zovuta za kondomu ya abambo ndi chiyani?

Komabe, maubwino amakondomu a abambo ndi ochulukirapo komanso zovuta zake, m'malo mwake ndizochepa.

Zina mwazabwino zake ndi :

• Kupezeka kwake : makondomu onse ndi otchipa komanso amapezeka kwambiri (m'masitolo akuluakulu, m'masitolo, ndi zina zambiri)
• Mphamvu yake yolimbana ndi matenda opatsirana pogonana : kondomu (yamwamuna kapena yaikazi) ndiyo njira yokhayo yolerera yolimbana ndi matenda opatsirana pogonana. Chifukwa chake amalimbikitsidwa pamaubwenzi omwe ali pachiwopsezo (abwenzi angapo, maubwenzi wamba) kapena ngati kulibe ubale wolimba.
• Kugwirizana kwake ndi njira ina yolerera (njira yolerera ya mahomoni kapena intrauterine, spermicide, ndi zina zambiri), kupatula kondomu ya amayi.

Chotsatira chake, kondomu ikhoza ...

• Limbikitsani kuyambika kwa zomwe zimachitika mwa anthu omwe ali ndi ziwengo zamtundu wa latex. Pomwe kuli koyenera, makondomu a polyurethane, omwe sakhala ndi vuto lililonse, ayenera kukondedwa.

• kutaya mphamvu ngati agwiritsidwa ntchito molakwika, chifukwa chake kufunika kophunzira za machitidwe abwino (ikani kondomu kaye musanachite zogonana, igwireni ndi dzanja mukamachotsa, ndi zina zambiri)
• ziwopsezo zomwe zilipo poterera ndikuphwanya. Mwakutero, sichikulimbikitsidwa makamaka kugwiritsa ntchito mafuta opangira mafuta okhala ndi kondomu yamwamuna ya latex, pachiwopsezo chonyozetsa latex ndikulimbikitsa kutuluka kwa njira yolerera.
• kuchepetsa kapena kusintha kukhudzidwa panthawi yogonana mwa ogwiritsa ntchito ena.

Kodi mtengo wa njira yolelera imeneyi ndi yotani?

Mtengo wapakati wa kondomu yamwamuna uli pakati pa masenti 50 ndi 70 chidutswa. Ndipo mosiyana ndi zomwe ambiri amakhulupirira, kondomu itha kulipiridwa ndi Inshuwaransi ya Zaumoyo munthawi zina. Inde, kuyambira 2018, mabokosi ena, omwe amapezeka m'masitolo, amatha kubwezeredwa mpaka 60% ngati ataperekedwa ndi dokotala kapena mzamba (pamtengo wogulitsa wa $ 1,30, € 6 pa bokosi la 2,60, € 12 pa bokosi la 5,20 ndi € 24 la bokosi la XNUMX.). Zitha kupezekanso kwaulere kumalo olera.

Kusokonezedwa kwa ma coitus, omwe amadziwikanso kuti njira yochotsera, amagwiritsidwa ntchito ndi amuna pafupifupi 5% padziko lonse lapansi, 8% ku France. Njira yolerera yamwamuna iyi ikadakhala yotchuka kwambiri panthawi yamavuto "mapiritsi" komanso kufunsa za njira yolerera ya amayi mu 2012.

Kodi njira yobwererera ndi iti?

Njira yochotsera imakhudza, monga dzinali likusonyezera, kuchotsa mbolo kumaliseche ndi malo ozungulira maliseche asanayambe kukodzera. Mwakutero, ndi imodzi mwanjira zachilengedwe "zolerera" za abambo, imodzi mwazomwe zili ndi machitidwe otchedwa "otentha".

Kodi ma coitus osokonezedwa ndi njira yolera yothandiza amuna?

Mwachidziwitso, ndi Pearl index ya 4, ma coitus omwe adasokonezedwa amakhalabe osankhidwa, malinga ndi Haute Autorité de Santé, mgulu la njira zolera zoyendetsera amuna ... bola ngati zigwiritsidwe ntchito moyenera komanso pafupipafupi. Koma pakuchita, kulephera kuli kwakukulu kwambiri (27%). Njira yokhayo yodzichotsera payokha siyikulimbikitsidwa ndi akatswiri azaumoyo.

Kodi maubwino ndi zovuta za njira yochotsera ndi chiyani?

