Hypogonadism

I-Hypogonadism yenzeka xa amadlala esini omzimba evelisa amancinci okanye engenawo kwaphela amahomoni. Emadodeni, ezi gland (gonads) zii-testes. Kwabasetyhini, la madlala abizwa ngokuba ngama-ovari.

Unobangela we-hypogonadism inokuba ziiprayimari (ii-testes okanye ii-ovari) okanye ezesibini (ingxaki ngepituitary okanye hypothalamus). Kwi-hypogonadism ephambili, ii-ovari okanye ii-testes ngokwazo azisebenzi kakuhle. Izizathu ze-hypogonadism eziphambili zibandakanya:

• Ukuphazamiseka okuthile okuzenzekelayo
• Ukuphazamiseka kwemfuza kunye nokukhula
• Usulelo
• Isibindi kunye nesifo sezintso
• Imitha (ukuya kwiigonads)
• Ugqirha
• Umonzakalo
  

Ezona ngxaki zixhaphakileyo zemfuza ezibangela i-hypogonadism ephambili yi-Turner syndrome (kwabasetyhini) kunye ne-Klinefelter's syndrome (emadodeni).

Ukuba sele unezinye iingxaki zokuzimela komzimba unokuba semngciphekweni omkhulu wokonakaliswa komzimba kwiigonads. Oku kunokubandakanya ukuphazamiseka okuchaphazela isibindi, i-adrenal gland, kunye ne-thyroid gland, kunye nohlobo lweswekile sokuqala.

Kumbindi we-hypogonadism, amaziko kwingqondo alawula ii-gonads (hypothalamus kunye ne-pituitary) awasebenzi kakuhle. Izizathu ze-hypogonadism esembindini zibandakanya:

• Anorexia amanosa
• Ukopha kwindawo yebhinqa
• Ukuthatha amayeza, njenge-glucocorticoids kunye ne-opiates
• Ukuyeka i-anabolic steroids
• Iingxaki zemfuza
• Usulelo
• Ukuswela ukutya
• Ukugqithisa kwentsimbi (hemochromatosis)
• Imitha (kwi-pituitary okanye kwi-hypothalamus)
• Ukukhawuleza, ukwehla kobunzima (kubandakanya ukuphulukana nobunzima emva kotyando lwe-bariatric)
• Utyando (uqhaqho lwesiseko skull kufutshane nepituitary)
• Umonzakalo
• Amathumba

Unobangela wofuzo we-hypogonadism esembindini sisifo seKallmann. Abantu abaninzi abanale meko banokwehla kwevumba.

Ukuyeka ukuya exesheni sesona sizathu siqhelekileyo sehypogonadism. Kuqhelekile kubo bonke abantu basetyhini kwaye kwenzeka ngokomndilili malunga neminyaka engama-50. Amanqanaba e-testosterone ayehla emadodeni njengoko ekhula, ngokunjalo. Uluhlu lwe testosterone eqhelekileyo egazini iphantsi kakhulu kwindoda eneminyaka engama-50 ukuya kwengama-60 ubudala kunakwiminyaka engama-20 ukuya kwengama-30 ubudala.

Amantombazana ane-hypogonadism awayi kuqala ukuya exesheni. I-Hypogonadism inokuchaphazela ukukhula kwabo kwebele kunye nokuphakama. Ukuba i-hypogonadism yenzeka emva kokufikisa, iimpawu kwabasetyhini zibandakanya:

• Kushushu
• Amandla kunye notshintsho lwemozulu
• Ukuya exesheni kuba kokungahambelaniyo okanye kokuyeka

Kumakhwenkwe, i-hypogonadism ichaphazela izihlunu, iindevu, amalungu okuzala kunye nelizwi. Ikwakhokelela kwiingxaki zokukhula. Emadodeni iimpawu zezi:

• Ukwandiswa kwebele
• Ukuphulukana nezihlunu
• Ukunciphisa umdla kwisini (i-libido ephantsi)

Ukuba i-pituitary okanye elinye ithumba lobuchopho likhona (central hypogonadism), kunokubakho:

• Intloko okanye ukulahleka kombono
• Ukukhutshwa kwebele ebisi (ukusuka kwiprolactinoma)
• Iimpawu zokunye ukusilela kwehomoni (njengehypothyroidism)

Ezona tumors zixhaphakileyo zichaphazela indawo yebhinqa yi-craniopharyngioma ebantwaneni kunye neprolactinoma adenomas kubantu abadala.

