Ke hopohopo nei hoʻi ʻoe e pili ana i ka piʻi ʻana o nā hormones kāne i loko o ke kino? E kamaʻilio kākou e pili ana i ka hyperandrogenism!

Ke hopohopo nei ʻoe no kekahi mau loli i kou kino? Malia paha ʻo ke kumu ka hoʻonui ʻia ʻana o ka nui o ka androgen, kahi ʻano hormone kāne, i loko o ke kino. Ua kapa ʻia kēia ʻano ma ke ʻano lapaʻau he hyperandrogenism . Mai hopohopo, e kamaʻilio maʻalahi mākou e pili ana i kēia, ma ke ʻano hiki iā ʻoe ke hoʻomaopopo.

He aha maoli ka hyperandrogenism?

I ka ʻōlelo maʻalahi, ʻo ka hyperandrogenism ke ʻano he nui loa nā androgens i loko o kou kino, kahi ʻano hormone wahine. He mea nui nā Androgens no ka wā ʻōpio, ke olakino hānau hou, a me ka ulu ʻana o ke kino.

E nānā, he mau kemika nā hormones i loko o ko kākou kino. Ua like lākou me nā ʻelele. Hele lākou ma ke koko a haʻi i ko kākou mau ʻōpū, nā ʻiʻo, a me nā ʻiʻo ʻē aʻe i ka mea e hana ai a me ka manawa e hana ai.

Hoʻopuka ʻia nā Androgens i loko o ke kino o kēlā me kēia kanaka. Akā, ʻo nā kāne ka mea nui loa. Hoʻopuka nā wāhine ma kahi o hoʻokahi hapaʻumikūmālua o ka nui i loko o ke kino o ke kāne. ʻO Testosterone ka mea nui o kēia mau androgens.

Hoʻopuka ʻia nā Androgens e nā testicles i nā kāne a me nā ovaries i nā wahine. Hoʻopuka ʻia kēia mau hormones e nā kelepa adrenal i luna o ko kākou mau puʻupaʻa. Kōkua pū lākou i ka hoʻololi ʻana i nā androgens nāwaliwali i nā mea ikaika ma nā wahi e like me ka ʻiʻo momona a me ka ʻili.

Hiki ke ʻokoʻa nā hōʻailona o kēia ʻano, i kapa ʻia ʻo hyperandrogenism, ma muli o kou makahiki a me ke kāne. Nui nā kumu kūpono, a aia nā lāʻau lapaʻau no ia.

He like anei ka Hyperandrogenism a me ka PCOS?

Manaʻo ka poʻe he nui he maʻi like ka Hyperandrogenism a me ka Polycystic Ovary Syndrome (PCOS) . ʻOiai he pilina pili loa ma waena o nā mea ʻelua, ʻaʻole like lāua.

ʻO ka Hyperandrogenism kahi hiʻohiʻona koʻikoʻi o ka PCOS. ʻO ka PCOS kahi kūlike ʻole hormonal i hoʻokumu ʻia e nā ovaries e hana ana i ka nui o nā hormones kāne. Hoʻopilikia ia i nā wahine.

No laila, ʻoiai ʻo ka PCOS kahi kumu maʻamau o ka hyperandrogenism, aia kekahi mau kumu ʻē aʻe o ka hyperandrogenism. Pēlā nō, loaʻa i ka PCOS nā hōʻailona ʻē aʻe, e like me nā ovarian cysts, ma waho aʻe o nā hōʻailona o ka hyperandrogenism.

ʻO wai ka mea i hoʻopilikia nui ʻia e kēia maʻi? Pehea ka maʻamau o ia mea?

Hiki i ka Hyperandrogenism ke hoʻopilikia i kekahi - nā keiki ʻōpio, nā pākeke, nā mea āpau. Eia nō naʻe, ʻoi aku ka maʻamau i nā wahine o ka wā hānau keiki .

Ma waena o 5% a me 10% o nā wahine o ka makahiki hānauHe mea hoʻopilikia kēia kūlana. ʻO ia hoʻi, ʻaʻole kēia he mea kakaikahi e like me kou manaʻo.

ʻAʻole hiki ke hoʻopilikia iki kēia maʻi i nā keikikāne a me nā kāne makua.

He aha nā hōʻailona o kēia?

