Cov tshuaj tua kab mob thiab tshuaj tiv thaiv kev yug menyuam: Qhov tseeb lossis kev dag?

Koj puas tuaj yeem noj tshuaj tua kab mob nrog kev tiv thaiv kev yug menyuam?

Yuav tsum tau koj siv txoj kev barrier thaub qab ntawm tswj kev yug me nyuam (xws li hnab looj tes) thaum koj tseem noj tshuaj tua kab mob nrog cov tshuaj tiv thaiv hormonal?

  • Tau ntau xyoo, cov poj niam tau raug ntuas tias lawv txoj kev tswj kev yug me nyuam yuav ua tsis tau zoo yog tias lawv tau siv tshuaj tua kab mob tib lub sijhawm. Cov lus qhia ib txwm muaj rau cov poj niam los ntawm cov kws kho mob yog ntxiv cov txheej txheem tiv thaiv kev xeeb tub rau lawv cov tshuaj tiv thaiv kab mob (xws li hnab looj tes), thiab tej zaum 7 hnub tom qab ua tiav cov tshuaj tua kab mob, pab tiv thaiv kev xeeb tub.
  • Niaj hnub no, kev tshawb fawb feem ntau hais tias cov tshuaj tua kab mob, tshwj tsis yog cov tshuaj tua kab mob rifampin ua (tseem hu ua Rifadin thiab Rimactane) thiab tej zaum lwm yam rifamycins zoo li rifabutin, tsis hloov cov txiaj ntsig ntawm cov tshuaj hormonal ntawm kev tiv thaiv kev yug menyuam zoo li cov ntsiav tshuaj. Txawm li cas los xij, cov neeg thuam hais tias ntau qhov kev tshawb fawb uas pom tias tsis muaj kev sib cuam tshuam tau me me thiab yog li tsis zoo li tsis pom kev sib cuam tshuam.
  • Hauv qhov sib piv, qhov loj tab sis kev soj ntsuam cov ntaub ntawv tshawb fawb los ntawm BMJ Evidence-Based Medicine luam tawm thaum Lub Yim Hli 2020 qhia tias muaj peev xwm xeeb tub thaum tswj kev yug me nyuam thiab tshuaj tua kab mob ua ke. Txawm li cas los xij, qhov kev tshawb fawb no tsis tuaj yeem ua pov thawj qhov ua rau thiab cov txiaj ntsig tshwm sim raws li kev tsim rov qab thiab kev txwv ntawm kev tshawb fawb.

Vim tias ntau qhov kev tshawb fawb tsis sib haum xeeb, koj yuav tsum sib tham txog cov ncauj lus no nrog koj tus kws kho mob yog tias koj tau txais tshuaj tua kab mob thiab koj siv cov tshuaj hormonal ntawm kev tiv thaiv kev yug menyuam.



  • Nws tau tshaj tawm tias cov tshuaj tiv thaiv kev yug menyuam poob 1% ntawm lub sijhawm siv zoo kawg nkaus thiab 9% ntawm lub sijhawm nrog ib txwm siv . Qhov no txhais tau tias, nrog ib txwm siv, txog 9 tawm ntawm txhua 100 tus poj niam tej zaum tseem yuav xeeb tub txhua xyoo uas siv tshuaj.
  • Ntau tus poj niam tsis kam lees txais qhov ntxiv ntawm kev xeeb tub thaum siv tshuaj tua kab mob, tshwj xeeb tshaj yog nrog cov ntaub ntawv kawm tsis sib haum.
  • Ntawm qhov tod tes, qee tus poj niam tsis nyiam qhov kev xav ntawm kev tiv thaiv kev tiv thaiv kev yug menyuam rau ib lossis ob lub lis piam, lossis ntev dua.
  • Tham nrog koj tus kws kho mob. Koj tus kws kho mob tseem yuav pom zoo kom koj siv ib txoj hauv kev ntxiv kev tiv thaiv kev yug menyuam (piv txwv li, hnab looj tes thiab / lossis tshuaj tua kab mob) rau koj txoj kev hormonal thaum lub sijhawm luv luv ntawm kev kho tshuaj tua kab mob.

Kev tshawb fawb qhia li cas?

Raws li cov cov lus qhia kho mob , cov kws tshaj lij thiab poj niam cov kws kho mob , tsuas yog ib qho tshuaj tua kab mob - rifampin ua (cov khoom lag luam: Rifadin thiab Rimactane), thiab rau qhov tsawg dua rifabutin - tau raug pov thawj los ua kom cov tshuaj tiv thaiv kev yug me nyuam tsis zoo.

