Vanosvika 60% yevarume nhasi vanoti vakagadzirira kushandisa nzira dzekudzivirira nadzo pamuviri. Zvakadaro, kuwanda kwenzira dzekudzivirira kubata pamuviri dzechirume kunoramba kuri kushoma panguva ino uye dzimwe nzira dzakajairwa hadzina kunyatsoshanda. Kutaura zvazviri, kudzivirira kwepamuviri kunogona kuitika kuchiri kuwira, muhuwandu hwakawanda hwezviitiko, kumukadzi. Ndedzipi nzira dzakajairika dzekudzivirira kubata pamuviri kwevarume nhasi? Ndedzipi nzira dzevarume dzakavimbika dzekudzivirira pamuviri? Overview.

Kondomu revarume ndiro rinoshandiswa zvakanyanya kudzivirira kubata pamuviri kwevarume: 21% yevakaroorana vanorishandisa pasi rose.

Kondomu rechirume chii?

Kondomu rechirume ndeimwe yezvinonzi "chipingamupinyi" nzira dzekudzivirira kubata pamuviri uye ine membrane yakatetepa, inowanzogadzirwa nelatex, inoiswa panhengo yemurume musati masangana, kudzivirira kubuda kwembeu mumukadzi. Kondomu yechirume inokurudzirwa, maererano neHaute Autorité de Santé, "kana pasina mudiwa akagadzikana kana senzira yekutsiva inofanira kuchengetwa iripo kana pane imwe nguva isingasvikike kana kutadza kutevedzera nzira yehomoni".

Kondomu rinoshanda here?

Kondomu revarume rinoonekwa senzira yekudzivirira pamuviri inoshanda. Zvechokwadi, iyo Pearl index, iyo inobvumira kuongorora chikamu che "tsaona" pamuviri pamusoro pegore rekushandisa zvakakwana, ndeyechokwadi 2. Asi chaizvoizvo, kondomu inonyanya kugutsikana mukudzivirira kubata pamuviri. isingadiwi nekutadza kwehuwandu hwe15% nekuda kwemamiriro ayo ekushandiswa. Kutadza uku kunonyanya kukonzerwa nekutyoka kwemakondomu, asiwo nekusashandiswa kwaro zvisina tsarukano, kana kutombobuda kwaro panguva yebonde.

Ndezvipi zvakanakira nekuipira kondomu revarume?

Zvakadaro, zvakanakira kondomu revarume zvakawanda uye zvazvakaipira, pane zvishoma.

Pakati pezvakanakira zvayo pane :

• Kusvikika kwayo : makondomu haadhure uye anowanikwa zvakanyanya (masupamaketi, zvitoro zvemishonga, nezvimwewo)
• Kubudirira kwayo pakurwisa zvirwere zvepabonde : kondomu (revarume kana vakadzi) ndiyo yega nzira yekudzivirira kubata pamuviri inoshanda pakurwisa zvirwere zvepabonde. Naizvozvo inokurudzirwa muhukama hune njodzi (vakawanda vanofambidzana, hukama hwemazuva ese) kana pasina hukama hwakagadzikana.
• Kuenderana kwayo neimwe nzira yekudzivirira kubata pamuviri (mahomoni echikadzi kana kuti intrauterine contraception, spermicide, zvichingodaro), tisingabatanidzi kondomu revakadzi.

Pakudzika, kondomu rinogona…

• kukurudzira kutanga kwekuita muvanhu vane allergy kune latex. Pazvinenge zvakakodzera, makondomu epolyurethane, ayo asingaratidzi njodzi yeallergy, anofanira kusarudzwa.

• kurasikirwa nekubudirira kana kushandiswa zvisiri izvo, nokudaro kukosha kwekudzidza nezvemaitiro akanaka (pfekedza kondomu zvachose musati matanga kusangana, ribate neruoko rwako paunenge uchibvisa, nezvimwewo)
• njodzi dziripo dzekutsvedza nekutyoka. Sezvo zvakadaro, kunyanya hazvikurudzirwi kushandisa mafuta-based lubricants nekondomu ye latex yevarume, pangozi yekunyadzisa inonzi latex uye kukurudzira kuputika kwekudzivirira pamuviri.
• kuderedza kana kugadzirisa manzwiro panguva yepabonde mune vamwe vashandisi.

