Hypogonadotropic hypogonadism

I-Hypogonadism yisimo lapho izivivinyo zesilisa noma amaqanda esifazane akhiqiza khona ama-hormone ocansi amancane noma cha.

I-Hypogonadotropic hypogonadism (HH) uhlobo lwe-hypogonadism olubangelwa inkinga ye-pituitary gland noma i-hypothalamus.

I-HH ibangelwa ukuntuleka kwamahomoni ngokuvamile okukhuthaza ama-ovari noma ama-testes. Lawa mahomoni afaka i-gonadotropin-release hormone (GnRH), i-follicle stimulating hormone (FSH) ne-luteinizing hormone (LH).

Imvamisa:

• I-hypothalamus ebuchosheni ikhipha i-GnRH.
• Le hormone ivuselela i-pituitary gland ukukhipha i-FSH ne-LH.
• Lawa mahomoni atshela ama-ovaries abesifazane noma ama-testes wesilisa ukuthi akhiphe ama-hormone aholela ekukhuleni okuvamile kwezocansi ekuthombeni, imijikelezo yokuya esikhathini ejwayelekile, amazinga e-estrogen nokuzala kwabesifazane abadala, kanye nokukhiqizwa okujwayelekile kwe-testosterone nokukhiqizwa kwesidoda emadodeni amadala.
• Noma yiluphi ushintsho kulolu chungechunge lokukhishwa kwamahomoni lubangela ukungabikho kwamahomoni ocansi. Lokhu kuvimbela ukuvuthwa kocansi okuvamile ezinganeni nokusebenza okujwayelekile kwamasende noma ama-ovari kubantu abadala.

Kunezimbangela eziningana ze-HH:

• Ukulimala kwe-pituitary gland noma i-hypothalamus kusuka ekuhlinzweni, ekulimaleni, ekulimaleni, ekuthelelekeni, noma emisebeni
• Ukukhubazeka kofuzo
• Ukweqiwa okuphezulu noma ukusetshenziswa kwesikhathi eside kwemithi ye-opioid noma ye-steroid (glucocorticoid)
• Izinga eliphezulu le-prolactin (i-hormone ekhishwe yi-pituitary)
• Ukucindezeleka okukhulu
• Izinkinga zokudla okunempilo (kokubili ukuzuza kwesisindo okusheshayo noma ukunciphisa umzimba)
• Izifo zezokwelapha zesikhathi eside (ezingapheli), kufaka phakathi ukuvuvukala okungapheli noma izifo
• Ukusetshenziswa kwezidakamizwa, njenge-heroin noma ukusetshenziswa noma ukuhlukunyezwa kwemithi kadokotela opiate
• Izimo ezithile zezokwelapha, njengokugcwala kwe-iron

I-Kallmann syndrome iyindlela ezuzwe njengefa ka-HH. Abanye abantu abanalesi simo futhi bane-anosmia (ukulahleka komuzwa wephunga).

Izingane:

• Ukuntuleka kwentuthuko ngesikhathi sokuthomba (ukukhula kungahle kube sekwephuze kakhulu noma kungaphelele)
  
• Emantombazaneni, ukuntuleka kokukhula kwamabele nezikhathi zokuya esikhathini
• Kubafana, akukho ukukhula kwezici zobulili, njengokukhuliswa kwamasende nepipi, ukujula kwezwi, nezinwele zobuso
• Ukungakwazi ukuhogela (kwezinye izimo)
• Isiqu esifushane (kwezinye izimo)

Abantu abadala:

• Ukuphela kwesithakazelo kwezocansi (libido) emadodeni
• Ukulahleka kwezikhathi zokuya esikhathini (amenorrhea) kwabesifazane
• Ukwehla kwamandla nentshisekelo emisebenzini
• Ukulahleka kwemisipha emadodeni
• Ukuzuza kwesisindo
• Ukushintsha kwemizwelo
• Ukungabi nenzalo
  

Umhlinzeki wezokunakekelwa kwempilo uzokwenza ukuhlolwa komzimba abuze ngezimpawu zakho.

Ukuhlolwa okungenziwa kufaka phakathi:

• Ukuhlolwa kwegazi ukukala amazinga ama-hormone afana ne-FSH, LH, ne-TSH, i-prolactin, i-testosterone ne-estradiol
• Impendulo ye-LH ku-GnRH
• I-MRI ye-pituitary gland / hypothalamus (ukubheka isimila noma okunye ukukhula)
• Ukuhlolwa kofuzo
• Ukuhlolwa kwegazi ukuhlola izinga lensimbi

Ukwelashwa kuya ngomthombo wenkinga, kepha kungabandakanya:

• Imijovo ye-testosterone (kwabesilisa)
• Isiqephu sesikhumba se-testosterone esikhipha kancane (kwabesilisa)
• Ama-testosterone gel (kwabesilisa)
• Amaphilisi e-Estrogen ne-progesterone noma amabala wesikhumba (kwabesifazane)
• Imijovo ye-GnRH
• Imijovo ye-HCG
  

Ukwelashwa okufanele kwehomoni kuzobangela ukuthomba kuqale ezinganeni futhi kungabuyisa ukuzala kubantu abadala. Uma lesi simo siqala ngemuva kokuthomba noma ebudaleni, izimpawu zizovama ukwelashwa.

Izinkinga zempilo ezingabangelwa yi-HH zifaka:

• Ukuthomba okulibazisekile
• Ukunqamuka kokuqala (kwabesifazane)
• Ukungabi nenzalo
• Ubuningi bamathambo aphansi nokuqhekeka kamuva empilweni
• Ukuzethemba okuphansi ngenxa yokuthomba sekwedlule isikhathi (ukusekelwa ngokomzwelo kungasiza)
• Izinkinga zocansi, njenge-libido ephansi

Shayela umhlinzeki wakho uma:

• Ingane yakho ayiqali ukuthomba ngesikhathi esifanele.
• Ungowesifazane ongaphansi kweminyaka engama-40 futhi imijikelezo yakho yokuya esikhathini iyeka.
• Ulahlekelwe yikhwapha noma izinwele zasesidlangalaleni.
• Uyindoda futhi wehlise intshisekelo kwezocansi.

Ukuntuleka kwe-Gonadotropin; I-hypogonadism yesibili

• Izindlala ze-Endocrine
• Indlala yamapayipi
• Ama-gonadotropin

UBhasin S, uBrito JP, uCunningham GR, et al. Ukwelashwa kwe-testosterone emadodeni ane-hypogonadism: umhlahlandlela wokuzijwayeza ngomtholampilo we-Endocrine Society. UJ Clin Endocrinol Metab. 2018; 103 (5): 1715-1744. I-PMID: 29562364 www.ncbi.nlm.nih.gov/pubmed/29562364.

I-Styne DM, i-Grumbach MM. I-Physiology nokuphazamiseka kokuthomba. Ku: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, abahleli. Incwadi kaWilliams ye-Endocrinology. Umhlaka 13. IPhiladelphia, PA: Elsevier; 2016: isahluko 25.

I-PC emhlophe. Ukuthuthuka kwezocansi kanye nokuzazi. Ku: IGoldman L, iSchafer AI, ama-eds. Imithi yeGoldman-Cecil. Umhla ka-26. IPhiladelphia, PA: Elsevier; 2020: isahluko 220.