  • Rifampin txo qis qhov ua tau zoo los ntawm kev txo qis cov tshuaj tiv thaiv kev yug menyuam (ethinyl estradiol thiab progestin) hauv cov poj niam noj cov tshuaj tiv thaiv qhov ncauj. Cov theem ntawm cov tshuaj hormones yog xav tau los tiv thaiv ovulation.
  • Rifampin tuaj yeem tsim cov enzymes hauv koj lub siab uas yuav zom cov tshuaj estrogen sai dua li qub. Kev txo qis cov tshuaj hormones tuaj yeem txo qhov ua tau zoo ntawm koj txoj kev tswj kev yug menyuam.
  • Rifampin kuj tseem tuaj yeem txo qhov ua tau zoo ntawm cov tshuaj tiv thaiv kev yug menyuam (Ortho Evra) thiab lub nplhaib ntawm qhov chaw mos (NuvaRing), yog li yuav tsum siv lwm hom kev tiv thaiv kev yug menyuam nrog cov khoom no.
  • A nonhormonal txoj kev tswj kev yug menyuam - Piv txwv li, hnab looj tes, diaphragm, lossis tooj liab IUD, raug pom zoo nrog rifampin. Depot-Provera , kev txhaj tshuaj tiv thaiv yug menyuam, tej zaum yuav yog lwm txoj kev xaiv.

Ib qho kev tshuaj xyuas xyoo 2018 tau luam tawm hauv American Journal of Obstetrics thiab Gynecology pom zoo nrog cov ntaub ntawv no. Cov kws tshawb fawb tau ua tiav cov ntaub ntawv tshuaj xyuas ntawm ntau qhov kev tshawb fawb uas ua tau raws li cov txheej txheem suav nrog.

Lawv nrhiav kev los txiav txim seb puas muaj kev cuam tshuam ntawm cov tshuaj tua kab mob uas tsis yog rifamycin thiab cov tshuaj hormonal contraceptives ua rau txo qis kev ua tau zoo lossis nce toxicity ntawm ob txoj kev kho. Cov kws sau ntawv tsis tau pom cov pov thawj los txhawb qhov muaj kev sib cuam tshuam ntawm cov tshuaj hormonal contraceptives thiab tshuaj tua kab mob (tsis suav nrog rifamycins).

  • Ob txoj kev tshawb fawb pom tsis muaj qhov sib txawv ntawm cev xeeb tub hauv cov poj niam uas siv cov tshuaj tiv thaiv qhov ncauj nrog thiab tsis muaj tshuaj tua kab mob.
  • Tsis muaj qhov sib txawv ntawm kev tiv thaiv ovulation los yog los ntshav tawg tau pom nyob rau hauv ib qho kev tshawb fawb uas ua ke cov tshuaj tiv thaiv hormonal nrog rau cov tshuaj tua kab mob.
  • Tsis muaj qhov txo qis hauv cov tshuaj progestin lossis ethinyl estradiol pharmacokinetic parameter tshwm sim nrog kev tswj hwm cov tshuaj tua kab mob, tshwj tsis yog thaj tsam ethinyl estradiol qis dua hauv qab nkhaus thaum muab nrog dirithromycin (tsis muaj nyob hauv Asmeskas lawm).

Cov kws sau ntawv xaus lus tias cov poj niam feem ntau tuaj yeem xav tias tsis muaj kev txo qis hauv kev siv tshuaj tiv thaiv kab mob thiab tshuaj tua kab mob (tshwj tsis yog rifamycins).

Kev tshuaj xyuas los ntawm Phau ntawv Journal ntawm American Academy of Dermatology hais tias cov pov thawj pharmacokinetic qhia tau hais tias qib ntawm qhov ncauj contraceptive steroids tsis hloov nrog kev tswj hwm ntawm cov tshuaj tua kab mob, suav nrog:

Txawm hais tias nrog cov ntaub ntawv tshawb fawb no, kev sib koom ua ke ntawm kev siv tshuaj tua kab mob thiab kev tiv thaiv tsis ua haujlwm tseem muaj teeb meem. Cov kev sim loj loj tsis tau ua tiav, tab sis ntau qhov kev tshawb fawb ntawm tus kheej tau raug soj ntsuam. Qee cov kws tshaj lij tau sib cav tias cov kev tshawb fawb me me dhau los yog tsim tsis zoo los txiav txim siab kev sib cuam tshuam ntawm tus kheej cov tshuaj tua kab mob thiab kev tiv thaiv kev yug menyuam.

Thaum Lub Yim Hli 2020, cov kws tshawb fawb los ntawm UK tau tshaj tawm cov kev tshawb fawb soj ntsuam hauv BMJ Evidence-Based Medicine .

