Hypogonadism

Hypogonadism imachitika pamene tinthu tomwe timagonana tating'onoting'ono timatulutsa timadzi tating'ono kapena ayi. Mwa amuna, ma gland awa ndi ma testes. Kwa akazi, izi ndi zotengera m'mimba mwake.

Zomwe zimayambitsa hypogonadism zimatha kukhala zoyambirira (ma testes kapena ovaries) kapena yachiwiri (vuto la pituitary kapena hypothalamus). Mu hypogonadism yoyambirira, thumba losunga mazira kapena ma testes enieni sagwira ntchito moyenera. Zomwe zimayambitsa hypogonadism yoyambirira ndi monga:

• Matenda ena amadzimadzi
• Matenda a chibadwa ndi chitukuko
• Matenda
• Chiwindi ndi matenda a impso
• Mafunde (kwa ma gonads)
• Opaleshoni
• Zowopsa
  

Matenda omwe amabwera chifukwa cha hypogonadism ndi Turner syndrome (mwa akazi) ndi Klinefelter syndrome (mwa amuna).

Ngati muli ndi zovuta zina zama autoimmune mutha kukhala pachiwopsezo chachikulu chowonongeka ndi ma gonads. Izi zitha kuphatikizira zovuta zomwe zimakhudza chiwindi, adrenal gland, ndi chithokomiro, komanso mtundu wa 1 shuga.

Pakatikati mwa hypogonadism, malo omwe ali muubongo omwe amayang'anira ma gonads (hypothalamus ndi pituitary) sagwira ntchito moyenera. Zomwe zimayambitsa hypogonadism yapakati ndi monga:

• Matenda a anorexia
• Magazi m'dera la pituitary
• Kutenga mankhwala, monga glucocorticoids ndi opiates
• Kuletsa anabolic steroids
• Mavuto amtundu
• Matenda
• Kuperewera kwa zakudya
• Iron yochulukirapo (hemochromatosis)
• Mafunde (kwa pituitary kapena hypothalamus)
• Mofulumira, kuonda kwambiri (kuphatikizapo kuonda pambuyo pa opaleshoni ya bariatric)
• Opaleshoni (opareshoni ya chigaza pafupi ndi pituitary)
• Zowopsa
• Zotupa

Zomwe zimayambitsa hypogonadism yapakati ndi matenda a Kallmann. Anthu ambiri omwe ali ndi vutoli amachepetsanso kununkhiza.

Kusamba kwa thupi ndicho chifukwa chofala kwambiri cha hypogonadism. Ndi zachilendo mwa amayi onse ndipo amapezeka pafupifupi pafupifupi zaka 50. Magulu a testosterone amacheperanso amuna akamakalamba. Kuchuluka kwa testosterone wabwinobwino m'magazi ndikotsika kwambiri mwa bambo wazaka 50 mpaka 60 kuposa momwe zimakhalira ndi bambo wazaka 20 mpaka 30.

Atsikana omwe ali ndi hypogonadism sangayambe kusamba. Hypogonadism imatha kukhudza kukula kwa mawere ndi kutalika kwawo. Ngati hypogonadism imachitika munthu atatha msinkhu, zizindikiro mwa amayi zimaphatikizapo:

• Kutentha kotentha
• Mphamvu ndi malingaliro amasintha
• Msambo umakhala wosasintha kapena umasiya

Kwa anyamata, hypogonadism imakhudza minofu, ndevu, maliseche ndi kukula kwa mawu. Zimayambitsanso mavuto akukula. Mwa amuna zizindikirozo ndi izi:

• Kukula kwa m'mawere
• Kutaya minofu
• Kuchepetsa chidwi pa kugonana (low libido)

Ngati pituitary kapena chotupa china chaubongo chiripo (central hypogonadism), pakhoza kukhala:

• Mutu kapena kutayika kwa masomphenya
• Kutulutsa mkaka wamkaka (kuchokera ku prolactinoma)
• Zizindikiro za kuperewera kwina kwamahomoni (monga hypothyroidism)

Zotupa zofala kwambiri zomwe zimakhudza chiberekero ndi craniopharyngioma mwa ana komanso prolactinoma adenomas mwa akulu.

Mungafunike kuyesedwa kuti muwone:

• Mulingo wa Estrogen (akazi)
• Follicle yolimbikitsa mahomoni (FSH mulingo) ndi luteinizing hormone (LH)
• Mulingo wa testosterone (amuna) - kutanthauzira mayesowa mwa akulu ndi abambo omwe ali onenepa kwambiri kumatha kukhala kovuta chifukwa chake zotsatira ziyenera kukambidwa ndi katswiri wamahomoni (endocrinologist)
• Njira zina zogwirira ntchito pituitary

Mayesero ena atha kuphatikizira:

• Kuyezetsa magazi magazi ndi chitsulo
• Mayeso a chibadwa kuphatikiza karyotype kuti awone mawonekedwe a chromosomal
• Mulingo wa Prolactin (mahomoni amkaka)
• Kuwerengera kwa umuna
• Mayeso a chithokomiro

Nthawi zina kuyesa kulingalira kumafunikira, monga sonogram ya thumba losunga mazira. Ngati matenda a pituitary akukayikiridwa, MRI kapena CT scan yaubongo itha kuchitidwa.

