I-Hypogonadism

I-hypogonadism yenzeka lapho izindlala zocansi lomzimba zikhiqiza ama-hormone amancane noma zingawenzi nhlobo. Emadodeni, lezi zindlala (ama-gonads) zingama-testes. Kwabesifazane, lezi zindlala zingamaqanda.

Imbangela ye-hypogonadism ingaba eyinhloko (amasende noma ama-ovari) noma yesibili (inkinga nge-pituitary noma i-hypothalamus). Ku-hypogonadism eyinhloko, ama-ovari noma ama-testes ngokwawo awasebenzi kahle. Izimbangela ze-hypogonadism eyinhloko zifaka:

• Ukuphazamiseka okuthile okuzenzakalelayo
• Izinkinga zofuzo nezentuthuko
• Ukutheleleka
• Isibindi nesifo sezinso
• Imisebe (kuya kuma-gonads)
• Ukuhlinzwa
• Ukuhlukumezeka
  

Izinkinga zofuzo ezivame kakhulu ezibangela i-hypogonadism eyinhloko yi-Turner syndrome (kwabesifazane) ne-Klinefelter syndrome (emadodeni).

Uma usuvele unezinye izinkinga zokuzilimaza ungaba sengozini enkulu yokulimala okuzenzakalelayo kuma-gonads. Lokhu kungafaka ukuphazamiseka okuthinta isibindi, izindlala ze-adrenal, nezindlala ze-thyroid, kanye nohlobo 1 lwesifo sikashukela.

E-hypogonadism emaphakathi, izikhungo ebuchosheni ezilawula ama-gonads (hypothalamus kanye ne-pituitary) azisebenzi kahle. Izimbangela ze-hypogonadism emaphakathi zifaka:

• I-anorexia nervosa
• Ukopha endaweni ye-pituitary
• Ukuthatha imithi, njenge-glucocorticoids nama-opiates
• Ukumisa ama-anabolic steroids
• Izinkinga zofuzo
• Izifo
• Ukushoda kokudla okunempilo
• I-iron ngokweqile (hemochromatosis)
• Imisebe (kuya ku-pituitary noma i-hypothalamus)
• Ngokushesha, ukulahleka kwesisindo okukhulu (kufaka phakathi ukulahleka kwesisindo ngemuva kokuhlinzwa nge-bariatric)
• Ukuhlinzwa (ukuhlinzwa kwe-skull base eduze ne-pituitary)
• Ukuhlukumezeka
• Izimila

Imbangela yofuzo ye-hypogonadism emaphakathi yi-Kallmann syndrome. Abantu abaningi abanalesi simo banomqondo owehlisiwe wephunga.

Ukunqamuka kokuya esikhathini yisizathu esivame kakhulu se-hypogonadism. Kujwayelekile kubo bonke abesifazane futhi kwenzeka ngokwesilinganiso seminyaka yobudala engama-50. Amazinga e-testosterone ancipha emadodeni njengoba ekhula, nawo. Ububanzi be-testosterone ejwayelekile egazini buphansi kakhulu endodeni eneminyaka engama-50 kuye kwengu-60 kunangendoda eneminyaka engama-20 kuye kwengama-30.

Amantombazane ane-hypogonadism ngeke aqale ukuya esikhathini. I-Hypogonadism ingathinta ukukhula kwabo kwamabele nokuphakama. Uma i-hypogonadism yenzeka ngemuva kokuthomba, izimpawu kwabesifazane zifaka:

• Ukushisa okushisayo
• Izinguquko zamandla nemizwelo
• Ukuya esikhathini kuba ngokungajwayelekile noma kuyama

Kubafana, i-hypogonadism ithinta ukukhula kwemisipha, intshebe, izitho zangasese nezwi. Futhi kuholela ezinkingeni zokukhula. Emadodeni izimpawu yilezi:

• Ukukhuliswa kwamabele
• Ukulahleka kwemisipha
• Intshisekelo eyehlisiwe kwezocansi (libido ephansi)

Uma kukhona i-pituitary noma esinye isimila sobuchopho (hypogonadism emaphakathi), kungahle kube khona:

• Ukuphathwa yikhanda noma ukulahleka kombono
• Ukukhishwa kwesifuba se-Milky (kusuka ku-prolactinoma)
• Izimpawu zokunye ukusilela kwe-hormonal (njenge-hypothyroidism)

Izicubu ezivame kakhulu ezithinta i-pituitary yi-craniopharyngioma ezinganeni kanye ne-prolactinoma adenomas kubantu abadala.

Ungahle udinge ukuhlolwa.

