Strict Standards: call_user_func_array() expects parameter 1 to be a valid callback, non-static method JModuleHelper::renderModule() should not be called statically in /home/vasginek/public_html/libraries/joomla/cache/handler/callback.php on line 99

Strict Standards: Non-static method JFactory::getApplication() should not be called statically in /home/vasginek/public_html/plugins/system/advancedmodules/modulehelper.php on line 143

Strict Standards: Non-static method JRequest::getCmd() should not be called statically in /home/vasginek/public_html/plugins/system/advancedmodules/modulehelper.php on line 144

Strict Standards: Non-static method JRequest::getVar() should not be called statically in /home/vasginek/public_html/libraries/joomla/environment/request.php on line 255

Strict Standards: Non-static method JRequest::_cleanVar() should not be called statically in /home/vasginek/public_html/libraries/joomla/environment/request.php on line 134

Strict Standards: Non-static method JFilterInput::getInstance() should not be called statically in /home/vasginek/public_html/libraries/joomla/environment/request.php on line 577

Strict Standards: Non-static method JFactory::getConfig() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 394

Strict Standards: Non-static method JRegistryFormat::getInstance() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/registry/registry.php on line 373

Strict Standards: Non-static method JFilterInput::clean() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/registry/format.php on line 45

Strict Standards: Non-static method JFactory::getLanguage() should not be called statically in /home/vasginek/public_html/plugins/system/advancedmodules/modulehelper.php on line 188

Strict Standards: Non-static method JRegistryFormat::getInstance() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/registry/registry.php on line 373

Strict Standards: Non-static method JFilterInput::clean() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/registry/format.php on line 45

Strict Standards: Non-static method JRequest::getBool() should not be called statically in /home/vasginek/public_html/plugins/system/advancedmodules/modulehelper.php on line 219

Strict Standards: Non-static method JRequest::getVar() should not be called statically in /home/vasginek/public_html/libraries/joomla/environment/request.php on line 217

Strict Standards: Non-static method JRequest::_cleanVar() should not be called statically in /home/vasginek/public_html/libraries/joomla/environment/request.php on line 151

Strict Standards: Non-static method JFilterInput::getInstance() should not be called statically in /home/vasginek/public_html/libraries/joomla/environment/request.php on line 577

Strict Standards: Non-static method JDispatcher::getInstance() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 511

Strict Standards: Non-static method JFactory::getApplication() should not be called statically in /home/vasginek/public_html/plugins/system/advancedmodules/advancedmodules.php on line 132
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Strict Standards: Non-static method JLoader::import() should not be called statically in /home/vasginek/public_html/libraries/loader.php on line 186

Strict Standards: Non-static method JLoader::register() should not be called statically in /home/vasginek/public_html/libraries/loader.php on line 71

Strict Standards: Non-static method JLoader::import() should not be called statically in /home/vasginek/public_html/libraries/loader.php on line 186

Strict Standards: Non-static method JLoader::load() should not be called statically in /home/vasginek/public_html/libraries/loader.php on line 161

Strict Standards: Non-static method JLoader::register() should not be called statically in /home/vasginek/public_html/libraries/loader.php on line 138

Strict Standards: Non-static method JModuleHelper::getLayoutPath() should not be called statically in /home/vasginek/public_html/modules/mod_mainmenu/mod_mainmenu.php on line 42

Strict Standards: Non-static method JFactory::getApplication() should not be called statically in /home/vasginek/public_html/plugins/system/advancedmodules/modulehelper.php on line 266

Strict Standards: Non-static method JDispatcher::getInstance() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 511

Strict Standards: Non-static method modMainMenuHelper::render() should not be called statically in /home/vasginek/public_html/modules/mod_mainmenu/tmpl/default.php on line 82

Strict Standards: Non-static method JSite::getMenu() should not be called statically in /home/vasginek/public_html/modules/mod_mainmenu/legacy.php on line 345

Strict Standards: Non-static method JApplication::getMenu() should not be called statically in /home/vasginek/public_html/includes/application.php on line 345

Strict Standards: Non-static method JLoader::import() should not be called statically in /home/vasginek/public_html/libraries/loader.php on line 186

Strict Standards: Non-static method JMenu::getInstance() should not be called statically in /home/vasginek/public_html/libraries/joomla/application/application.php on line 720

Strict Standards: Non-static method JError::isError() should not be called statically in /home/vasginek/public_html/libraries/joomla/application/application.php on line 721

