Ukwehluleka kwamasende

Ukwehluleka kwamasende kwenzeka lapho amasende engakwazi ukukhiqiza isidoda noma ama-hormone wesilisa, njenge-testosterone.

Ukwehluleka kwamasende akuvamile. Izimbangela zifaka:

• Imithi ethile, kufaka phakathi i-glucocorticoids, i-ketoconazole, i-chemotherapy, kanye nemithi yezinhlungu ze-opioid
• Izifo ezithinta isende, kufaka phakathi i-hemochromatosis, mumps, orchitis, umdlavuza wamasende, i-testicular torsion, ne-varicocele
• Ukulimala noma ukuhlukumezeka emasendeni
• Ukukhuluphala ngokweqile
• Izifo zofuzo, njenge-Klinefelter syndrome noma i-Prader-Willi syndrome
• Ezinye izifo, njenge-cystic fibrosis

Okulandelayo kungandisa ubungozi bokuhluleka kwamasende:

• Imisebenzi edala ukulimala okungapheli, okunamazinga aphansi esikhwameni, njengokugibela isithuthuthu noma ibhayisikili
• Ukusetshenziswa kwensangu njalo nangokusindayo
• Amasende angehlisiwe lapho ezalwa

Izimpawu zincike ebudaleni lapho ukwehluleka kwamasende kukhula, kungaba ngaphambi noma ngemuva kokuthomba.

Izimpawu zingafaka:

• Nciphisa ukuphakama
• Amabele akhulisiwe (gynecomastia)
• Ukungabi nenzalo
• Ukulahleka kwemisipha
• Ukuntuleka kocansi (libido)
• Ukulahleka kwekhwapha nezinwele zasesidlangalaleni
• Ukuthuthuka okuhamba kancane noma ukuntuleka kwezici zobulili zesilisa zesibili (ukukhula kwezinwele, ukukhuliswa kwesikhumba, ukukhuliswa kwepipi, ukushintsha kwezwi)

Abesilisa futhi bangaqaphela ukuthi abadingi ukushefa kaningi.

Ukuhlolwa ngokomzimba kungakhombisa:

• Izitho zobulili ezingabonakali kahle ukuthi ziyindoda noma owesifazane (imvamisa itholakala ngesikhathi siseyinsana)
• Amasende amancane, angaqinile
• Isigaxa noma isisindo esingajwayelekile esendeni noma esikrinini

Ezinye izivivinyo zingakhombisa ukuminyana kwamathambo okuphansi kanye nokuqhekeka. Ukuhlolwa kwegazi kungakhombisa izinga eliphansi le-testosterone namazinga aphezulu we-prolactin, i-FSH, ne-LH (inquma ukuthi ngabe inkinga iyinhloko noma yesibili).

Uma ukukhathazeka kwakho kungukuzala, umhlinzeki wakho wezokunakekelwa kwempilo angaphinde ayalele ukuhlaziywa kwesidoda ukuhlola inani lesidoda esinempilo osikhiqizayo.

Kwesinye isikhathi, i-ultrasound yamasende izolandelwa.

Ukwehluleka kwamasende nezinga eliphansi le-testosterone kungaba nzima ukuwathola emadodeni amadala ngoba izinga le-testosterone ngokuvamile lehla kancane ngokukhula.

Izithako zokwengeza ze-hormone yamadoda zingaphatha ezinye izinhlobo zokuhluleka kwamasende. Le ndlela yokwelashwa ibizwa ngokuthi yi-testosterone replacement therapy (TRT). I-TRT inganikezwa njenge-gel, i-patch, umjovo, noma ukufakelwa.

Ukugwema umuthi noma umsebenzi odala inkinga kungabuyisa ukusebenza kwesende emuva kokujwayelekile.

Izinhlobo eziningi zokwehluleka kwamasende azinakuhlehliswa. I-TRT ingasiza ukuguqula izimpawu, noma ingahle ingabuyisi ukuzala.

Abesilisa abathola i-chemotherapy engadala ukwehluleka kwamasende kufanele baxoxe ngamasampula wesidoda aqandayo ngaphambi kokwelapha kokuqala.

Ukwehluleka kwamasende okuqala ngaphambi kokuthomba kuzomisa ukukhula komzimba okujwayelekile. Kungavimbela izici zesilisa ezindala (njengezwi elijulile nentshebe) ekuthuthukiseni. Lokhu kungaphathwa nge-TRT.

Abesilisa abaku-TRT badinga ukugadwa ngokucophelela ngudokotela. I-TRT ingadala lokhu okulandelayo:

• I-prostate enwetshiwe, okuholela ebunzimeni bokuchama
• Amahlule egazi
• Izinguquko zokulala nemizwa

Shayela i-aphoyintimenti nomhlinzeki wakho uma unezimpawu zokwehluleka kwamasende.

Phinda ushayele umhlinzeki wakho uma uku-TRT futhi ucabanga ukuthi unemiphumela emibi evela ekwelashweni.

Gwema imisebenzi enobungozi obukhulu uma kungenzeka.

I-hypogonadism eyinhloko - owesilisa

• I-anatomy yamasende
• I-anatomy yokuzala yowesilisa

U-Allan CA, McLachlan RI. Izinkinga zokushoda kwe-Androgen. 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 139.

UMorgentaler A, uZitzmann M, Traish AM, et al. Imiqondo eyisisekelo maqondana nokushoda nokwelashwa kwe-testosterone: izinqumo zomhlaba wonke zokuvumelana kwabachwepheshe. IMayo Clin Proc. 2016; 91 (7): 881-896. I-PMID: 27313122 www.ncbi.nlm.nih.gov/pubmed/27313122.

Iwebhusayithi ye-US Food and Drug Administration. Ukuxhumana nokuphepha kwezidakamizwa kwe-FDA: I-FDA iyaxwayisa ngokusebenzisa imikhiqizo ye-testosterone ye-testosterone ephansi ngenxa yokuguga; kudinga ushintsho lwamalebula ukwazisa ngengozi ekhulayo yokuhlaselwa yisifo senhliziyo nokushaywa unhlangothi ngokusetshenziswa. www.fda.gov/Drugs/DrugSafety/ucm436259.htm. Kubuyekezwe ngoFebhuwari 26, 2018. Kufinyelelwe ngoMeyi 20, 2019.