  • Txoj kev tshawb no qhia (tab sis tsis tuaj yeem ua pov thawj) tias cov tshuaj tua kab mob tuaj yeem txo cov txiaj ntsig ntawm cov tshuaj tiv thaiv hormonal, suav nrog cov ntsiav tshuaj.
  • Cov kws tshawb fawb tau tshuaj xyuas qhov kev soj ntsuam ntawm cov kev mob tshwm sim uas tsis xav tau (hu ua Yellow Cards hauv UK) thiab pom tias kev xeeb tub uas tsis tau npaj siab muaj 7 npaug ntau dua rau cov neeg siv tshuaj tua kab mob ntau dua li lwm hom tshuaj tsis cuam tshuam.
  • Kev xeeb tub tsis xav tau kuj tseem muaj 13 npaug ntau dua hauv cov ntawv ceeb toom ntawm cov tshuaj enzyme-inducing, uas suav nrog qee cov tshuaj tua kab mob.
  • Cov kws sau ntawv tau xaus lus tias cov poj niam ntawm cov tshuaj tiv thaiv hormonal yuav tsum tau qhia kom siv cov kev ceev faj ntxiv kom tsis txhob muaj kev xeeb tub thaum muaj tshuaj tua kab mob. Txawm li cas los xij, lawv tau hais tias qhov kev pheej hmoo yuav txawv ntawm poj niam mus rau ib tus poj niam, raws li nws lub cev tsim thiab qhov xwm txheej.

Lwm hom tshuaj twg tuaj yeem hloov kho kev tiv thaiv kev yug menyuam?

Lwm cov tshuaj uas tsis yog rifampin lossis rifamycins tuaj yeem cuam tshuam txog kev tiv thaiv kev yug menyuam. Lwm cov tshuaj uas ntxias cov enzymes tuaj yeem cuam tshuam rau qib hormonal ntawm koj qhov kev tiv thaiv kev yug menyuam thiab tuaj yeem txo nws cov txiaj ntsig.

Yog li ntawd, ib txwm kom koj tus kws kho mob lossis tus kws muag tshuaj ua tiav kev tshuaj xyuas tshuaj xyuas txhua lub sijhawm koj pib lossis txawm nres ib qho tshuaj. Qhov no suav nrog cov tshuaj kws kho mob, nrog rau cov tshuaj hauv khw muag khoom (OTC), tshuaj vitamin thiab tshuaj ntsuab lossis tshuaj noj.

Piv txwv li:

  • Cov tshuaj antifungal griseofulvin tuaj yeem ua rau qis dua ntawm cov tshuaj tiv thaiv kev yug menyuam thiab txo cov txiaj ntsig ntawm cov tshuaj tiv thaiv kev yug menyuam.
  • Qee cov tshuaj qaug dab peg kuj tuaj yeem txo cov txiaj ntsig ntawm cov tshuaj tiv thaiv kev yug menyuam, piv txwv li cov tshuaj tiv thaiv kab mob xws li:
    • Carbamazepine (Tegretol)
    • phenytoin (Dilantin)
    • primidone (Mysoline) hmoov
    • Topiramate (Topamax, Qudexy XR)
    • Felbatol (zeeg)
    • Oxcarbazepine (Oxtellar XR, Trileptal)
    • thiab barbiturates zoo li phenobarbital
  • Qee cov tshuaj HIV, xws li efavirenz, protease inhibitors, lossis tshuaj tiv thaiv kab mob kuj tseem tuaj yeem cuam tshuam kev tiv thaiv kev yug menyuam.
  • Ob qhov kev tshawb fawb me me qhia tias St. John lub wort tuaj yeem ua rau lub siab enzymes, uas tuaj yeem ua rau cov tshuaj tiv thaiv kev yug menyuam metabolism thiab txo cov kev kho mob . Qhov no tuaj yeem ua tau nrog thaj thiab lub nplhaib tswj kev yug menyuam, ib yam nkaus.

Yog tias koj tab tom noj ib yam ntawm cov tshuaj no siv cov hnab looj tes ua ib txoj hauv kev thaub qab. Tham nrog koj tus kws kho mob txog kev hloov mus rau lwm txoj hauv kev uas tsis yog tshuaj tiv thaiv kev yug menyuam (piv txwv li: tooj liab IUD lossis lub diaphragm) yog tias koj yuav nyob rau cov tshuaj sib cuam tshuam ntev.

Qhov no tsis yog txhua qhov kev sib cuam tshuam nrog kev tswj kev yug menyuam. Siv cov Sib tham sib Checker txhawm rau tshuaj xyuas cov tshuaj muaj peev xwm cuam tshuam nrog koj txoj kev tswj kev yug menyuam thiab tshuaj xyuas nrog koj tus kws kho mob lossis tus kws muag tshuaj.

Thiab nco ntsoov, lub ntsiab yog vim li cas cov poj niam cev xeeb tub thaum siv cov tshuaj yog vim lawv tsis coj kom raug .