Strict Standards: Non-static method JFactory::getUser() should not be called statically in /home/vasginek/public_html/modules/mod_mainmenu/legacy.php on line 346

Strict Standards: Non-static method JLoader::import() should not be called statically in /home/vasginek/public_html/libraries/loader.php on line 186

Strict Standards: Non-static method JFactory::getSession() should not be called statically in /home/vasginek/public_html/libraries/joomla/factory.php on line 163

Strict Standards: Non-static method JRegistryFormat::getInstance() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/registry/registry.php on line 373

Strict Standards: Non-static method JFilterInput::clean() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/registry/format.php on line 45

Strict Standards: Non-static method JRoute::_() should not be called statically in /home/vasginek/public_html/modules/mod_mainmenu/legacy.php on line 107

Strict Standards: Non-static method JFactory::getApplication() should not be called statically in /home/vasginek/public_html/libraries/joomla/methods.php on line 41

Strict Standards: Non-static method JFactory::getConfig() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/application.php on line 372

Strict Standards: Non-static method JLoader::import() should not be called statically in /home/vasginek/public_html/libraries/loader.php on line 186

Strict Standards: Non-static method JRouter::getInstance() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 674

Strict Standards: Non-static method JError::isError() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 675

Strict Standards: Non-static method JSite::getMenu() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/router.php on line 419

Strict Standards: Non-static method JApplication::getMenu() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/application.php on line 345

Strict Standards: Non-static method JLoader::import() should not be called statically in /home/vasginek/public_html/libraries/loader.php on line 186

Strict Standards: Non-static method JMenu::getInstance() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 720

Strict Standards: Non-static method JError::isError() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 721

Strict Standards: Non-static method JFactory::getApplication() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/router.php on line 401

Strict Standards: Non-static method JSite::getMenu() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/router.php on line 295

Strict Standards: Non-static method JApplication::getMenu() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/application.php on line 345

Strict Standards: Non-static method JLoader::import() should not be called statically in /home/vasginek/public_html/libraries/loader.php on line 186

Strict Standards: Non-static method JMenu::getInstance() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 720

Strict Standards: Non-static method JError::isError() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 721

Strict Standards: Non-static method JSite::getMenu() should not be called statically in /home/vasginek/public_html/components/com_content/router.php on line 19

Strict Standards: Non-static method JApplication::getMenu() should not be called statically in /home/vasginek/public_html/includes/application.php on line 345

Strict Standards: Non-static method JLoader::import() should not be called statically in /home/vasginek/public_html/libraries/loader.php on line 186

Strict Standards: Non-static method JMenu::getInstance() should not be called statically in /home/vasginek/public_html/libraries/joomla/application/application.php on line 720

Strict Standards: Non-static method JError::isError() should not be called statically in /home/vasginek/public_html/libraries/joomla/application/application.php on line 721

Strict Standards: Non-static method JFactory::getApplication() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/router.php on line 90

Strict Standards: Non-static method JFactory::getConfig() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 394

Strict Standards: Non-static method JFactory::getConfig() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 394

Strict Standards: Non-static method JURI::base() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/router.php on line 109

Strict Standards: Non-static method JRegistryFormat::getInstance() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/registry/registry.php on line 373

Strict Standards: Non-static method JFilterInput::clean() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/registry/format.php on line 45

Strict Standards: Non-static method JRoute::_() should not be called statically in /home/vasginek/public_html/modules/mod_mainmenu/legacy.php on line 107

Strict Standards: Non-static method JFactory::getApplication() should not be called statically in /home/vasginek/public_html/libraries/joomla/methods.php on line 41

Strict Standards: Non-static method JFactory::getConfig() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/application.php on line 372

Strict Standards: Non-static method JLoader::import() should not be called statically in /home/vasginek/public_html/libraries/loader.php on line 186

Strict Standards: Non-static method JRouter::getInstance() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 674

Strict Standards: Non-static method JError::isError() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 675

Strict Standards: Non-static method JSite::getMenu() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/router.php on line 419

Strict Standards: Non-static method JApplication::getMenu() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/application.php on line 345

Strict Standards: Non-static method JLoader::import() should not be called statically in /home/vasginek/public_html/libraries/loader.php on line 186

Strict Standards: Non-static method JMenu::getInstance() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 720

Strict Standards: Non-static method JError::isError() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 721