Mungafunike kumwa mankhwala opangira mahomoni. Estrogen ndi progesterone amagwiritsidwa ntchito kwa atsikana ndi amayi. Mankhwalawa amabwera ngati mapiritsi kapena khungu. Testosterone imagwiritsidwa ntchito kwa anyamata ndi abambo. Mankhwalawa amatha kuperekedwa ngati chikopa cha khungu, gel osakaniza khungu, yankho logwiritsidwa ntchito kukhwapa, chigamba chogwiridwa ndi chingamu chapamwamba, kapena jakisoni.

Kwa amayi omwe sanachotsedwe chiberekero, kuphatikiza mankhwala ndi estrogen ndi progesterone kumachepetsa mwayi wokhala ndi khansa ya endometrial. Amayi omwe ali ndi hypogonadism omwe amakhala ndi vuto lachiwerewere amatha kuperekedwanso testosterone wa mlingo wochepa kapena mahomoni ena achimuna otchedwa dehydroepiandrosterone (DHEA).

Amayi ena, jakisoni kapena mapiritsi atha kugwiritsidwa ntchito kuti athandize ovulation. Majekeseni a mahomoni amtundu wa pituitary atha kugwiritsidwa ntchito kuthandiza amuna kupanga umuna. Anthu ena angafunike kuchitidwa opaleshoni ndi mankhwala a radiation ngati pali vuto la pituitary kapena hypothalamic la matendawa.

Mitundu yambiri ya hypogonadism imachiritsidwa ndipo imakhala ndi chiyembekezo.

Kwa amayi, hypogonadism ingayambitse kusabereka. Kusamba kwa thupi ndi mtundu wa hypogonadism womwe umachitika mwachilengedwe. Zitha kupangitsa kutentha, ukazi kuuma, komanso kukwiya m'mene milingo ya estrogen imagwera. Chiwopsezo cha kufooka kwa mafupa ndi matenda amtima chimawonjezeka atatha kusamba.

Amayi ena omwe ali ndi hypogonadism amatenga mankhwala a estrogen, nthawi zambiri omwe amasamba msanga. Koma kugwiritsa ntchito mankhwala kwa nthawi yayitali kumawonjezera chiopsezo cha khansa ya m'mawere, kuundana kwamagazi ndi matenda amtima (makamaka azimayi achikulire). Amayi amayenera kukambirana ndi omwe amawasamalira azaumoyo za kuopsa ndi phindu la mankhwala a mahomoni otha msinkhu.

Mwa amuna, hypogonadism imabweretsa kutayika kwakugonana ndipo itha kuyambitsa:

• Mphamvu
• Kusabereka
• Kufooka kwa mafupa
• Kufooka

Amuna nthawi zambiri amakhala ndi testosterone m'munsi akamakalamba. Komabe, kuchepa kwa milingo ya mahomoni sikokwanira monga momwe kumakhalira ndi akazi.

Lankhulani ndi omwe akukuthandizani mukawona:

• Kutulutsa m'mawere
• Kukulitsa mawere (amuna)
• Kutentha (akazi)
• Mphamvu
• Kutaya tsitsi
• Kutaya msambo
• Mavuto kutenga pakati
• Mavuto ndi kugonana kwanu
• Kufooka

Amuna ndi akazi ayenera kuyimbira omwe amawapatsa ngati ali ndi vuto la mutu kapena masomphenya.

Kukhala wathanzi, kulemera thupi komanso kudya moyenera kumatha kuthandiza nthawi zina. Zoyambitsa zina sizingalephereke.

Kuperewera kwa Gonadal; Testicular kulephera; Ovarian kulephera; Testosterone - hypogonadism

• Gonadotropin

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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 adatulutsidwa.ncbi.nlm.nih.gov/29562364/.

Styne DM. Physiology ndi zovuta zakutha msinkhu. Mu: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, olemba. Nelson Textbook of Pediatrics. Wolemba 21. Philadelphia, PA: Elsevier; 2020: mutu 26.

Swerdloff RS, Wang C. The testis ndi hypogonadism yamwamuna, kusabereka, komanso kulephera kugonana. Mu: Goldman L, Schafer AI, olemba. Mankhwala a Goldman-Cecil. 26 wa. Philadelphia, PA: Elsevier; 2020: chap 221.

van den Beld AW, Lambert SWJ. Endocrinology ndi ukalamba. Mu: Melmed S, Auchus RJ, Goldfine AB, Koenig RJ, Rosen CJ, olemba. Buku la Williams la Endocrinology. Wolemba 14th. Philadelphia, PA: Elsevier; 2020: mutu 28.