Hypogonadotropic hypogonadism

Hypogonadism ndimikhalidwe yomwe mayeso amphongo kapena mazira azimayi amatulutsa mahomoni ochepa kapena osagonana.

Hypogonadotropic hypogonadism (HH) ndi mtundu wa hypogonadism womwe umachitika chifukwa cha vuto la pituitary gland kapena hypothalamus.

HH imayambitsidwa chifukwa cha kusowa kwa mahomoni omwe nthawi zambiri amalimbikitsa thumba losunga mazira kapena ma testes. Mahomoniwa amaphatikizapo mahomoni otulutsa gonadotropin (GnRH), mahomoni opatsa chidwi (FSH) ndi luteinizing hormone (LH).

Nthawi zambiri:

• Hypothalamus muubongo imatulutsa GnRH.
• Hormone iyi imathandizira kutulutsa kwa pituitary kutulutsa FSH ndi LH.
• Mahomoniwa amauza thumba losunga mazira achikazi kapena ma testes achimuna kuti atulutse mahomoni omwe amatsogolera kukukula bwino pakagwiridwe kathupi, msambo wabwinobwino, milingo ya estrogen ndi kubereka mwa azimayi achikulire, ndikupanga testosterone wabwinobwino ndi umuna mwa amuna achikulire.
• Kusintha kulikonse kwamutulutsidwe wa mahomoni kumayambitsa kusowa kwa mahomoni ogonana. Izi zimalepheretsa kukhwima kwabwino kwa ana komanso magwiridwe antchito a machende kapena thumba losunga mazira akuluakulu.

Pali zifukwa zingapo za HH:

• Kuwonongeka kwa pituitary gland kapena hypothalamus kuchokera ku opareshoni, kuvulala, chotupa, matenda, kapena radiation
• Zofooka za chibadwa
• Mlingo waukulu kapena kugwiritsa ntchito mankhwala opioid kapena steroid (glucocorticoid) kwakanthawi
• Mulingo wapamwamba wa prolactin (hormone yotulutsidwa ndi pituitary)
• Kupsinjika kwakukulu
• Mavuto azakudya (kulemera mwachangu kapena kuwonda)
• Matenda azachipatala a nthawi yayitali, kuphatikiza kutupa kwanthawi yayitali kapena matenda
• Kugwiritsa ntchito mankhwala osokoneza bongo, monga heroin kapena kugwiritsa ntchito mankhwala osokoneza bongo
• Matenda ena, monga chitsulo chambiri

Matenda a Kallmann ndi mtundu wobadwa nawo wa HH. Anthu ena omwe ali ndi vutoli amakhalanso ndi anosmia (kutaya kununkhiza).

Ana:

• Kusakhala ndi chitukuko msinkhu (kukula kumatha kuchedwa kapena kusakwanira)
  
• Atsikana, kusowa kwa chitukuko cha m'mawere ndi kusamba
• Kwa anyamata, palibe kukula kwa mikhalidwe yakugonana, monga kukulitsa ma testes ndi mbolo, kukulitsa mawu, ndi tsitsi la nkhope
• Kulephera kununkhiza (nthawi zina)
• Msinkhu waufupi (nthawi zina)

Akuluakulu:

• Kutaya chidwi pa kugonana (libido) mwa amuna
• Kutaya msambo (amenorrhea) mwa amayi
• Kuchepetsa mphamvu ndi chidwi pazinthu
• Kutaya minofu kwa amuna
• Kulemera
• Khalidwe limasintha
• Kusabereka
  

Wothandizira zaumoyo adzakuyesani ndikufunsani za matenda anu.

Mayeso omwe angachitike ndi awa:

• Kuyezetsa magazi kuyeza kuchuluka kwama mahomoni monga FSH, LH, ndi TSH, prolactin, testosterone ndi estradiol
• Kuyankha kwa LH ku GnRH
• MRI ya pituitary gland / hypothalamus (kuyang'ana chotupa kapena kukula kwina)
• Kuyesedwa kwachibadwa
• Kuyezetsa magazi kuti muwone ngati chitsulo chili cholimba

Chithandizo chimadalira komwe kumayambitsa vutoli, koma chitha kuphatikizira:

• Majekeseni a testosterone (mwa amuna)
• Chigamba chotsitsa cha testosterone chotsika pang'onopang'ono (mwa amuna)
• Ma gels a testosterone (mwa amuna)
• Mapiritsi a Estrogen ndi progesterone kapena zigamba za khungu (mwa akazi)
• JnRH jakisoni
• HCG jakisoni
  

Chithandizo choyenera cha mahomoni chimayambitsa kutha msinkhu mwa ana ndipo chitha kubwezeretsa chonde kwa akulu. Ngati vutoli limayamba munthu atatha msinkhu kapena atakula, nthawi zambiri matenda amayamba bwino.

Mavuto azaumoyo omwe angabwere chifukwa cha HH ndi awa:

• Kuchedwa kutha msinkhu
• Kutha msambo (mwa akazi)
• Kusabereka
• Kutsika kwa mafupa ochepa ndikuphwanyika pambuyo pake m'moyo
• Kudzidalira chifukwa chakuchedwa kutha msinkhu (kuthandizira pamalingaliro kungakhale kothandiza)
• Mavuto azakugonana, monga otsika libido

Itanani omwe akukuthandizani ngati:

• Mwana wanu samayamba msinkhu panthawi yoyenera.
• Ndinu mkazi wosakwanitsa zaka 40 ndipo kusamba kwanu kumasiya.
• Mwataya tsitsi lakukhwapa kapena labanja.
• Ndiwe mwamuna ndipo wachepetsa chidwi pa kugonana.

Kulephera kwa Gonadotropin; Hypogonadism yachiwiri

• Matenda a Endocrine
• Matenda a pituitary
• Gonadotropin

Bhasin S, Brito JP, Cunningham GR, ndi al. Mankhwala a testosterone mwa amuna omwe ali ndi hypogonadism: malangizo othandizira a Endocrine Society. J Clin Endocrinol Metab. 2018; 103 (5): 1715-1744. PMID: 29562364 www.ncbi.nlm.nih.gov/pubmed/29562364.

Styne DM, Grumbach MM. Physiology ndi zovuta zakutha msinkhu. Mu: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, olemba. Buku la Williams la Endocrinology. Wolemba 13. Philadelphia, PA: Elsevier; 2016: chap 25.

PC yoyera. Kukula kwakugonana komanso kudziwika. Mu: Goldman L, Schafer AI, olemba. Mankhwala a Goldman-Cecil. 26 wa. Philadelphia, PA: Elsevier; 2020: chap 220.