• Izinga le-Estrogen (abesifazane)
• I-follicle evuselela i-hormone (izinga le-FSH) nezinga le-luteinizing hormone (LH)
• Izinga le-testosterone (amadoda) - ukuhunyushwa kwalolu vivinyo emadodeni amadala nakwabesilisa abakhuluphele kungaba nzima ngakho-ke imiphumela kufanele ixoxwe nodokotela wehomoni (i-endocrinologist)
• Ezinye izinyathelo zomsebenzi we-pituitary

Ezinye izivivinyo zingafaka:

• Ukuhlolwa kwegazi kwe-anemia nensimbi
• Ukuhlolwa kwe-Genetic kufaka phakathi i-karyotype ukuhlola ukwakheka kwe-chromosomal
• Izinga leprolactin (i-hormone yobisi)
• Isibalo sesidoda
• Ukuhlolwa kwendlala yegilo

Kwesinye isikhathi ukuhlolwa kwe-imaging kuyadingeka, njenge-sonogram yama-ovari. Uma kusolwa isifo se-pituitary, kungenziwa i-MRI noma i-CT scan yobuchopho.

Ungadinga ukuthatha imishanguzo esekwe kuma-hormone. I-Estrogen ne-progesterone kusetshenziselwa amantombazane nabesifazane. Imithi iza ngesimo sephilisi noma isichibi sesikhumba. I-Testosterone isetshenziselwa abafana namadoda. Umuthi unganikezwa njengesichibi sesikhumba, ijeli yesikhumba, isixazululo esisetshenziswe ekhwapheni, isichibi esifakwe kusinhla esingenhla, noma ngomjovo.

Kwabesifazane abangazange basuswe isibeletho, ukwelashwa okuhlanganisiwe nge-estrogen ne-progesterone kunganciphisa amathuba okuba nomdlavuza we-endometrium. Abesifazane abane-hypogonadism abane-low drive drive bangabuye banikezwe i-testosterone enomthamo ophansi noma enye i-hormone yabesilisa ebizwa nge-dehydroepiandrosterone (DHEA).

Kwabanye besifazane, imijovo noma amaphilisi angasetshenziselwa ukuvuselela ama-ovulation. Imijovo ye-pituitary hormone ingasetshenziswa ukusiza amadoda ukuthi akhiqize isidoda. Abanye abantu bangadinga ukuhlinzwa nokwelashwa ngemisebe uma kukhona imbangela yebuchopho noma ye-hypothalamic yalesi sifo.

Izinhlobo eziningi ze-hypogonadism ziyelapheka futhi zinombono omuhle.

Kwabesifazane, i-hypogonadism ingadala ukungazali. Ukunqamuka kokuya esikhathini kuyindlela ye-hypogonadism eyenzeka ngokwemvelo. Kungadala ukushisa okushisayo, ukoma kwesitho sangasese sowesifazane, nokucasuka njengoba amazinga e-estrogen ehla. Ingcuphe yokwanda kwamathambo nesifo senhliziyo iyanda ngemuva kokunqamuka kokuya esikhathini.

Abanye besifazane abane-hypogonadism bathatha imishanguzo ye-estrogen, imvamisa labo abasheshe baye esikhathini. Kepha ukusetshenziswa kwesikhathi eside kokwelashwa kwama-hormone kungakhuphula ubungozi besifo somdlavuza webele, amahlule egazi nesifo senhliziyo (ikakhulukazi kwabesifazane asebekhulile). Abesifazane kufanele bakhulume nomhlinzeki wabo wezokunakekelwa kwempilo mayelana nezingozi nezinzuzo zokwelashwa kwe-hormone menopausal.

Emadodeni, i-hypogonadism iholela ekulahlekelweni kwe-sex drive futhi ingadala:

• Ukungabi namandla
• Ukungabi nenzalo
• I-osteoporosis
• Ubuthakathaka

Ngokuvamile amadoda ane-testosterone ephansi njengoba ekhula. Kodwa-ke, ukwehla kwamazinga ama-hormone akuyona into ephawulekayo njengoba kwenzeka kwabesifazane.

Khuluma nomhlinzeki wakho uma uqaphela:

• Ukukhishwa kwesisu
• Ukwandiswa kwamabele (amadoda)
• Ukushisa okushisayo (abesifazane)
• Ukungabi namandla
• Ukulahleka kwezinwele zomzimba
• Ukulahleka kwesikhathi sokuya esikhathini
• Izinkinga zokukhulelwa
• Izinkinga nge-sex drive yakho
• Ubuthakathaka

Bobabili abesilisa nabesifazane kufanele babize umhlinzeki wabo uma enekhanda noma izinkinga zokubona.

Ukugcina ukuqina komzimba, isisindo somzimba esijwayelekile nemikhuba yokudla enempilo kungasiza kwezinye izimo. Ezinye izimbangela zingavikeleka.

Ukushoda kweGonadal; Ukwehluleka kwamasende; Ukwehluleka kwe-ovari; I-testosterone - i-hypogonadism

• Ama-gonadotropin

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