Mutengo werudzi urwu rwekudzivirira pamuviri?

Mutengo wepakati pekondomu revarume uri pakati pemasendi makumi mashanu nemakumi manomwe pachidimbu. Uye zvinopesana nezvinotendwa nevakawanda, kondomu rinogona kuvharwa neHealth Inishuwarenzi mune mamwe mamiriro. Chokwadi, kubvira 50, mamwe mabhokisi, anowanikwa muma pharmacy, anogona kudzoserwa kusvika makumi matanhatu muzana kana akanyorerwa nachiremba kana nyamukuta (pamusana pemutengo wekutengesa we $ 70, € 2018 yebhokisi re 60, € 1,30 yebhokisi re6 uye € 2,60 yebhokisi re12.). Vanogonawo kuwanikwa pachena kunzvimbo dzekuronga mhuri.

Kuvhiringidzwa kwe coitus, inozivikanwawo senzira yekubvisa, inoshandiswa nevanenge 5% yevarume pasi rose, 8% muFrance. Uyu murume wekudzivirira kubata pamuviri angadai akawana mukurumbira panguva ye "dambudziko repiritsi" uye mubvunzo wekudzivirira kwehomoni yevakadzi muna 2012.

Ndeipi nzira yekubvisa?

Nzira yekubvisa inosanganisira, sezvinoreva zita, kubvisa nhengo yemurume uye nzvimbo yakapoteredza vulva isati yabuda. Sezvo zvakadaro, ndeimwe ye "zvakasikwa" nzira dzekudzivirira kubata pamuviri dzevarume, imwe yevashoma vane inonzi "thermal" maitiro.

Ko interrupted coitus chirongwa chekudzivirira pamuviri chemurume here?

Mune dzidziso, ine Pearl index ye4, yakakanganiswa coitus inoramba yakarongedzerwa, maererano neHaute Autorité de Santé, muchikamu chekubudirira kwechirume kudzivirira kubata pamuviri… chero bedzi ichishandiswa nemazvo uye nguva dzose. Asi mukuita, chiyero chekukundikana chakanyanya kwazvo (27%). Iyo nzira yekubvisa yega saka haikurudzirwe nevashandi vehutano.

Ndezvipi zvakanakira uye zvakaipira nzira yekubvisa?

Kubatsira kukuru kwenzira yekubvisa ndiyo yayo “kuwanikwa” : yakasununguka, inowanikwa mumamiriro ese ezvinhu, pasina contraindications, saka inowanzoonekwa se "zviri nani pane chinhu".

Asi drawback yayo huru inoramba iri yayo kushanda zvishoma. Zvechokwadi, nzira iyi haidi chete kutonga kwakakwana kwekubuda (izvo zvisiri nguva dzose), asi kunyange kana "zviri pachena" iyo nyaya, iyo pre-seminal fluid (inotangira mbeu uye kubuda uye saka inogona kuiswa. munhengo yemukadzi) ine urume uye nekudaro inogona kusanganisa iyo oocyte panguva yekuzvimba. Uyewo, kuvhiringidza coitus hakudziviriri pazvirwere zvepabonde.

Vasectomy inzira yekudzivirira kubata pamuviri nezvinangwa zvekudzivirira kubata pamuviri (kana kuti nzira chaiyo yekudzivirira kubata pamuviri mumutauro wemazuva ese) inoshandiswa ne2% yevakaroorana pasi rose, isingasviki 1% muFrance. Inoshanda zvakanyanya, asi inoonekwa se isingachinjiki. Saka inongokurudzirwa chete kune varume vanoshuvira nzira yechigarire yekudzivirira kubata pamuviri uye inofanira kunge iri nyaya yeruzivo rwakadzama uye kufungisisa.

Chii chinonzi vasectomy?

Vasectomy kuvhiyiwa kuvhara vas deferens, izvo zvinoita kuti urume huyerere kubva muma testes. Mushure mevasectomy, urume nokudaro hausisina spermatozoa (azoospermia), kusangana kweoocyte mushure mekubuda (uye nokudaro nhumbu) haichagoneki.

