Isifo sePolycystic ovary

I-Polycystic ovary syndrome (i-PCOS) yimeko apho owasetyhini anyuse amanqanaba eehomoni zesilisa (androgens). Iingxaki ezininzi zivela ngenxa yokunyuka kwamahomoni, kubandakanya:

• Izitenxo zokuya exesheni
• Ukungachumi
• Iingxaki zolusu ezifana namabala kunye nokwanda kokukhula kweenwele
• Ukonyuka kwenani leecyst ezincinci kwii-ovari

I-PCOS inxulunyaniswa notshintsho kumanqanaba ehomoni enza ukuba kube nzima kwii-ovari ukuba zikhulule amaqanda akhule ngokupheleleyo (aqolileyo). Izizathu zolu tshintsho azicacanga. Iihomoni ezichaphazelekayo zezi:

• I-Estrogen kunye neprogesterone, iihomoni zabasetyhini ezinceda ii-ovari zowasetyhini ukuba zikhulule amaqanda
• Androgen, ihomoni eyindoda efumaneka ngesixa esincinci kwabasetyhini

Ngokuqhelekileyo, elinye okanye amaqanda amaninzi akhululwa ngexesha lomfazi. Oku kwaziwa njenge-ovulation. Kwiimeko ezininzi, ukukhutshwa kwamaqanda kwenzeka malunga neeveki ezi-2 emva kokuqala kwexesha lokuya exesheni.

Kwi-PCOS, amaqanda aqolileyo akakhutshwa. Endaweni yoko, bahlala kwii-ovari kunye nenani elincinci le-fluid (cyst) ejikeleze bona. Zinokubakho ezininzi kwezi. Nangona kunjalo, ayingabo bonke abantu besetyhini abanemeko abaya kuba nama-ovari ngale nkangeleko.

Abasetyhini abane-PCOS banemijikelezo apho i-ovulation ingenzeki inyanga nenyanga ezinokuthi zibe negalelo ekungachumi Ezinye iimpawu zolu phazamiso zibangelwa ngamanqanaba aphezulu ehomoni yamadoda.

Uninzi lwexesha, i-PCOS ifunyaniswa kwabasetyhini abaneminyaka engama-20 okanye engama-30. Nangona kunjalo, inokuthi ichaphazele namantombazana akwishumi elivisayo. Iimpawu zihlala ziqala xa ixesha lentombazana liqala. Abafazi abanale ngxaki bahlala benomama okanye udade oneempawu ezifanayo.

Iimpawu ze-PCOS zibandakanya utshintsho kumjikelo wokuya esikhathini, njenge:

• Ungafumani thuba emva kokuba ubenesiqhelo okanye enye eqhelekileyo ngexesha lokufikisa (i-amenorrhea yesibini)
• Amaxesha angaqhelekanga anokufika kwaye ahambe, kwaye abe nokukhanya kakhulu ukuya kubunzima kakhulu

Ezinye iimpawu ze-PCOS zibandakanya:

• Iinwele zomzimba ezongezelelekileyo ezikhula esifubeni, esiswini, ebusweni nasezingubeni
• Amabala ebusweni, esifubeni, okanye emqolo
• Utshintsho lolusu, njengophawu olumnyama okanye olungqingqwa lolusu kunye neentsimbi ezijikeleze amakhwapha, ukubola, intamo namabele

Ukuphuhliswa kweempawu zesilisa akuqhelekanga kwi-PCOS kwaye kunokubonisa enye ingxaki. Olu tshintsho lulandelayo lunokubonisa enye ingxaki ngaphandle kwePCOS:

• Ukucoca iinwele entloko kwiitempile, okubizwa ngokuba yimpandla yamadoda
• Ukwandiswa kwe-clitoris
• Ukujula kwelizwi
• Nciphisa ubungakanani besifuba

Umboneleli wakho wezempilo uya kwenza uvavanyo lomzimba. Oku kuya kubandakanya uvavanyo lwe-pelvic. Uviwo lunokubonisa:

• Ukwandiswa kwee-ovari kunye ne-cysts ezininzi ezincinci ziphawulwe kwi-ultrasound
• I-clitoris eyandisiweyo (inqabile kakhulu)

Ezi meko zilandelayo zempilo ziqhelekileyo kubafazi abane-PCOS:

• Ukuxhathisa kwe-insulin kunye neswekile
• Igazi elonyukayo
• Cholesterol ephezulu
• Ukutyeba kunye nokutyeba kakhulu

Umboneleli wakho uya kujonga ubunzima bakho kunye nesalathiso sobunzima bomzimba (BMI) kunye nokulinganisa ubungakanani besisu sakho.

Uvavanyo lwegazi lunokwenziwa ukujonga amanqanaba ehomoni. Olu vavanyo lunokubandakanya:

• Inqanaba le-Estrogen
• Inqanaba le-FSH
• Inqanaba le-LH
• Inqanaba lehomoni yamadoda (testosterone)

Olunye uvavanyo lwegazi olunokuthi lwenziwe lubandakanya:

• Ukuzila ukutya kweglucose (iswekile yegazi) kunye nezinye iimvavanyo zokunganyamezeli iswekile kunye nokumelana ne-insulin
• Inqanaba leLipid
• Uvavanyo lokukhulelwa (i-serum hCG)
• Inqanaba leprolactin
• Uvavanyo lomsebenzi we-thyroid

Umboneleli wakho unokuyalela kwakhona i-ultrasound yamathambo akho ukuba ajonge ii-ovari zakho.

