Isifo se-Polycystic ovary

I-Polycystic ovary syndrome (i-PCOS) yisimo lapho owesifazane enamazinga akhuphukayo ama-hormone wesilisa (androgens). Izinkinga eziningi zenzeka ngenxa yalokhu kwanda kwamahomoni, kufaka phakathi:

• Ukungahambi kahle esikhathini
• Ukungabi nenzalo
• Izinkinga zesikhumba ezifana nezinduna nokwanda kokukhula kwezinwele
• Inani elikhulayo lama-cysts amancane kuma-ovari

I-PCOS ixhunyaniswe nezinguquko kumazinga e-hormone enza kube nzima ngama-ovari ukuthi akhulule amaqanda akhule ngokugcwele (avuthiwe). Izizathu zalolu shintsho azicaci. Ama-hormone athintekile yile:

• I-Estrogen ne-progesterone, ama-hormone abesifazane asiza amaqanda esifazane akhiphe amaqanda
• I-Androgen, ihomoni yesilisa etholakala ngamanani amancane kwabesifazane

Imvamisa, kukhululwa iqanda elilodwa noma amaningi ngesikhathi somjikelezo wowesifazane. Lokhu kwaziwa ngokuthi yi-ovulation. Ezimweni eziningi, lokhu kukhishwa kwamaqanda kwenzeka cishe emavikini amabili ngemuva kokuqala kokuya esikhathini.

Ku-PCOS, amaqanda avuthiwe awakhishwa. Esikhundleni salokho, bahlala kuma-ovari ngenani elincane le-fluid (cyst) elibazungezile. Kungaba khona okuningi kwalokhu. Kodwa-ke, akubona bonke abesifazane abanesimo abazoba nama-ovari ngalokhu kubonakala.

Abesifazane abane-PCOS banemijikelezo lapho i-ovulation ingenzeki njalo ngenyanga okungaba nomthelela ekungazali Ezinye izimpawu zalesi sifo zibangelwa amazinga aphezulu ama-hormone abesilisa.

Isikhathi esiningi, i-PCOS itholakala kwabesifazane abaneminyaka engama-20 noma engama-30. Kodwa-ke, kungathinta namantombazane asakhula. Izimpawu zivame ukuqala lapho izinkathi zentombazane ziqala. Abesifazane abanalesi sifo bavame ukuba nomama noma udadewabo onezimpawu ezifanayo.

Izimpawu ze-PCOS zifaka phakathi izinguquko kumjikelezo wokuya esikhathini, njenge:

• Ukungatholi isikhathi ngemuva kokuthola okukodwa noma okuningi okujwayelekile ngesikhathi sokuthomba (i-amenorrhea yesibili)
• Izikhathi ezingajwayelekile ezingafika zidlule, futhi zibe lula kakhulu zisindwe kakhulu

Ezinye izimpawu ze-PCOS zifaka:

• Uboya bomzimba obungezelele obumila esifubeni, esiswini, ebusweni, nasemaceleni ezingono
• Izinduna ebusweni, esifubeni noma emuva
• Izinguquko zesikhumba, ezinjengokumakwa kwesikhumba okumnyama noma okujiyile nama-creases azungeze amakhwapha, ukububula, intamo, namabele

Ukuthuthukiswa kwezimpawu zesilisa akujwayelekile nge-PCOS futhi kungakhombisa enye inkinga. Izinguquko ezilandelayo zingakhombisa enye inkinga ngaphandle kwe-PCOS:

• Izinwele ezinciphile ekhanda emathempelini, ezibizwa ngokuthi yi-male pattern baldness
• Ukukhuliswa kwe-clitoris
• Ukujula kwezwi
• Nciphisa usayizi webele

Umhlinzeki wakho wokunakekelwa kwezempilo uzokwenza ukuhlolwa komzimba. Lokhu kuzobandakanya ukuhlolwa kwe-pelvic. Ukuhlolwa kungakhombisa:

• Ama-ovari akhulisiwe anama-cysts amaningi amancane abhalwe ku-ultrasound
• I-clitoris ekhulisiwe (engavamile kakhulu)

Izimo zezempilo ezilandelayo zivamile kwabesifazane abane-PCOS:

• Ukumelana ne-insulin nesifo sikashukela
• Umfutho wegazi ophezulu
• I-cholesterol ephezulu
• Isisindo somzimba nokukhuluphala

Umhlinzeki wakho uzohlola isisindo sakho nesisindo somzimba (BMI) bese elinganisa usayizi wesisu sakho.

Ukuhlolwa kwegazi kungenziwa ukuhlola amazinga ama-hormone. Lezi zivivinyo zingafaka:

• Izinga le-Estrogen
• Izinga le-FSH
• Izinga le-LH
• Izinga lama-hormone wesilisa (testosterone)

Okunye ukuhlolwa kwegazi okungenziwa kufaka phakathi:

• Ukuzila ukudla i-glucose (ushukela wegazi) nezinye izivivinyo zokungabekezelelani kwe-glucose nokumelana ne-insulin
• Izinga le-Lipid
• Ukuhlolwa kokukhulelwa (i-serum hCG)
• Izinga leprolactin
• Ukuhlolwa komsebenzi we-thyroid

Umhlinzeki wakho angaphinde a-ode i-ultrasound yamathambo akho ukubheka amaqanda akho.