Strict Standards: Non-static method JFactory::getApplication() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/router.php on line 401

Strict Standards: Non-static method JSite::getMenu() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/router.php on line 295

Strict Standards: Non-static method JApplication::getMenu() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/application.php on line 345

Strict Standards: Non-static method JLoader::import() should not be called statically in /home/vasginek/public_html/libraries/loader.php on line 186

Strict Standards: Non-static method JMenu::getInstance() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 720

Strict Standards: Non-static method JError::isError() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 721

Strict Standards: Non-static method JComponentHelper::getComponent() should not be called statically in /home/vasginek/public_html/components/com_contact/router.php on line 23

Strict Standards: Non-static method JComponentHelper::_load() should not be called statically in /home/vasginek/public_html/libraries/joomla/application/component/helper.php on line 39

Strict Standards: Non-static method JSite::getMenu() should not be called statically in /home/vasginek/public_html/components/com_contact/router.php on line 24

Strict Standards: Non-static method JApplication::getMenu() should not be called statically in /home/vasginek/public_html/includes/application.php on line 345

Strict Standards: Non-static method JLoader::import() should not be called statically in /home/vasginek/public_html/libraries/loader.php on line 186

Strict Standards: Non-static method JMenu::getInstance() should not be called statically in /home/vasginek/public_html/libraries/joomla/application/application.php on line 720

Strict Standards: Non-static method JError::isError() should not be called statically in /home/vasginek/public_html/libraries/joomla/application/application.php on line 721

Strict Standards: Non-static method JFactory::getApplication() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/router.php on line 90

Strict Standards: Non-static method JFactory::getConfig() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 394

Strict Standards: Non-static method JFactory::getConfig() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 394

Strict Standards: Non-static method JURI::base() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/router.php on line 109

Strict Standards: Non-static method JRegistryFormat::getInstance() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/registry/registry.php on line 373

Strict Standards: Non-static method JFilterInput::clean() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/registry/format.php on line 45

Strict Standards: Non-static method JRoute::_() should not be called statically in /home/vasginek/public_html/modules/mod_mainmenu/legacy.php on line 107

Strict Standards: Non-static method JFactory::getApplication() should not be called statically in /home/vasginek/public_html/libraries/joomla/methods.php on line 41

Strict Standards: Non-static method JFactory::getConfig() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/application.php on line 372

Strict Standards: Non-static method JLoader::import() should not be called statically in /home/vasginek/public_html/libraries/loader.php on line 186

Strict Standards: Non-static method JRouter::getInstance() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 674

Strict Standards: Non-static method JError::isError() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 675

Strict Standards: Non-static method JSite::getMenu() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/router.php on line 419

Strict Standards: Non-static method JApplication::getMenu() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/application.php on line 345

Strict Standards: Non-static method JLoader::import() should not be called statically in /home/vasginek/public_html/libraries/loader.php on line 186

Strict Standards: Non-static method JMenu::getInstance() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 720

Strict Standards: Non-static method JError::isError() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 721

Strict Standards: Non-static method JFactory::getApplication() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/router.php on line 401

Strict Standards: Non-static method JSite::getMenu() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/router.php on line 295

Strict Standards: Non-static method JApplication::getMenu() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/application.php on line 345

Strict Standards: Non-static method JLoader::import() should not be called statically in /home/vasginek/public_html/libraries/loader.php on line 186

Strict Standards: Non-static method JMenu::getInstance() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 720

Strict Standards: Non-static method JError::isError() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 721

Strict Standards: Non-static method JSite::getMenu() should not be called statically in /home/vasginek/public_html/components/com_content/router.php on line 19

Strict Standards: Non-static method JApplication::getMenu() should not be called statically in /home/vasginek/public_html/includes/application.php on line 345

Strict Standards: Non-static method JLoader::import() should not be called statically in /home/vasginek/public_html/libraries/loader.php on line 186

Strict Standards: Non-static method JMenu::getInstance() should not be called statically in /home/vasginek/public_html/libraries/joomla/application/application.php on line 720

Strict Standards: Non-static method JError::isError() should not be called statically in /home/vasginek/public_html/libraries/joomla/application/application.php on line 721

Strict Standards: Non-static method JFactory::getApplication() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/router.php on line 90

Strict Standards: Non-static method JFactory::getConfig() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 394

Strict Standards: Non-static method JFactory::getConfig() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 394

Strict Standards: Non-static method JURI::base() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/router.php on line 109