Kuya kufuneka ukuba ube neemvavanyo ukujonga:

• Inqanaba le-Estrogen (abasetyhini)
• I-follicle evuselela i-hormone (inqanaba le-FSH) kunye nenqanaba le-luteinizing hormone (LH)
• Inqanaba leTesttosterone (amadoda) -ukutolikwa kolu vavanyo kumadoda amadala nakumadoda atyebileyo kunokuba nzima ngenxa yoko iziphumo kufuneka kuxoxwe ngazo nengcali yehomoni (i-endocrinologist)
• Amanye amanyathelo omsebenzi wepituitary

Olunye uvavanyo lunokubandakanya:

• Uvavanyo lwegazi lwe-anemia kunye nentsimbi
• Uvavanyo lwe-Genetic kubandakanya i-karyotype ukujonga ubume be-chromosomal
• Inqanaba leprolactin (ubisi lwehomoni)
• Ubalo lwesidoda
• Uvavanyo lwe-thyroid

Ngamanye amaxesha uvavanyo lwe-imaging luyafuneka, njenge sonogram yee-ovari. Ukuba kurhanelwa ukuba isifo se-pituitary sinokwenziwa nge-MRI okanye nge-CT.

Kuya kufuneka uthathe amayeza asekwe kwihomoni. I-Estrogen kunye neprogesterone zisetyenziselwa amantombazana nabasetyhini. Amayeza eza ngohlobo lwepilisi okanye isikhumba. I-Testosterone isetyenziselwa amakhwenkwe kunye namadoda. Iyeza linokunikwa njengonobumba wesikhumba, ijeli yolusu, isisombululo esifakwe ekhwapheni, isiziba esifakwe kwintlaka ephezulu, okanye ngenaliti.

Kwabasetyhini abangakhange basuswe isibeleko, unyango oludibeneyo kunye ne-estrogen kunye neprogesterone lunokwehlisa ithuba lokuphuhliswa ngumhlaza we-endometrium. Abasetyhini abane-hypogonadism abane-drive esezantsi yesini banokuchazwa nge-testosterone yedosi ephantsi okanye enye ihomoni yamadoda ebizwa ngokuba yi-dehydroepiandrosterone (DHEA).

Kwabanye abantu basetyhini, inaliti okanye iipilisi zinokusetyenziselwa ukukhuthaza i-ovulation. Inaliti yehomoni yebhinqa ingasetyenziselwa ukunceda amadoda ukuba avelise isidoda. Abanye abantu banokufuna utyando kunye nonyango lwemitha ukuba ngaba kukho unobangela wesifo okanye unobangela wokuphazamiseka.

Iindlela ezininzi ze-hypogonadism ziyanyangeka kwaye zinembonakalo elungileyo.

Kwabasetyhini, i-hypogonadism inokubangela ukungachumi. Ukuyeka ukuya exesheni kuluhlobo lwe-hypogonadism olwenzeka ngokwendalo. Inokubangela ukukhanya okushushu, ukoma kwilungu lobufazi, kunye nokucaphuka njengoko amanqanaba e-estrogen esiwa. Umngcipheko we-osteoporosis kunye nesifo senhliziyo siyanda emva kokuyeka ukuya exesheni.

Abanye abantu basetyhini abane-hypogonadism bathatha unyango lwe-estrogen, ubukhulu becala abo banokuphelisa ukuya exesheni kwangoko. Kodwa ukusetyenziswa kwexesha elide kunyango lwehomoni kunokunyusa umngcipheko womhlaza webele, amahlwili egazi kunye nesifo sentliziyo (ngakumbi kubafazi abadala). Abasetyhini kufuneka bathethe nomboneleli wabo wezempilo malunga nemingcipheko kunye nezibonelelo zonyango lwe-menopausal hormone.

Emadodeni, i-hypogonadism ikhokelela ekuphulukaneni nesondo kwaye inokubangela:

• Ukungabi namandla
• Ukungachumi
• Unyango
• Ubuthathaka

Amadoda ngesiqhelo ane testosterone esezantsi njengoko bekhula. Nangona kunjalo, ukwehla kwamanqanaba eehomoni ayothusi kangako njengakwabasetyhini.

Thetha nomboneleli wakho ukuba uqaphela:

• Ukukhutshwa kwebele
• Ukwandiswa kwebele (amadoda)
• Ukutshisa okutshisayo (abasetyhini)
• Ukungabi namandla
• Ukulahleka kweenwele zomzimba
• Ukuphulukana nexesha lokuya exesheni
• Iingxaki zokukhulelwa
• Iingxaki ngesondo lakho lokuqhuba
• Ubuthathaka

Bobabini abesilisa nabasetyhini kufuneka babize umboneleli wabo ukuba baneentloko okanye iingxaki zombono.

Ukugcina ukomelela, ubunzima bomzimba oqhelekileyo kunye nokutya ngendlela esempilweni kunokunceda kwezinye iimeko. Abanye oonobangela abanokuthinteleka.

Ukusilela kweGonadal; Ukungaphumeleli kovavanyo; Ukungaphumeleli kwe-Ovarian; I-testosterone-hypogonadism

• IiGonadotropins

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