Vasectomy inoshanda here?

Vasectomy inoshanda zvikuru. Yayo theoretical Pearl index ndeye 0,1% mudzidziso uye 0,15% mukuita kwazvino. Mimba isingatarisirwi naizvozvo ishoma zvikuru.

Ndezvipi zvakanakira uye zvakaipira zvevasectomy?

Kubatsira kukuru kwevasectomy kuri pamusoro pese kushanda kwayo. Mamwe mapoinzi ayo akanaka?

• Izvo hazvikanganisi erectile basa, kunyanya nokuti haikanganisi, sezvinowanzogona kutenda, kugadzirwa kwehomoni dzevarume. Unhu hweiyo erection, kuwanda kweiyo ejaculate, manzwiro anoramba akafanana.
• Iyo haina kumanikidzwa kwezuva nezuva uye ye (yakanyanya) nguva yakareba.
• Kuvhiyiwa kunowanzotenderwa zvakanyanya.

Pakati pemapoinzi ayo asina kunaka, zvakakosha kuyeuka kuti vasectomy ...

• hazvidzoreki: nzira dzemazuva ano dzakanangana nekuita kuti vas deferens ipindike zvakare ine mhedzisiro isina chokwadi. Nechikonzero ichi, vasectomy inoonekwa seyekupedzisira, isingabvumiri chirongwa chemwana chinotevera. Ichi ndicho chikonzero nguva yekutonhora yemwedzi ye4 inoiswa. Pamusoro pezvo, murapi anogona kupa zano rekuita cryopreservation yesperm (kutonhora kwemagametes) munzvimbo yakatsaurirwa yekurapa (CECOS).
• haishande nekukasira. Iyo seminal vesicle (inoburitsa urume) inogona kunge ichiri nembeu pakati pemasvondo masere kusvika gumi nematanhatu mushure mekuvhiyiwa kana mushure mekubuda kwemakumi maviri. Kupindirana kwekudzivirira kubata pamuviri saka kunonyorerwa kwemwedzi mitatu mushure mekuvhiyiwa uye kuwedzerwa kusvika kusavapo kwembeu kwasimbiswa nespermogram.
• haidziviriri kubva kuzvirwere zvepabonde,
• zvinogona kutungamirira kumatambudziko epashure (kubuda ropa, kuputika, utachiona, kurwadziwa, nezvimwewo) mu1 kusvika ku2% yezviitiko. Zvisinei, izvi zvinogona kutsigirwa.
• ane zvimwe contraindications : WHO inogara ichikurudzira kufunga nezvevasectomy pane imwe nyaya-ne-case hwaro kuti tifunge nezve "mamiriro ese nemamiriro ezvinhu anoda mamwe matanho". Uye zvakare, zvimwe zvikonzero zvekurapa chete zvinogona kutungamira kumisikidza kupindira kwakadai sehutachiona hwemunharaunda (STIs, epididymitis, orchitis, nezvimwewo), hutachiona hwese kana gastroenteritis, kuzivikanwa kwehuwandu muscrotum, nezvimwe.

Mutengo werudzi urwu rwekudzivirira pamuviri?

Vasectomy inodhura paavhareji 65 euros uye inovharwa kusvika 80% neHealth Inishuwarenzi.

Male thermal contraceptive (kana CMT) nzira dzakabva pane zvinodzima mhedzisiro yekupisa pakuzvara kwemurume. Kana ivo vari vekutanga pane kutendeseka, ivo parizvino havasati vasvika zvakanyanya kana vachifanira kunge vari nyaya yekusimbiswa kwesainzi.

Chii chinonzi thermal male contraception chinosanganisira?

