Hypogonadotropic hypogonadism

I-Hypogonadism yimeko apho iimvavanyo zamadoda okanye ii-ovari zabasetyhini zivelisa incinci okanye zingabikho kwaphela iihomoni zesini.

I-Hypogonadotropic hypogonadism (HH) luhlobo lwehypogonadism ngenxa yengxaki yedlala lengqula okanye ihipothalamus.

I-HH ibangelwa kukungabikho kwamahomoni ahlala evuselela ii-ovari okanye ii-testes. Ezi hormone zibandakanya i-gonadotropin-ekhulula i-hormone (GnRH), i-follicle evuselela i-hormone (FSH) kunye ne-luteinizing hormone (LH).

Ngokwesiqhelo:

• Ihypothalamus kwingqondo ikhupha i-GnRH.
• Le hormone ikhuthaza i-pituitary gland ukukhupha i-FSH kunye ne-LH.
• Ezi hormone zixelela ama-ovari ababhinqileyo okanye iimvavanyo zamadoda ukuba zikhuphe iihormoni ezikhokelela ekukhuleni ngokwesini okuqhelekileyo xa ufikisa, imijikelo yesiqhelo yokuya exesheni, amanqanaba e-estrogen kunye nokuzala kwabafazi abadala, kunye nemveliso yesiqhelo ye testosterone kunye nemveliso yesidoda emadodeni amadala.
• Naluphi na utshintsho kule khonkco lokukhupha ihomoni lubangela ukunqongophala kwamahomoni esini. Oku kuthintela ukukhula ngokwesini okuqhelekileyo ebantwaneni kunye nokusebenza kwesiqhelo kwamatyhalarha okanye amaqanda kubantu abadala.

Kukho izizathu ezininzi zeHH:

• Ukonakala kwendlala yebhinqa okanye ihypothalamus kuqhaqho, ukwenzakala, ithumba, usulelo okanye imitha
• Iziphene zemfuza
• Amanani aphezulu okanye ukusetyenziswa kwexesha elide kwamayeza e-opioid okanye i-steroid (glucocorticoid)
• Inqanaba eliphezulu leprolactin (ihomoni ekhutshwa yipituitary)
• Uxinzelelo olukhulu
• Iingxaki zesondlo (kokubini ukukhawuleza ukufumana ubunzima okanye ukunciphisa umzimba)
• Izifo zonyango zexesha elide (ezingapheliyo), kubandakanya ukudumba okungapheliyo okanye usulelo
• Ukusetyenziswa kweziyobisi, njengeheroin okanye ukusetyenziswa gwenxa kwamayeza kagqirha
• Iimeko ezithile zonyango, ezinjenge-iron overload

I-Kallmann syndrome luhlobo lweHH. Abanye abantu abakule meko banayo i-anosmia (ukuphulukana nokuziva ngevumba).

Bantwana:

• Ukungabikho kophuhliso ekukhulelweni (ukukhula kunokuba semva kwexesha okanye kungagqityi)
  
• Kumantombazana, ukunqongophala kokukhula kwebele kunye nokuya exesheni
• Kumakhwenkwe, akukho phuhliso lweempawu zesondo, ezinje ngokwandiswa kovavanyo kunye nepenisi, ukujula kwelizwi, kunye neenwele zobuso
• Ukungakwazi ukunuka (kwezinye iimeko)
• Ubume obufutshane (kwezinye iimeko)

Abantu abadala:

• Ukuphulukana nomdla kwisini (libido) emadodeni
• Ukuphulukana nexesha lokuya exesheni (amenorrhea) kwabasetyhini
• Ukuncipha kwamandla kunye nomdla kwimisebenzi
• Ukuphulukana nobunzima bemisipha emadodeni
• Ukutyeba kwakho
• Imood iyatshintsha
• Ukungachumi
  

Umboneleli wezempilo uya kwenza uvavanyo lomzimba kwaye abuze malunga neempawu zakho.

Uvavanyo olunokwenziwa lunokubandakanya:

• Uvavanyo lwegazi ukulinganisa amanqanaba ehomoni afana ne-FSH, LH, kunye ne-TSH, iprolactin, testosterone kunye ne-estradiol
• Impendulo ye-LH kwi-GnRH
• I-MRI ye-pituitary gland / hypothalamus (ukukhangela ithumba okanye olunye ukukhula)
• Uvavanyo lwemfuzo
• Uvavanyo lwegazi ukukhangela inqanaba le-iron

Unyango luxhomekeke kumthombo wengxaki, kodwa inokubandakanya:

• Inaliti ye testosterone (emadodeni)
• Ukucothisa isikhululo se testosterone esikhulayo (emadodeni)
• Igelosi ye testosterone (emadodeni)
• Iipilisi ze-Estrogen kunye neprogesterone okanye amabala esikhumba (kubantu ababhinqileyo)
• Inaliti ye-GnRH
• Inaliti ye-HCG
  

Unyango olululo lwehomoni luya kubangela ukuba ukufikisa luqale ebantwaneni kwaye lunokubuyisela ukuchuma kubantu abadala. Ukuba imeko iqala emva kokufikisa okanye ebudaleni, iimpawu ziya kuhlala ziphucula kunyango.

Iingxaki zempilo ezinokubangelwa yi-HH zibandakanya:

• Ukulibaziseka kokufikisa
• Ukuyeka ukuya exesheni (kwabasetyhini)
• Ukungachumi
• Ukuxinana kwamathambo kunye nokuqhekeka kamva ebomini
• Ukuzithemba okuphantsi ngenxa yokuqalisa kwexesha lokufikisa (inkxaso yeemvakalelo inokuba luncedo)
• Iingxaki zesondo, ezinjenge-libido ephantsi

Fowunela umnikezeli wakho ukuba:

• Umntwana wakho akaqali ukufikisa ngexesha elifanelekileyo.
• Ungumfazi ongaphantsi kweminyaka engama-40 kwaye ukuyeka kwakho ukuya exesheni kuyeke.
• Uphulukene nekhwapha okanye iinwele zasesidlangalaleni.
• Uyindoda kwaye uye wancipha umdla kwisini.

Ukunqongophala kweGonadotropin; Isekondari hypogonadism

• Amadlala endocrine
• Indawo yolwimi lamathe
• IiGonadotropins

UBhasin S, uBrito JP, uCunningham GR, et al. Unyango lwe-testosterone emadodeni ane-hypogonadism: Isikhokelo se-Endocrine Society sonyango. J Ikliniki ye-Endocrinol Metab. 2018; 103 (5): 1715-1744. IINKCUKACHA: 29562364 www.ncbi.nlm.nih.gov/pubmed/29562364.

I-Styne DM, iGrumbach MM. I-Physiology kunye nokuphazamiseka kokufikisa. Ku: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, ii-eds. Incwadi ebhaliweyo kaWilliam ye-Endocrinology. Umhla we-13. IPhiladelphia, PA: Elsevier; 2016: isahluko 25.

IPc emhlophe. Ukukhula ngokwesondo kunye nokuzazisa. Ku: IGoldman L, iSchafer AI, ii-eds. Amayeza eGoldman-Cecil. Ngomhla wama-26. IPhiladelphia, PA: Elsevier; 2020: isahluko 220.