Ukutyeba kunye nokutyeba kuqhelekile kubafazi abane-PCOS. Ukuphulukana nesixa esincinci sobunzima kunokunceda ukunyanga:

• Utshintsho lweHormone
• Imiqathango efana nesifo sikashukela, uxinzelelo lwegazi oluphezulu, okanye i-cholesterol ephezulu

Umboneleli wakho unokumisela iipilisi zolawulo lokuzalwa ukuze wenze amaxesha akho rhoqo. Ezi pilisi zinokunceda ekunciphiseni ukukhula kweenwele okungaqhelekanga kunye namabala ukuba uzithatha iinyanga ezininzi. Iindlela ezisebenza ixesha elide zokuthintela ukukhulelwa, ezinje nge-Mirena IUD, zinokunceda ukuyeka amaxesha angaqhelekanga kunye nokukhula okungaqhelekanga komtya wesibeleko.

Iyeza leswekile elibizwa ngokuba yiGlucophage (metformin) linokumiselwa ukuba:

• Yenza amaxesha akho rhoqo
• Nqanda uhlobo lweswekile yesi-2
• Nceda unciphise umzimba

Amanye amayeza anokumiselwa ukunceda ukwenza amaxesha akho rhoqo kwaye akuncede ukhulelwe zezi:

• Ukukhupha i-LH-hormone ekhupha i-LHRH
• I-Clomiphene citrate okanye i-letrozole, enokuvumela ii-ovari zakho ukuba zikhulule amaqanda kunye nokuphucula ithuba lokukhulelwa

La mayeza asebenza ngcono ukuba isalathiso sobunzima bomzimba wakho (i-BMI) ingama-30 okanye ngaphantsi (ngaphantsi koluhlu lokutyeba).

Umboneleli wakho unokucebisa nolunye unyango malunga nokukhula kweenwele okungaqhelekanga. Ezinye zezi:

• Spironolactone okanye iiplutamide iipilisi
• I-cream ye-Eflornithine

Iindlela ezisebenzayo zokususa iinwele zibandakanya i-electrolysis kunye nokususwa kweenwele ze-laser. Nangona kunjalo, unyango oluninzi lunokufuneka. Unyango luyabiza kwaye iziphumo zihlala zingasigxina.

I-laparoscopy ye-pelvic inokwenziwa ukususa okanye ukutshintsha i-ovary ukunyanga ukungachumi. Oku kuphucula amathuba okukhulula iqanda. Iziphumo zezokwexeshana.

Ngonyango, abasetyhini abane-PCOS bahlala bekwazi ukukhulelwa. Ngexesha lokukhulelwa, kukho umngcipheko okhulayo:

• Ukuphuma kwesisu
• Igazi elonyukayo
• Isifo seswekile

Abasetyhini abane-PCOS banamathuba okuphuhlisa:

• Umhlaza we-Endometrial
• Ukungachumi
• Seswekile
• Iingxaki ezinxulumene nokutyeba

Tsalela umnikezeli wakho ukuba unempawu zolu gulo.

IiPolycystic ovaries; Isifo sePolycystic ovary; Isifo se-Stein-Leventhal; Isifo se-ovarian Polyfollicular; I-PCOS

• Amadlala endocrine
• Iiparvic laparoscopy
• I-anatomy yokuzala yabasetyhini
• Isifo seStein-Leventhal
• Isibeleko
• Uphuhliso lweefollicle

IBulun SE. I-physiology kunye ne-pathology ye-axis yokuzala yabasetyhini. KwiMelmed S, Auchus RJ, Goldfine AB, Loenig RJ, et al, ii-eds. Incwadi ebhaliweyo kaWilliam ye-Endocrinology. Umhla we-14. IPhiladelphia, PA: Elsevier; 2020: isahluko 17.

UCatherino WH. Ukuzala i-endocrinology kunye nokungachumi. Ku: IGoldman L, iSchafer AI, ii-eds. Amayeza eGoldman-Cecil. Ngomhla wama-26. IPhiladelphia, PA: Elsevier; 2020: isahluko 223.

Lobo RA. Isifo sePolycystic ovary. Ku: Lobo RA, Gershenson DM, Lentz GM, Valea FA, ii-eds. Gynecology egqibeleleyo. Umhla wesi-7. IPhiladelphia, PA: Elsevier; Ngo-2017: isahluko 41.

IRosenfield RL, iBarnes RB, i-Ehrmann DA. Hyperandrogenism, hirsutism, kunye ne-polycystic ovary syndrome. Ku: Jameson JL, De Groot LJ, de Kretser DM, et al, ii-eds. Endocrinology: Abantu abadala kunye nabantwana. Umhla wesi-7. IPhiladelphia, PA: Elsevier Saunders; I-2016: isahluko 133.