CMT yakavakirwa pazviri nyore physiological observation: kuti spermatogenesis ive yakanaka, ma testes anofanirwa kunge ari zvachose pane tembiricha yakadzikira zvishoma pane yemuviri (pakati pe2 ne4 ° C). Nechikonzero ichi kuti scrotum iri anatomically kunze kwemuviri. Pane zvinopesana, kana tembiricha muma testes yakanyanya, spermatogenesis inogona kukanganisa. CMT saka ine chinangwa chekusimudzira kukwira kwenzvimbo iyi kwekushisa kuitira kuti spermatozoa isaite fetereza, kutadza kugadzira azoospermia. Izvi zvinogona kuwanikwa nenzira dzakawanda. Sechinyakare, CMT yakange yakavakirwa painodzokororwa yekugezera inopisa (pamusoro pe41 ° C). Munguva pfupi yapfuura, nzira mbiri dzekusimudza kupisa dzakagadzirwa:

• kupfeka zvipfeko zvemukati uchishandisa thermal insulation (maawa makumi maviri nemana pazuva)
• kuchengeta machende ari pakakwirira (inonzi supra-scrotal) kweanenge maawa gumi nemashanu pazuva, zvakare nekuda kwechipfeko chemukati chaimo. Tinobva tataura nezve artificial cryptorchidism.

Kubata pamuviri kwechirume kwechirume kunoshanda here?

Nhasi, artificial cryptorchidism ndiyo yakanyanya kuongororwa nekuda kwebasa raDr. Mieusset. Iyi tekinoroji inoonekwa seyakashanda, kunyangwe ichiri kuda kuve musoro wezvidzidzo zvitsva zvekutonga kuti titarise huwandu hwevanhu. Yakayedzwa pa51 vakaroorana uye 536 kuratidzwa kutenderera, zvakangopa kuti pave nemimba imwe chete, nekuda kwekukanganisa mukushandiswa kwenzira.

Ndezvipi zvakanakira nekuipira kwechirume chekudzivirira kubata pamuviri?

Pane ino nhanho yekutsvagisa munzvimbo ino, CMT ine hunhu hwekuita zvese zvinobudirira, kana maitiro ayo ekushandisa akanyatsoshandiswa, uye achidzoreredzwa. Inogona zvakare kuve yenguva refu: iyo yakakurudzirwa nguva inogona kusvika kumakore mana.

Zvisinei, kupisa kwekudzivirira kwemurume kune zvimwe zvipingamupinyi, zvinoti:

• Kusagadzikana zvakabatana nekupfeka zvipfeko zvemukati zvakagadzirirwa chinangwa ichi (zvinonzwikwa nemumwe muvarume vaviri)
• chimwe chinomanikidza: kana chipfeko chemukati chisina kupfekwa kwemaawa angangoita gumi nemashanu pazuva kana kuti chisina kupfekwa zvachose kwezuva, mhedzisiro yekudzivirira haina kuvimbiswa. Mukuwedzera, kushanda kwespermograms nguva dzose kusati kwaona kushanda kwemaitiro kunodiwa (mwedzi mitatu yega yega kwemakore maviri ekutanga, uye mwedzi mitanhatu yega yega).
• Thermal murume kudzivirira pamuviri haidzivirire pazvirwere zvepabonde (STIs).

Mukuwedzera, iyi nzira haina kuratidzwa munyaya ye cryptorchidism yechisikigo (chirwere chekutama kwe testes, iyo inobva yanzi "yakashata yakadzika"), testicular ectopia, inguinal hernia, testicular cancer, varicocele. kufambira mberi uye muvarume vane kufutisa kwakanyanya. 

• CMT inoramba isingasvikike, hapana kugadzirwa kwemaindasitiri panguva ino zvichiita kuti zvikwanise kuwana zvipfeko zvemukati zvakati pamwero mukuru.

Inoshandiswa zvakanyanya muvakadzi, hormonal contraception inoramba yakavanzika kune nguva iri muvarume. Zvakadaro, nzira iyi yanga iri nyaya yezvidzidzo kubvira kuma1970 uye yakatopa mukana wekutendiswa kwekiriniki kuyedzwa kwemakore akati wandei.

Chii chinonzi hormonal male contraception?