Strict Standards: Non-static method JRegistryFormat::getInstance() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/registry/registry.php on line 373

Strict Standards: Non-static method JFilterInput::clean() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/registry/format.php on line 45

Strict Standards: Non-static method JRoute::_() should not be called statically in /home/vasginek/public_html/modules/mod_mainmenu/legacy.php on line 107

Strict Standards: Non-static method JFactory::getApplication() should not be called statically in /home/vasginek/public_html/libraries/joomla/methods.php on line 41

Strict Standards: Non-static method JFactory::getConfig() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/application.php on line 372

Strict Standards: Non-static method JLoader::import() should not be called statically in /home/vasginek/public_html/libraries/loader.php on line 186

Strict Standards: Non-static method JRouter::getInstance() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 674

Strict Standards: Non-static method JError::isError() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 675

Strict Standards: Non-static method JSite::getMenu() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/router.php on line 419

Strict Standards: Non-static method JApplication::getMenu() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/application.php on line 345

Strict Standards: Non-static method JLoader::import() should not be called statically in /home/vasginek/public_html/libraries/loader.php on line 186

Strict Standards: Non-static method JMenu::getInstance() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 720

Strict Standards: Non-static method JError::isError() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 721

Strict Standards: Non-static method JFactory::getApplication() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/router.php on line 401

Strict Standards: Non-static method JSite::getMenu() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/router.php on line 295

Strict Standards: Non-static method JApplication::getMenu() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/application.php on line 345

Strict Standards: Non-static method JLoader::import() should not be called statically in /home/vasginek/public_html/libraries/loader.php on line 186

Strict Standards: Non-static method JMenu::getInstance() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 720

Strict Standards: Non-static method JError::isError() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 721

Strict Standards: Non-static method JSite::getMenu() should not be called statically in /home/vasginek/public_html/components/com_content/router.php on line 19

Strict Standards: Non-static method JApplication::getMenu() should not be called statically in /home/vasginek/public_html/includes/application.php on line 345

Strict Standards: Non-static method JLoader::import() should not be called statically in /home/vasginek/public_html/libraries/loader.php on line 186

Strict Standards: Non-static method JMenu::getInstance() should not be called statically in /home/vasginek/public_html/libraries/joomla/application/application.php on line 720

Strict Standards: Non-static method JError::isError() should not be called statically in /home/vasginek/public_html/libraries/joomla/application/application.php on line 721

Strict Standards: Non-static method JFactory::getApplication() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/router.php on line 90

Strict Standards: Non-static method JFactory::getConfig() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 394

Strict Standards: Non-static method JFactory::getConfig() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 394

Strict Standards: Non-static method JURI::base() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/router.php on line 109

Strict Standards: Non-static method JRegistryFormat::getInstance() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/registry/registry.php on line 373

Strict Standards: Non-static method JFilterInput::clean() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/registry/format.php on line 45

Strict Standards: Non-static method JRoute::_() should not be called statically in /home/vasginek/public_html/modules/mod_mainmenu/legacy.php on line 107

Strict Standards: Non-static method JFactory::getApplication() should not be called statically in /home/vasginek/public_html/libraries/joomla/methods.php on line 41

Strict Standards: Non-static method JFactory::getConfig() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/application.php on line 372

Strict Standards: Non-static method JLoader::import() should not be called statically in /home/vasginek/public_html/libraries/loader.php on line 186

Strict Standards: Non-static method JRouter::getInstance() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 674

Strict Standards: Non-static method JError::isError() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 675

Strict Standards: Non-static method JSite::getMenu() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/router.php on line 419

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BMI Kalkulator

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Kalkulator kalorija

Starost(god)
Visina(cm)
Težina(kg)
Pol
Aktivnost

Kalkulator trudnoce

Unesite datum poslednjeg ciklusa:
Da li se menstruacije mogu odložiti i da li to treba da se savetuje?
Ocena korisnika: / 13
LošeNajbolje 
Napisao Dr Anđela Petrović - Milinković   

Upravo ulazimo u period godine kada u ambulanti često čujem pitanje: kako da odložim menstruaciju i da li će mi to škoditi? Naravno, i tokom godine, brojnim povodima, reagujem u cilju rešavanja identičnog problema. U proteklim decenijama bilo je gotovo prirodno da ženama propadne letovanje i boravak na moru zbog regularnog menstrualnog krvarenja.