Ubwino waukulu wa njira yobweretsera ndi yake "Kupezeka" : yaulere, yopezeka munthawi zonse, popanda zotsutsana, chifukwa chake imawonedwa ngati "yoposa chilichonse".

Koma zovuta zake zazikulu zimakhalabe zake mphamvu zochepa. Inde, njirayi imafunikira osati kokha kuwongolera koyenera kwa umuna (zomwe sizikhala choncho nthawi zonse), koma ngakhale zili choncho "zowoneka", madzi am'mbuyomu (omwe amatsogolera umuna ndi umuna ndipo chifukwa chake atha kusungidwa mu nyini) mumakhala umuna ndipo chifukwa chake umatha kuthira oocyte nthawi yozizira. Komanso, kusokoneza coitus sikungateteze ku matenda opatsirana pogonana.

Vasectomy ndi njira yolerera yolera (kapena kulera kotsimikizika mchilankhulo cha tsiku ndi tsiku) yogwiritsidwa ntchito ndi 2% ya mabanja padziko lapansi, ochepera 1% ku France. Zothandiza kwambiri, komabe zimawoneka ngati zosasinthika. Chifukwa chake zimangolimbikitsidwa kwa amuna omwe akufuna njira yokhazikika yolerera ndipo ayenera kukhala mutu wazambiri komanso zowunikira.

Vasectomy ndi chiyani?

Vasectomy ndi opaleshoni yoletsa ma vas deferens, omwe amalola umuna kutuluka kuchokera kumayeso. Pambuyo pa vasectomy, umuna sulinso ndi spermatozoa (azoospermia), umuna wa oocyte utatha kutuluka (motero mimba) sichingatheke.

Kodi vasectomy ndiyothandiza?

Vasectomy ndi yothandiza kwambiri. Zolemba zake za Pearl ndi 0,1% pamalingaliro ndi 0,15% pakadali pano. Mimba zosayembekezeka ndizosowa.

Kodi zabwino ndi zoyipa za vasectomy ndi ziti?

Phindu lalikulu kwambiri la vasectomy ndilopambana kwambiri. Zina zake zabwino?

• Sizimakhudza erectile ntchito, makamaka chifukwa sizimakhudza, monga momwe munthu angakhulupirire, kupanga mahomoni achimuna. Ubwino wa erection, kuchuluka kwa ejaculate, zomverera zimakhalabe chimodzimodzi.
• Imakhala yopanikizika tsiku lililonse komanso (yayitali kwambiri) yayitali.
• Kuchita opaleshoniyi nthawi zambiri kumaloledwa.

Mwa zina zoyipa zake, ndikofunikira kukumbukira kuti vasectomy…

• sichingasinthike: Njira zamakono zopangira ma vas deferens kuti azidutsanso zimakhala ndi zotsatira zosatsimikizika. Pachifukwa ichi, vasectomy imawerengedwa kuti ndi yomaliza, osalola projekiti yotsatira ya mwana. Ichi ndichifukwa chake nyengo yozizira ya miyezi inayi imayikidwa. Kuphatikiza apo, adotolo atha kupanga malingaliro oti asungidwe umuna (kuzizira kwa ma gametes) kuchipatala chodzipereka (CECOS).
• sagwira ntchito nthawi yomweyo. Khungu lamwamuna (lomwe limatulutsa umuna) limakhalabe ndi umuna pakati pa masabata 8 ndi 16 pambuyo poti achite izi kapena atadutsa makumi awiri. Njira zowonjezera zakulera zimaperekedwa kwa miyezi itatu pambuyo pa opareshoni ndikuwonjezera mpaka kusowa kwa umuna kutsimikiziridwa ndi spermogram.
• sateteza kumatenda opatsirana pogonana,
• zingayambitse mavuto pambuyo pa opaleshoni (Kutuluka magazi, kuvulala, matenda, kupweteka, ndi zina zambiri) mu 1 mpaka 2% yamilandu. Komabe, izi zitha kuthandizidwa.
• ali ndi zotsutsana : WHO nthawi zonse imalimbikitsa kulingalira za vasectomy pazifukwa ndi zochitika kuti ziganizire "zikhalidwe zonse zomwe zingafunike kusamala". Kuphatikiza apo, zifukwa zina zachipatala zitha kubweretsa kuimitsa kuchitapo kanthu monga matenda am'deralo (matenda opatsirana pogonana, epididymitis, orchitis, ndi zina zambiri), matenda opatsirana kapena gastroenteritis, kuzindikiritsa unyinji wam'mimba, etc.