Iyo inzira inodzoreredzwa yekudzivirira kubata pamuviri inotarisirwa kuvharidzira spermatogenesis kuburikidza nemishonga yehomoni. Mhando mbiri huru dzeprotocol dzakagadzirwa munzvimbo iyi:

• kudzivirira pamuviri kunobva pa testosterone chete. Iyi monotherapy inobva pane jekiseni rinogara riripo reyero ye testosterone enanthate. Mushure mezvo, chirongwa chakavakirwa pakuburitswa-kwe testosterone kwenguva refu chakatsanangurwa kuitira kuti nzvimbo majekiseni, asi iyo yekupedzisira haisati yashandiswa muFrance.
• kusanganiswa kweprogesterone uye testosterone. Iyi protocol iri kudzidzwa nenzira dzinoverengeka, asi yakanyanya kubudirira nhasi gel yakavakirwa paprogesterone uye testosterone: Nestorone. Kushambadzira kwayo muFrance parizvino hakuna kubvumidzwa.

Munguva pfupi yapfuura, piritsi rekudzivirira pamuviri revarume rinobatanidza chiito che testosterone, androgen uye progesterone rakabudirira kupfuura chikamu chekutanga chekliniki miedzo muUnited States. Inonzi "11-beta-MNTDC", inogona kudzoserwa kumashure uye isina mhedzisiro. Kunyangwe ichivimbisa, iyi imwe nzira yepiritsi yevakadzi haifanirwe kuwanikwa pamusika weAmerica kweanenge makore gumi.

Ko hormonal male contraception inoshanda here?

Monotherapy inobva pa testosterone nhasi ndiyo fomu yeCMH iyo pane uchapupu hwakawanda. Zvidzidzo zvinogadzira iyo Pearl Index kubva ku0,8 kusvika ku1,4 kune enanthate-based contraceptive uye pakati pe1,1 uye 2,3 yeinoramba-yekusunungurwa nzira. Aya maviri ekudzivirira pamuviri echirume echirume anogona nokudaro kunzi anoshanda, kana akanyatsoshanda. Pamusoro pezvo, varume vaiishandisa vanowanzowanazve yakajairika spermatogenesis pakati pemwedzi mitatu ne3 mushure mekurapwa.

Kana iri Nestorone, inoratidzika kuva inovimbisa: miedzo yekiriniki yakaitwa muUnited States inoratidza kushanda kwe85% pasina migumisiro yakaipa.

Ndezvipi zvakanakira uye zvakaipira zvemahomoni echirume ekudzivirira pamuviri?

Kubatsira kukuru kwe testosterone monotherapy kuri pamusoro pezvose zvayo kunyatsoshanda, inofananidzwa neiyo yekudzivirira kubata pamuviri kwechikadzi. Vhiki nevhiki, yaizomiririrawo, kune vakaroorana, chisungo chisinganyanyi kukosha pane kutora kwezuva nezuva kwepiritsi yevakadzi.

Zvisinei, iyi nzira yekudzivirira kubata pamuviri kwevarume ine zvinoverengeka zvisingabatsiri:

• Haisi kushanda pakarepo : zvinowanzodiwa kumirira mwedzi mitatu mushure mekutanga kurapwa kuti izvi zvive zvakadaro.
• Inogumira kumwedzi ye18 yekushandiswa, nekuda kwekushaikwa kwezvidzidzo zvesainzi pamhedzisiro yayo yenguva refu.
• Inoramba ichiganhurira, kunyanya maererano nekutarisa : Kwete chete, kudzivirira kubata pamuviri kwemurume kunobva pa testosterone chete kunoda jekiseni nguva nenguva, asi kuonekwa kwespermogram kunokurudzirwa mwedzi yose ye3 uye kuongororwa kwehupenyu pamwe nekuongororwa kwekliniki mwedzi mitanhatu yega yega.
• Inokurudzira kuonekwa kwemamwe migumisiro senge mburwa (kazhinji), asi zvakare dzimwe nguva hukasha, yakawandisa libido kana kudonha mu libido, kuwedzera uremu ...
• Iine nhamba ye contraindications : varume vanogona kubatsirwa nazvo vanofanira kunge vari pasi pemakore makumi mana nemashanu, vasina mhuri kana nhoroondo yekenza yeprostate, vasingatambudzi necoagulation, moyo, kufema kana chirwere chepfungwa, havafanire (kana zvishoma) kuputa uye / kana kunwa doro. , usanyanyofuta ...