Hypogonadism

Hypogonadism inoitika kana gland remuviri repabonde rinoburitsa mashoma kana asina mahormone. Muvarume, izvi zvipembenene (gonads) ndiwo ma testes. Mumadzimai, izvi zvipembenene ndiwo mazamu.

Icho chinokonzera hypogonadism inogona kuve yekutanga (testes kana ovari) kana yechipiri (dambudziko nepituitary kana hypothalamus). Mukutanga hypogonadism, mazai kana ma testes pachawo haashande nemazvo. Zvikonzero zvekutanga hypogonadism zvinosanganisira:

• Zvimwe zvinokanganisa autoimmune
• Genetic uye kusimudzira kusagadzikana
• Utachiona
• Chiropa uye chirwere cheitsvo
• Radiation (kune iyo gonads)
• Kuvhiya
• Kushungurudzika
  

Matambudziko anowanzoitika anowanzoita hypogonadism ndeye Turner syndrome (mune vakadzi) uye Klinefelter syndrome (mune varume).

Kana iwe uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchingoita wega autoimmune kusagadzikana iwe unogona kunge uri padanho repamusoro rekukuvara kwega kuzvimiririra kumagonad Izvi zvinogona kusanganisira kusagadzikana kunokanganisa chiropa, adrenal gland, uye thyroid maseru, pamwe nerudzi rwe1 chirwere cheshuga.

Pakati pe hypogonadism, nzvimbo dziri muuropi dzinodzora gonads (hypothalamus uye pituitary) hadzishande nemazvo. Zvinokonzera epakati hypogonadism zvinosanganisira:

• Anorexia nervosa
• Kubuda ropa munzvimbo yepituitary
• Kutora mishonga, yakadai seglucocorticoids uye maopiates
• Kumisa vanabolic steroid
• Zvinetso zvemajini
• Zvirwere
• Kushomeka kwehutano
• Iron yakawandisa (hemochromatosis)
• Radiation (kune iyo pituitary kana hypothalamus)
• Inokurumidza, yakakosha kurasikirwa uremu (kusanganisira kurasikirwa uremu mushure mekuvhiyiwa bariatric)
• Kuvhiya (skull base surgery padhuze nepituitary)
• Kushungurudzika
• Mamota

Icho chinokonzera chikonzero chepakati hypogonadism ndiKallmann syndrome. Vanhu vazhinji vane chirwere ichi zvakare vane yakaderera pfungwa yekunhuwidza.

Kuenda kumwedzi ndicho chikonzero chakajairika che hypogonadism. Izvo zvakajairika mumadzimai ese uye zvinoitika paavhareji kutenderera makore makumi mashanu.Mazinga eTesttosterone anoderera muvarume sezvavanokura, zvakare Iyo renji yeyakajairika testosterone muropa yakadzika kwazvo mumurume ane makore makumi mashanu kusvika makumi matanhatu ekuberekwa pane zviri mumurume ane makore makumi maviri kusvika makumi matatu.

Vasikana vane hypogonadism havazotanga kuenda kumwedzi. Hypogonadism inogona kukanganisa kukura kwavo uye kukura. Kana hypogonadism ikaitika mushure mekuyaruka, zviratidzo mumadzimai zvinosanganisira:

• Kupisa kunopisa
• Simba uye mafungiro anochinja
• Kutevera kunova kusina kumira kana kumira

Muvakomana, hypogonadism inokanganisa mhasuru, ndebvu, genital uye kukura kwenzwi. Izvo zvinotungamirawo kumatambudziko ekukura. Mune varume zviratidzo ndeizvi:

• Kuwedzera kwemazamu
• Tsandanyama kurasikirwa
• Kuderedza kufarira pabonde (low libido)

Kana pituitary kana rimwe bundu rebongo riripo (central hypogonadism), panogona kuve ne:

• Kutemwa nemusoro kana kurasikirwa kwemaonero
• Milky zamu kubuda (kubva kune prolactinoma)
• Zviratidzo zvekumwe kushomeka kwehomoni (senge hypothyroidism)

Mamota akajairika anokanganisa pituitary ndiwo craniopharyngioma muvana uye prolactinoma adenomas muvakuru.

Ungangoda kuve nemiedzo kuti utarise:

• Estrogen level (vakadzi)
• Follicle inosimudzira mahormone (FSH mwero) uye luteinizing hormone (LH) nhanho
• Testosterone level (varume) - kududzirwa kweiyi bvunzo kuvarume vakuru nevarume vakafutisa kunogona kuva kwakaoma saka mhedzisiro inofanirwa kukurukurwa neyehormoni nyanzvi (endocrinologist)
• Mamwe matanho epituitary basa

Mimwe bvunzo inogona kusanganisira:

• Ropa kuongororwa kweanemia uye iron
• Genetic bvunzo inosanganisira karyotype kutarisa chromosomal chimiro
• Prolactin (mukaka mahormone)
• Kuverenga kwehurume
• Utachiona miedzo

Dzimwe nguva kuongororwa kwekufungidzira kunodiwa, senge sonogram yemazai. Kana chirwere chepituitary chiri kufungidzirwa, iyo MRI kana CT scan yehuropi inogona kuitwa.