Kodi mtengo wa njira yolelera imeneyi ndi yotani?

Vasectomy imawononga pafupifupi ma 65 euros ndipo imaphimbidwa mpaka 80% ndi Health Insurance.

Njira zakulera zamtundu wamwamuna (kapena CMT) zimachokera ku zovuta zakutentha pakubala kwamwamuna. Ngati ali a priori m'malo mokhutiritsa, ndiye kuti pakadali pano sangafikire kapena akuyenera kukhala mutu wotsimikizira zasayansi.

Kodi njira yolera yotentha yamwamuna imakhala ndi chiyani?

CMT imakhazikitsidwa potengera momwe thupi limagwirira ntchito: kuti spermatogenesis ikhale yabwino, ma testes amayenera kukhala otentherako pang'ono pang'ono kuposa thupi (pakati pa 2 ndi 4 ° C). Pachifukwa ichi minyewa imakhala kunja kwa thupi. M'malo mwake, kutentha m'mayeso kukachuluka, spermatogenesis imatha kusokonekera. CMT chifukwa chake cholinga chake ndikulimbikitsa kukwera kwadzikoli kutentha kuti spermatozoa isamere fetereza, kulephera kupanga azoospermia. Izi zimatheka ndi njira zingapo. Pachikhalidwe, CMT yakhazikitsidwa posambira mobwerezabwereza (pamwamba pa 41 ° C). Posachedwapa, njira ziwiri zakukwera kwamatenthedwe zakonzedwa:

• kuvala zovala zamkati pogwiritsa ntchito kutchinjiriza kwamafuta (maola 24 patsiku)
• kusunga machende pamalo okwera (wotchedwa supra-scrotal) kwa maola 15 patsiku, kachiwiri chifukwa cha zovala zamkati. Timalankhula za cryptorchidism yokumba.

Kodi njira yolera yotentha yamwamuna ndiyothandiza?

Lero, cryptorchidism yokumba ndiyabwino kwambiri chifukwa cha ntchito ya Dr. Mieusset. Njira imeneyi imawerengedwa kuti ndiyothandiza, ngakhale ikufunikirabe kukhala mutu wamaphunziro atsopano owunikiranso kuti athe kuganizira za anthu ochulukirapo. Kuyesedwa kwa maanja 51 ndi ma 536 owonekera, zimangobweretsa pakati, chifukwa cholakwitsa kugwiritsa ntchito njirayo.

Kodi maubwino ndi zovuta za kulera kotentha kwamwamuna ndi ziti?

Pakadali pano kafufuzidwe mderali, CMT ili ndi mwayi wokhala wogwira ntchito, ngati njira yake yogwiritsidwira ntchito imagwiritsidwa ntchito, ndikusinthidwa. Itha kukhalanso yayitali: nthawi yolimbikitsidwa imatha kukhala zaka 4.

Komabe, njira yolera yotentha yamphongo ili ndi zovuta zina, izi:

• Kusakhumudwitsidwa zolumikizidwa ndi kuvala kabudula wamkati wopangidwira izi (kumverera ndi m'modzi mwa amuna awiri)
• choletsa china: ngati kabudula wamkati sanavale kwa maola osachepera 15 patsiku kapena ngati sanavalepo kwa tsiku limodzi, njira yolerera siyitsimikizidwanso. Kuphatikiza apo, magwiridwe anthawi zonse a spermograms musanatsimikizire kuti njirayo ndiyofunika (miyezi itatu iliyonse pazaka ziwiri zoyambirira, kenako miyezi isanu ndi umodzi).
• matenthedwe abambo olera sateteza kumatenda opatsirana pogonana.

Kuphatikiza apo, njirayi sinafotokozeredwe ngati chilengedwe cha cryptorchidism (chisokonezo cha kusamuka kwa ma testes, omwe amati "sanatsike bwino"), testicular ectopia, inguinal hernia, khansa ya testicular, varicocele. atsogola komanso mwa amuna omwe ali onenepa kwambiri. 

• CMT imakhalabe yosafikirika.

