Ukulibaziseka kokufikisa kumantombazana

Ukulibaziseka kokufikisa emantombazaneni kwenzeka xa amabele engakhuli ngeminyaka eli-13 okanye ukuya exesheni angaqali ngeminyaka eli-16.

Utshintsho olwenzeka kwinqanaba lokufikisa lwenzeka xa umzimba uqala ukwenza iihomoni zesini. Olu tshintsho ngesiqhelo luqala ukuvela kumantombazana aphakathi kweminyaka esi-8 ukuya kweli-14 ubudala.

Ngokulibaziseka kokufikisa, olu tshintsho mhlawumbi alwenzeki, okanye ukuba luyenzeka, alwenzi nkqubela phambili ngokwesiqhelo. Ukulibaziseka kokufikisa kuxhaphake kakhulu kubafana kunakwamantombazana.

Kwiimeko ezininzi zokulibaziseka kokufikisa, ukukhula kukhula kuqala emva kwexesha kunesiqhelo, ngamanye amaxesha kubizwa ngokuba yibloomer esekude. Nje ukuba ukufikisa kuqale, kuyaqhubeka ngokwesiqhelo. Le patheni isebenza kwiintsapho. Esi sesona sizathu siqhelekileyo sokuvuthwa kade.

Esinye isizathu esiqhelekileyo sokulibazisa ukufikisa kumantombazana kukunqongophala kwamafutha omzimba. Ukuba mncinci kakhulu kunokuphazamisa inkqubo yesiqhelo yokufikisa. Oku kunokwenzeka kumantombazana athi:

• Basebenza kakhulu kwezemidlalo, ezinje ngezokudada, iimbaleki, okanye abadanisi
• Unengxaki yokutya, njenge-anorexia okanye i-bulimia
• Abondlekanga

Ukulibaziseka kokufikisa nako kunokubakho xa ii-ovari zivelisa incinci kakhulu okanye zingabikho kwahomoni. Oku kubizwa ngokuba yi-hypogonadism.

• Oku kunokwenzeka xa ii-ovari zonakalisiwe okanye zingaphuhlisi njengoko kufanelekile.
• Inokwenzeka kwakhona ukuba kukho ingxaki ngamalungu engqondo abandakanyeka ekufikiseni.

Ezinye iimeko zonyango okanye unyango zinokukhokelela kwi-hypogonadism, kubandakanya:

• Imvelaphi yeCeliac
• Isifo sesibindi sokuvuvukala (IBD)
• IHypothyroidism
• Iswekile yemellitus
• Icystic fibrosis
• Isibindi kunye nesifo sezintso
• Izifo ezizimela ngokuzenzekelayo, ezinje ngeHashimoto thyroiditis okanye isifo iAddison
• I-Chemotherapy okanye unyango lomhlaza we-radiation olonakalisa ama-ovari
• Ithumba kwindlala yebhinqa
• I-Turner syndrome, isifo semfuza

Amantombazana aqala ukufikisa phakathi kweminyaka eyi-8 ukuya kwi-15. Ngokulibaziseka ekufikiseni, umntwana wakho unokuba nolunye okanye ezingaphezulu kwezi mpawu:

• Amabele akakhuli nge-13 yobudala
• Akukho zinwele zikawonke-wonke
• Ukuya esikhathini akuqali xa uneminyaka eli-16 ubudala
• Ukuphakama okufutshane kunye nezinga lokukhula kancinci
• Isibeleko asikhuli
• Ubudala bethambo bungaphantsi kobudala bomntwana wakho

Kunokubakho ezinye iimpawu, kuxhomekeka kwinto ebangela ukulibaziseka kokufikisa.

Umboneleli wezempilo womntwana wakho uya kuthatha imbali yosapho ukuba azi ukuba ukulibaziseka kokufikisa kuqhuba kusapho.