Ukuzuza kwesisindo nokukhuluphala kuvamile kwabesifazane abane-PCOS. Ukulahlekelwa yisisindo esincane kungasiza ekwelapheni:

• Izinguquko zeHormone
• Izimo ezinjengesifo sikashukela, umfutho wegazi ophakeme, noma i-cholesterol ephezulu

Umhlinzeki wakho angahle anikeze amaphilisi okulawula ukubeletha ukwenza izikhathi zakho zijwayeleke kakhulu. Lawa maphilisi angasiza futhi ekunciphiseni ukukhula kwezinwele okungajwayelekile kanye nezinduna uma uwaphuza izinyanga ezimbalwa. Izindlela ezisebenza isikhathi eside zamahomoni okuvimbela ukukhulelwa, njengeMirena IUD, zingasiza ekunqandeni izikhathi ezingajwayelekile nokukhula okungajwayelekile kolwelwesi lwesibeletho.

Umuthi wesifo sikashukela obizwa ngeGlucophage (metformin) nawo unganikezwa:

• Yenza izikhathi zakho zibe njalo
• Vimbela uhlobo lwesibili sikashukela
• Siza ukunciphisa umzimba

Eminye imishanguzo engabekwa ukusiza ukwenza isikhathi sakho njalo futhi ikusize ukuthi ukhulelwe yile:

• Ama-analog we-LH-akhulula ama-hormone (LHRH)
• I-Clomiphene citrate noma i-letrozole, engavumela ama-ovari akho ukuthi akhulule amaqanda futhi athuthukise nethuba lakho lokukhulelwa

Le mithi isebenza kangcono uma inkomba yomzimba wakho (BMI) ingama-30 noma ngaphansi (ngaphansi kobubanzi obukhuluphele).

Umhlinzeki wakho futhi angaphakamisa ezinye izindlela zokwelapha ukukhula okungavamile kwezinwele. Eminye yile:

• Amaphilisi e-Spironolactone noma e-flutamide
• Ukhilimu we-Eflornithine

Izindlela eziphumelelayo zokususa izinwele zifaka phakathi i-electrolysis nokususwa kwezinwele ze-laser. Noma kunjalo, izindlela eziningi zokwelashwa zingadingeka. Ukwelashwa kuyabiza futhi imiphumela ayivamisile ukuba yaphakade.

I-laparoscopy ye-pelvic ingenziwa ukususa noma ukuguqula i-ovary ukwelapha ukungazali. Lokhu kuthuthukisa amathuba okukhulula iqanda. Imiphumela ingeyesikhashana.

Ngokwelashwa, abesifazane abane-PCOS bavame kakhulu ukukhulelwa. Ngesikhathi sokukhulelwa, kunengozi eyengeziwe yoku:

• Ukuphuphuma kwesisu
• Umfutho wegazi ophezulu
• Isifo sikashukela sokukhulelwa

Abesifazane abane-PCOS banamathuba amaningi okuthuthukisa:

• Umdlavuza we-Endometrial
• Ukungabi nenzalo
• Isifo sikashukela
• Izinkinga ezihlobene nokukhuluphala

Shayela umhlinzeki wakho uma unezimpawu zalesi sifo.

Amaqanda ama-Polycystic; Isifo se-Polycystic ovary; Isifo se-Stein-Leventhal; Isifo se-ovarian se-polyfollicular; I-PCOS

• Izindlala ze-Endocrine
• I-laparoscopy yomzimba
• I-anatomy yokuzala yabesifazane
• Isifo se-Stein-Leventhal
• Isibeletho
• Ukuthuthukiswa kwezinhlamvu

I-Bulun SE. I-Physiology kanye ne-pathology ye-eksisi yokuzala yabesifazane. KuMelmed S, Auchus RJ, Goldfine AB, Loenig RJ, et al, abakwa-eds. Incwadi kaWilliams ye-Endocrinology. Umhlaka 14. IPhiladelphia, PA: Elsevier; 2020: isahluko 17.

UCatherino WH. I-endocrinology yokuzala nokungazali. Ku: IGoldman L, iSchafer AI, ama-eds. Imithi yeGoldman-Cecil. Umhla ka-26. IPhiladelphia, PA: Elsevier; 2020: isahluko 223.

Lobo RA. Isifo se-Polycystic ovary. Ku: Lobo RA, Gershenson DM, Lentz GM, Valea FA, eds. I-Gynecology ephelele. Umhla wesi-7. IPhiladelphia, PA: Elsevier; I-2017: isahluko 41.

URosenfield RL, uBarnes RB, u-Ehrmann DA. I-Hyperandrogenism, i-hirsutism, ne-polycystic ovary syndrome. Ku: Jameson JL, De Groot LJ, de Kretser DM, et al, abahleli. I-Endocrinology: Eyabantu Abadala Neyengane. Umhla wesi-7. IPhiladelphia, PA: Elsevier Saunders; 2016: isahluko 133.