Kontraceptivne pilule i dijabetes?

Postoji mnoštvo rešenja zaštite od neželjene trudnoće za žene sa dijbetesom tip 1 ili 2. Kontraceptivne pilule su veoma dobar izbor jer sadrže vrlo nizak nivo estrogena, mada će vam uz njihovo korišćenje možda biti potrebno malo više insulina, jer vas hormoni mogu dovesti do toga da postanete insulin rezistentni.
Postoje 2 vrste kontraceptivnih pilula- one sa kombinacijom estrogena i progestagena i one koje sadrže samo progestagen.
Najpopularniji tip pilula su kombinovane pilule. One sadrže estrogen, čija je uloga da spreči ovulaciju, i progestagen, koji izaziva zadebljanje sluzokože grlića materice. Dobre strane ovih pilula su što sprečavaju začeće u 99 odsto slučajeva (onaj jedan procenat uglavnom otpada na žene koje su zaboravile da uzmu pilulu, kao i na veoma gojazne žene, kod kojih pilula ima slabije dejstvo zbog znatno povećane količine masti u organizmu) i što vrlo često ublaže akne i menstrualne grčeve, plus, menstruacije često postanu kraće i manje obilne. Loša strana ovih pilula jeste što kod nekih žena izazivaju nuspojave kao što su mučnina i promene na koži.
Još jedan popularan tip pilula, naročito kod mladih devojaka, jesu pilule sa malim sadržajem hormona. Ove pilule sadrže nešto manju količinu estrogena, a potpuno istu količinu progestogena. Što se sprečavanja začeća tiče, efikasne su koliko i kombinovane pilule i podjednako dobro utiču na ten i na sprečavanje menstrualnih grčeva. Njihova dodatna prednost je što i devojke kod kojih kombinovana pilula izaziva mučninu mogu da ih koriste bez problema. Negativna strana ovog tipa pilula jeste što nose veći rizik kod problema sa kožom nego što je slučaj sa kombinovanim pilulama.
Kod kombinovanih pilula postoji veća verovatnoća da dođe do promena vrednosti šećera u krvi zato što sarže kombinaciju sintetičkih hormona estrogena i progestagena, tako da se ženama sa dijabetesom više preporučuje druga vrsta kontraceptivnih pilula, sa malim sadržajem hormona. Kontraceptivne pilule nisu preporučljive ukoliko patite od bolesti srca, imate slabu cirkulaciju ili visok krvni pritisak.
Kondomi, dijafragma, hemijska kontraceptivna sredstva (vaginalna krema, tableta, pasta, želea, pena, ABF i C film) se sa sigurnošću mogu koristiti. Možda ćete želeti da konsultujete svog lekara kako biste proverili da li su hormonski implanti i injekcije pogodne za vas, jer pružaju kontracepciju tokom dužeg perioda. Međutim, oni mogu uticati na dobru kontrolu dijabetesa.
Druga opcija za neke žene je intrauterina kontracepcija. To je metod kontracepcije koji se zasniva na postavljanju malog, savitljivog umetka od plastične mase u šupljinu materice, kod nas popularno nazvanim „spirala“. Ti Intrauterini ulošci (IUU) deluju na nivou materice tako što stvaraju sredinu nepovoljnu za preživljavanje spermatozoida i na taj način sprečavaju da uopšte dođe do oplodnje jajne ćelije. Istovremeno ometaju biohemijsko sazrevanje endometrijuma i izazivaju enzimske promene u njemu, sprečavajući na taj način usađivanje oplođene jajne ćelije, ukoliko je do oplodnje kojim slučajem došlo. Preporučuju se ženama koje su završile sa rađanjem ili su imale bar jedan porođaj. Aplikuju se kod prethodno pregledane i ispitane žene, idealno bi bilo poslednjeg dana menstruacije. Zbog povećane šanse nastanka infekcija IUU se ne preporučuju većini žena koje imaju dijabetes.
*Istraživanja o ženama sa dijabetesom koje koriste kontraceptivne pilule
Prema istraživanjima Američkog Udruženja za borbu protiv dijabetesa (ADA), žene sa dijabetesom koje piju kontraceptivne pilule ne podležu većoj vrednosti šećera u krvi, lipidima i holesterolu, nego ostale žene sa dijabetesom koje ne uzimaju pilule. To znači da tokom izvođenja ovih istraživanja nije došlo do značajnih razlika vrednosti šećera u krvi, lipidima i holesterolu u poređenju žena koje imaju dijabetes i piju i one koje imaju dijabetes, a ne piju kontraceptivne pilule. Te iz ovog razloga ADA preporučuje i ukazuje na to da su kontraceptivne pilule bezbedne za žene sa dijabetesom.
Na kraju se postavlja pitanje sa početka teksta, da li uzimati pilule ili ne?
Odluku o uzimanju kontraceptivnih pilula donosi sama žena koja boluje od dijabetesa u konsultaciji sa svojim lekarom. Jedno rešenje je da se uzimaju kontraceptivne pilule i da se intezivno prati nivo šećera u krvi i nivo holesterola, kako bi se videlo da li pilule utiču na kontrolu dijabetesa.
Ako imate neke nedoumice i pitanja ne ustručavajte se da pitate lekara i da se posavetujete sa edukatorima za dijabetes. Takođe, budite svesni ostalih kontraceptivnih metoda, o kojima smo pisali, a koje su manje rizična za vaš dijabetes i na osnovu svega toga donesite pravilnu odluku.
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