Ungangoda kutora mahormone-based mishonga. Estrogen uye progesterone zvinoshandiswa zvevasikana nevakadzi. Mishonga yacho inouya iri muchimiro chepiritsi kana chiganda cheganda. Testosterone inoshandiswa kune vakomana nevarume. Mushonga unogona kupihwa seganda chiganda, ganda gel, mhinduro inogadziriswa muhapwa, chigamba chakaiswa kuchikamu chepamusoro, kana jekiseni.

Kune vakadzi vasina kubviswa chibereko, kusanganiswa kurapwa neestrogen uye progesterone kunogona kudzora mukana wekuva nekenza yemendometri. Vakadzi vane hypogonadism vane yakaderera bonde drive vanogona zvakare kupihwa yakaderera-dose testosterone kana imwe hono mahormone inonzi dehydroepiandrosterone (DHEA).

Mune vamwe vakadzi, majekiseni kana mapiritsi anogona kushandiswa kukurudzira ovulation. Majekiseni epituitary hormone anogona kushandiswa kubatsira varume kuburitsa urume. Vamwe vanhu vangangoda kuvhiyiwa uye kurapwa nemwaranzi kana paine pituitary kana hypothalamic chinokonzera chirwere.

Mhando zhinji dze hypogonadism dzinorapika uye dzine tarisiro yakanaka.

Mune vakadzi, hypogonadism inogona kukonzera kushaya mbereko. Kuenda kumwedzi chimiro che hypogonadism chinoitika zvakasikwa. Inogona kukonzeresa kupisa, kusangana nekutsi kwemukadzi kusangana nekutsi kwemukadzi, uye kutsamwa senge mwero wesrogen unowira. Ngozi ye osteoporosis uye chirwere chemwoyo chinowedzera mushure mekuguma kuenda kumwedzi.

Vamwe vakadzi vane hypogonadism vanotora estrogen kurapwa, kazhinji kazhinji avo vanove nekutanga kuenda kumwedzi. Asi kushandiswa kwenguva refu kwehomoni yekurapa kunogona kuwedzera njodzi yekenza yemazamu, kugwamba kweropa uye chirwere chemwoyo (kunyanya kuvakadzi vakuru). Vakadzi vanofanirwa kutaura nemubatsiri wavo wezvehutano nezvengozi uye zvakanakira menopausal hormone therapy.

Mune varume, hypogonadism inokonzeresa kurasikirwa nebonde drive uye inogona kukonzera:

• Kushaya simba
• Kushaya mbereko
• Osteoporosis
• Kushaya simba

Varume kazhinji vane testosterone yakaderera sezvavanokwegura. Zvisinei, kuderera kwemazinga ehomoni hakusi kunoshamisa sezvazviri kuvakadzi.

Taura nemupi wako kana iwe ukaona:

• Kubuda zamu
• Kuwedzera kwemazamu (varume)
• Kupisa kupisa (vakadzi)
• Kushaya simba
• Kurasikirwa nevhudzi remuviri
• Kurasikirwa nekuenda kumwedzi
• Matambudziko kutora pamuviri
• Matambudziko neako bonde dhiraivha
• Kushaya simba

Vese varume nevakadzi vanofanirwa kufonera mupiki wavo kana vaine musoro kana matambudziko ekuona.

Kuchengetedza kugwinya, kurema kwemuviri uye tsika dzekudya zvine hutano zvinogona kubatsira mune dzimwe nguva. Zvimwe zvikonzero zvinogona kunge zvisingadziviririke.

Gonadal kushomeka; Testicular kutadza; Kukundikana kweovarian; Testosterone - hypogonadism

• Gonadotropin

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Bhasin S, Brito JP, Cunningham GR, uye al. Testosterone therapy mune varume vane hypogonadism: iyo Endocrine Society kiriniki yekudzidzira nhungamiro. J Clin Endocrinol Metab. 2018; 103 (5): 1715-1744. PMID: 29562364 pubmed.ncbi.nlm.nih.gov/29562364/.

Styne DM. Physiology uye kusagadzikana kwekuyaruka. Mune: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Chinyorwa chePediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020: chitsiko 26.

Swerdloff RS, Wang C. Iwo testis uye echikadzi hypogonadism, kushaya mbereko, uye kusagadzikana pabonde. Mune: Goldman L, Schafer AI, eds. Goldman-Cecil Mushonga. 26th ed. Philadelphia, PA: Elsevier; 2020: chitsiko 221.

van den Beld AW, Mambure SWJ. Endocrinology uye kuchembera. Mune: Melmed S, Auchus RJ, Goldfine AB, Koenig RJ, Rosen CJ, eds. Williams Chinyorwa cheEndocrinology. 14th ed. Philadelphia, PA: Elsevier; 2020: chitsiko 28.