Amagwiritsidwa ntchito kwambiri mwa amayi, kulera kwa mahomoni kumakhalabe kwachinsinsi kwakanthawi mwa amuna. Komabe, njirayi yakhala ikudziwika kuyambira zaka za m'ma 1970 ndipo yadzetsa mayesero okhutiritsa azachipatala kwazaka zingapo.

Kodi kulera kwamwamuna ndi chiyani?

Imeneyi ndi njira yolerera yosinthira yomwe cholinga chake ndi kuletsa spermatogenesis kudzera kuchipatala. Mitundu iwiri yayikulu yamapulogalamu yapangidwa m'dera lino:

• kulera kotengera testosterone yokha. Monotherapy iyi imadalira jakisoni wokhazikika wa mlingo wa testosterone enanthate. Pambuyo pake, pulogalamu yotengera testosterone yotulutsidwa kwa nthawi yayitali idakonzedwa kuti jekeseni jakisoni, koma yomalizirayi sigwiritsidwa ntchito ku France.
• kuphatikiza progesterone ndi testosterone. Protocol iyi ikuwerengedwa m'njira zingapo, koma yopambana kwambiri masiku ano ndi gel osakaniza progesterone ndi testosterone: Nestorone. Kutsatsa kwake ku France sikuloledwa.

Posachedwapa, mapiritsi oletsa kulera omwe amaphatikiza testosterone, androgen ndi progesterone apambana bwino gawo loyesedwa koyamba ku United States. Amatchedwa "11-beta-MNTDC", itha kusinthidwa komanso yopanda zovuta. Ngakhale kulonjeza, njira iyi piritsi lachikazi sayenera kupezeka pamsika waku America pafupifupi zaka khumi.

Kodi njira yolerera ya mahomoni ndiyothandiza?

Monotherapy yochokera ku testosterone lero ndi mtundu wa CMH pomwe pali umboni wambiri. Kafukufuku akhazikitsa Pearl Index yake kuchokera pa 0,8 mpaka 1,4 yolera yoteteza enanthate komanso pakati pa 1,1 ndi 2,3 yanjira yotulutsira. Njira ziwiri zakulera zamamuna izi zitha kuonedwa kuti ndizothandiza, komanso zothandiza kwambiri. Kuphatikiza apo, abambo omwe amaigwiritsa ntchito nthawi zambiri amayambiranso spermatogenesis pakati pa miyezi 3 ndi 6 atalandira chithandizo.

Ponena za Nestorone, zikuwoneka ngati zikulonjeza: mayesero azachipatala omwe amachitika ku United States akuwonetsa kuyenerera kwa 85% popanda zovuta.

Kodi maubwino ndi zovuta za njira yolera yamthupi yamwamuna ndi iti?

Ubwino waukulu wa testosterone monotherapy ndiwoposa zonse Mwachangu, yofanana ndi yomwe ya amayi yolera yakulera m'thupi. Sabata iliyonse, ziyimiliranso, kwa banjali, choletsa chofunikira kwambiri kuposa kumwa mapiritsi tsiku lililonse azimayi.

Komabe, njirayi yolera yamwamuna ili ndi zovuta zingapo:

• Sigwira ntchito nthawi yomweyo : ndikofunikira kudikirira miyezi itatu kuchokera pomwe mankhwala ayamba kuti izi zichitike.
• Ndi yokwanira miyezi 18 yogwiritsidwa ntchito, posowa maphunziro asayansi pazotsatira zake zakanthawi.
• Zimakhala zoletsa, makamaka pakuwunika : Osati kokha, kulera kwamwamuna kochokera pa testosterone kokha kumafuna jekeseni pafupipafupi, koma kuzindikira kwa umuna kumalimbikitsidwa miyezi itatu iliyonse ndikuwunika kwachilengedwe komanso kuyesa kuchipatala miyezi isanu ndi umodzi iliyonse.
• Imalimbikitsa kuwonekera kwa zovuta zina monga ziphuphu (pafupipafupi), komanso nthawi zina kupsa mtima, kuledzera kwambiri kapena kutsika kwa libido, kunenepa ...
• Ili ndi zotsutsana zingapo : amuna omwe atha kupindula nawo ayenera kukhala ochepera zaka 45, osakhala ndi banja kapena mbiri ya khansa ya prostate, osadwala matenda am'magazi, mtima, kupuma kapena matenda amisala, sayenera (kapena pang'ono) kusuta ndi / kapena kumwa mowa , osakhala onenepa kwambiri…