Umboneleli unokubuza malunga nomntwana wakho:

• Indlela zokutya
• Imikhwa yokuzilolonga
• Imbali yezempilo

Umboneleli uya kwenza uvavanyo lomzimba. Ezinye iimviwo zinokubandakanya:

• Uvavanyo lwegazi ukujonga amanqanaba okukhula kwamahomoni athile, iihomoni zesini, kunye nehomoni yedlala lengqula
• Impendulo ye-LH kuvavanyo lwegazi lwe-GnRH
• Uhlalutyo lweChromosomal
• I-MRI yentloko yamathumba
• I-Ultrasound yamaqanda kunye nesibeleko

IX-reyi yesandla sasekhohlo kunye nesihlahla sokuvavanya ubudala bethambo kunokufunyanwa kutyelelo lokuqala ukubona ukuba amathambo ayakhula na. Inokuphindwa ekuhambeni kwexesha, ukuba iyafuneka.

Unyango luya kuxhomekeka kwisizathu sokulibazisa ukufikisa.

Ukuba kukho imbali yosapho yokufikisa emva kwexesha, akukho lunyango lufunekayo. Ekuhambeni kwexesha, ukufikisa kuya kuqala ngokwakho.

Kumantombazana anamafutha omzimba amancinci kakhulu, ukufumana ubunzima obuncinci kunokunceda ukuqala ukufikisa.

Ukuba ukulibaziseka ukufikisa kubangelwa sisifo okanye kukungatyi, ukunyanga unobangela kunokunceda ukufikisa ukuba kukhule ngokwesiqhelo.

Ukuba ukufikisa kuyasilela ukukhula, okanye umntwana uxinezeleke kakhulu ngenxa yokulibaziseka, unyango lwehomoni lunokunceda ukuqala ukufikisa. Umboneleli uya:

• Nika i-estrogen (ihomoni yesini) ngeedosi eziphantsi kakhulu, nokuba kungomlomo okanye njengesiqwengana
• Ukubeka iliso kutshintsho lokukhula kunye nokunyusa idosi rhoqo kwiinyanga ezi-6 ukuya kwezi-12
• Yongeza iprogesterone (ihomoni yesini) ukuqala ukuya exesheni
• Nika iipilisi zomlomo zomlomo ukugcina amanqanaba aqhelekileyo ehomoni yesini

Ezi zixhobo zinokukunceda ufumane inkxaso kwaye uqonde ngakumbi malunga nokukhula komntwana wakho:

Isiseko seMAGIC- www.magicfoundation.org

I-Turner Syndrome Society yase-United States- www.turnersyndrome.org

Ukufikisa okulibazisekileyo okuqhuba kusapho kuya kuzisombulula.

Amanye amantombazana aneemeko ezithile, ezinje ngomonakalo kwii-ovari zawo, anokufuna ukuthatha iihormoni ubomi babo bonke.

Unyango lwe-estrogen lokutshintsha lunokuba neziphumo ebezingalindelekanga.

Ezinye iingxaki ezinokubakho zibandakanya:

• Ukuyeka ukuya exesheni kwangoko
• Ukungachumi
• Ukuxinana kwamathambo kunye nokuqhekeka kamva ebomini (i-osteoporosis)

Nxibelelana nomboneleli wakho ukuba:

• Umntwana wakho ubonakalisa ukukhula kancinci
• Ukufikisa akuqali ngeminyaka eli-13 ubudala
• Ukufikisa kuyaqala, kodwa akuhambi ngokwesiqhelo

Ukuthunyelwa kugqirha wonyango lwabantwana i-endocrinologist kunokucetyiswa kumantombazana anolibaziseko lokufikisa.

Ukulibaziseka kophuhliso lwezesondo - amantombazana; Ukulibaziseka esibelekweni - amantombazana; Umgaqo-siseko ukulibaziseka ukufikisa

IHaddad NG, i-Eugster EA. Ukulibaziseka kokufikisa. 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 122.

UKrueger C, Shah H. Amayeza okufikisa. Ku: Isibhedlele saseJohn Hopkins; UKleinman K, McDaniel L, Molloy M, ii-eds. Isibhedlele saseJohns Hopkins: Incwadana yeHarriet Lane. Umhla we-22. IPhiladelphia, PA: Elsevier; 2021: isahluko 5.

Isyne DM. I-Physiology kunye nokuphazamiseka kokufikisa. KwiMelmed S, Auchus RJ, Goldfine AB, Koenig RJ, Rosen CJ, ii-eds. Incwadi kaWilliam ye-Endocrinology. Umhla we-14. IPhiladelphia, PA: Elsevier; 2020: isahluko 26.