  • Cov tshuaj tiv thaiv kev yug menyuam ua tsis tau tsawg kawg yog 1% ntawm lub sijhawm nyob rau hauv cov xwm txheej zoo meej, thiab txog li 9% ntawm lub sijhawm nrog kev siv ib txwm, yog li kev noj koj cov ntsiav tshuaj raws li qhia lossis rau siab ntseeg siv lwm txoj kev tiv thaiv kev xeeb tub yog tus yuam sij rau kev tiv thaiv cev xeeb tub.
  • Lwm yam xwm txheej, xws li ntuav lossis raws plab ntev dua 48 teev kuj tseem tuaj yeem txo qis npaum li cas cov tshuaj tiv thaiv kev xeeb tub, thiab.

Saib Planned Parenthood yog xav paub ntxiv.

Saib ntxiv

Qhov chaw

  • Aronson JK, Ferner RE. Kev soj ntsuam ntawm cov ntawv ceeb toom ntawm kev xeeb tub tsis xav tau cuam tshuam nrog kev siv cov tshuaj tsis-enzyme-inducing tshuaj tua kab mob thiab tshuaj hormonal contraceptives
    BMJ Evidence-Based Medicine Published Online First: 18 August 2020. doi: 10.1136/bmjebm-2020-111363
  • Cov tshuaj tua kab mob tuaj yeem txo qis cov tshuaj tiv thaiv kev yug menyuam. Drugs.com. Lub Yim Hli 19, 2020. Tau qhov twg los: find-drugs-conditionsnews/antibiotics-might-lower-effectiveness-birth-control-pill-92216.html
  • Simmons KB, Haddad LB, Nanda K, et al. Cov tshuaj sib cuam tshuam ntawm rifamycin tshuaj tua kab mob thiab tshuaj tiv thaiv hormonal: kev tshuaj xyuas zoo. BJOG. 2018; 125(7):804-811. doi: 10.1111/1471-0528.15027
  • Mayo Clinic. FAQ: Cov txiaj ntsig, kev pheej hmoo thiab kev xaiv. Tau txais los ntawm Lub Ob Hlis 19, 2020 ntawm 8 https://www.mayoclinic.org/healthy-lifestyle/birth-control/in-depth/birth-control-pill/art-20045136
  • Dickinson BD, Altman RD, Nielsen NH, et al. Cov tshuaj sib cuam tshuam ntawm cov tshuaj tiv thaiv qhov ncauj thiab tshuaj tua kab mob. Obstet Gynecol. Xyoo 2001; 98: 853.
  • Archer JS, Archer DF. Kev siv tshuaj tiv thaiv qhov ncauj thiab kev sib cuam tshuam ntawm cov tshuaj tua kab mob: cov lus dab neeg debunked. J Am Acad Dermatol. 2002; 46:917.
  • Barditch-Crovo P, Trapnell CB, Ette E, et al. Cov teebmeem ntawm rifampin thiab rifabutin ntawm cov tshuaj pharmacokinetics thiab pharmacodynamics ntawm kev sib xyaw qhov ncauj qhov ncauj. Clin Pharmacol Ther. Xyoo 1999; 65: 428.
  • Weaver K, Glasier A. Kev sib cuam tshuam ntawm cov tshuaj tua kab mob dav dav thiab cov tshuaj tiv thaiv qhov ncauj ua ke. Kev tshuaj xyuas cov ntaub ntawv. Kev tiv thaiv kab mob. Xyoo 1999; 59: 71.
  • Martin K, Barbieri R, Crowley W, Martin K. Mus txog hnub tim. Ua ke cov tshuaj estrogen-progestin cov tshuaj tiv thaiv qhov ncauj: kev xaiv tus neeg mob, kev sab laj, thiab siv. Cov tshuaj sib cuam tshuam. Tau txais los ntawm Lub Ib Hlis 18, 2020 thaum https://www.uptodate.com/contents/overview-of-the-use-of-combination-oral-contraceptives
  • Kev kawm tus neeg mob: Hormonal method of birth control (Beyond the Basics). Txog hnub tim. Tau txais los ntawm Lub Ob Hlis 19, 2020 ntawm 8 https://www.uptodate.com/contents/hormonal-methods-of-birth-control-beyond-the-basics
  • DeRossi SS, Hersh EV. Cov tshuaj tua kab mob thiab tshuaj tiv thaiv qhov ncauj. Dent Clin North Am. 2002; 46(4): 653-664. doi: 10.1016/s0011-8532(02)00017-4

Cov ntaub ntawv ntxiv

Nco ntsoov sab laj nrog koj tus kws kho mob kom paub meej tias cov ntaub ntawv uas tshwm sim hauv nplooj ntawv no siv tau rau koj tus kheej.