Sećam se svoje prijateljice, veoma mlade, na dan svog venčanja sa prvim danom ciklusa- gotovo uništeno zadovoljstvo. Tada je retko postojala mogućnost da se većina od nas upozna sa sada već opšte prihvaćenim mogućnostima. Veliki procenat predrasuda vezanih za pilulu uopšte je premošten, pa i za ovu mogućnost odlaganja ciklusa kada za to postoji valjan razlog.
Obično se ovo pitanje postavlja pred odlazak na more. Neke devojke imaju iskustvo od prethodne godine, druge su krajnje bojažljive, negde su čule za postojanje ovih tableta koje nude novu mogućnost.
Moja dugogodišnja pacijentkinja bavi se aktivno atletikom. Kada ima važne pripreme i takmičenja obično se javlja sa ovim zahtevom jednom godišnje. Brojni su primeri devojaka koje imaju slične želje zbog letovanja, ekskurzije, boravka u prirodi, što zbog komfora to i zbog nemogućnosti održavanja adekvatne higijene. Sećam se pacijentkinje koja je iznenada dobila poziv da bude kuma prijateljici van zemlje i jedan od deprimirajućih momenata je bila činjenica da upravo u tom periodu očekuje menstrualno krvarenje. Gotovo sa nevericom je shvatila da će se rešiti opterećujućeg problema.
Kada se javi pacijentkinja sa ovim zahtevom obavim ginekološki pregled i ultrazvuk male karlice i dam preporuku da krene sa Primolut-Nor tabletama ( sintetski gestageni) 3 dana pre očekivane menstruacije, 2 puta na dan po jednu tabletu, najduže 14 dana, a očekivano krvarenje se uspostavlja 3 do 5 dana nakon poslednje tablete.

Šta su sintetski gestageni?

Da bi razumeli dejstvo gestagena osvrnućemo se na endometrijalni ciklus koji označava ciklične promene na funkcionalnom sloju endometrijuma pod uticajem hormona jajnika. On se deli na
▪ proliferativnu fazu ( ranu, srednju, kasnu)
▪ sekretornu fazu ( ranu, srednju, kasnu)
▪ menstruaciju
Prva faza počinje nakon menstruacije i traje do ovulacije. Estrogeni stvoreni u folikulu stimulišu endometrijum (sluzokoža materice) na proliferaciju i on zadebljava 1 mm na početku do 6-7 mm do kraja ove faze.
Druga faza, pod uticajem progesterona, dovodi do sekretornog preobražaja endometrijuma. Maksimalna transformacija se događa 22-23 dana ciklusa i koincidira sa maksimalnom koncentracijom progesterona.
I na kraju zbog pada koncentracije estrogena i progesterona i propadanja endometrijuma dolazi do odbacivanja funkcionalnog sloja i krvarenja. Gestageni sprečavaju dalju proliferaciju endometrijuma, i indukuju njegovu sekretornu transformaciju, a kada nakon upotrebe ovih preparata nastupi krvarenje, materica će odbaciti hiperplastični endometrijum skoro potpuno kao kod kiretaže.
Devojke koje su već na oralnoj kontracepciji jednostavnije rešavaju moguću poteškoću. Njima savetujem da u kontinuitetu, bez pauze od 7 dana, nastave sa novom kutijom kontraceptiva i tako odlažemo očekivano krvarenje.
Oralni kontraceptivi deluju kako na supresiju, tako i na promenu svojstava sluzi grlića materice, do stvaranja hipoplastičnog endometrijuma, a utiču i na kretanje u jajovodu. Najbitnije za nas u ovoj priči su promene na endometrijumu koje su reverzibilne i idu od hipoplazije do atrofije.
Jedno od izrazito dobrih rešenja je progesteronska spirala ( Mirena). Nakon postavljanja ove spirale pacijentkinja ima uredan hormonski status, ali je bez menstrualnog krvarenja. Idealno za komforan život žene.
Povremeno se doktori odlučuju na uključivanje hormonske terapije kako kod izrazitih anemija, tako i kod iregularnih krvarenja, kako bi se pacijentkinjama pomoglo u saniranju osnovnog oboljenja.
Kada imate ovakve probleme ili potrebe obavezno se javite ginekologu da vam pomogne u izboru najadekvatnijeg rešenja i prijatan odmor uz naš savet.

 

dr Nađa Ćurčić
specijalista ginekologije i akušerstva
www.21dan.com

 
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