ʻOkoʻa nā hōʻailona o ka hyperandrogenism ma muli o kou kāne a inā paha ua hala ʻoe i ka wā ʻōpio.

Akā eia kahi mea nui e hoʻomanaʻo ai. ʻOiai inā loaʻa iā ʻoe kēia mau hōʻailona, ​​​​hiki ke maʻamau kou mau pae androgen koko. ʻO kēia no ka mea hiki i kēlā me kēia o kēia mau hōʻailona ke loaʻa nā kumu ʻē aʻe. Eia kekahi, inā hōʻike nā hoʻokolohua koko ua kiʻekiʻe kou mau pae androgen, ʻaʻole paha ʻoe e loaʻa i kekahi mau hōʻailona nui.

ʻO ka mea nui loa, inā ʻike koke ʻia kēia mau hōʻailona me ka wikiwiki, pono ʻoe e ʻike koke i ke kauka, no ka mea, i ia mau hihia, hiki ke kumu i kahi tumo huna androgen.

I kēia manawa, e nānā kākou pehea e pili ai kēia i nā poʻe like ʻole.

No nā kaikamāhine (ma mua o ka wā ʻōpio)

• ʻO ka clitoris i hoʻonui ʻia .
• ʻIli ʻākala a me ka ʻili ʻaila.
• Ka ulu ʻole ʻana o ka lauoho kino (hirsutism) . ʻO ke ʻano kēia, ua pani ʻia ka "lauoho ʻeleʻele māmā" e ka lauoho ʻālohilohi a ʻālohilohi ma nā wahi e like me ka lehelehe luna, ka ʻauwae, ka umauma, ka ʻōpū, a me ke kua.

No nā keiki kāne (ma mua o ka wā ʻōpio)

• Penis i hoʻonui ʻia .
• Ka ulu mua ʻana o ka lauoho a nui paha ma nā wahi pilikino a me nā ʻēheu.
• Ka hoʻohōhonu ʻana o ka leo.

No nā wāhine ʻelemakule

• ʻIli ʻākala a me ka ʻili ʻaila.
• Ka ulu ʻole ʻana o nā follicle lauoho o ke kino ( hirsutism) .
• ʻO ke kaʻina hana menstrual maʻamau ʻole o kēlā me kēia mahina.
• Ka paʻakikī i ka hānau keiki ʻana (infertility) .
• ʻO ka nalowale o ka lauoho kāne ( androgenic alopecia) .

No nā kāne makua

ʻO ke ʻano o kēia hopena i nā kāne makua e pili ana i ka loaʻa ʻana o nā hormones keu mai nā kelepa adrenal a i ʻole mai kahi mea i lawe ʻia ma waho (e like me nā inikini steroid anabolic ). Inā piʻi aʻe nā androgens mai nā kelepa adrenal, ʻaʻole paha e ʻike nā kāne makua i nā loli kino nui. Eia nō naʻe, hiki iā ia ke hōʻemi i ka hana o nā testicles a hoʻolilo i mea paʻakikī ke loaʻa nā keiki.

No ke aha lā kēia e hana nei? He aha nā kumu?

Hoʻopuka ʻia nā hormones Androgen e nā ovaries, nā kelepa adrenal, a me nā hunaola momona i nā wahine, a e nā testicles a me nā kelepa adrenal i nā kāne.

Aia kekahi mau hormones ʻē aʻe e hoʻopilikia i ka hana ʻana a me ka hoʻokuʻu ʻana o kēia mau androgens. No ka laʻana , ka hormone luteinizing (LH) a me ka hormone adrenocorticotrophic (ACTH) . Hoʻokuʻu ʻia kēia mau hormones ʻelua e ka pituitary gland.

Inā ʻaʻole hana pono kekahi a ʻoi aku paha o kēia mau ʻāpana, a i ʻole kekahi o kēia mau hormones, hiki ke hana i ka hyperandrogenism.

Aia kekahi mau kumu nui no kēia:

• ʻO ka maʻi polycystic ovary (PCOS) - ʻO kēia ke kumu maʻamau.
• ʻO ka Hyperplasia Adrenal Congenital (CAH) .
• ʻO ka maʻi ʻo Cushing .
• Nā puʻupuʻu huna-androgen.
• Kekahi mau lāʻau lapaʻau.

I kēia manawa, e nānā kākou i kēlā me kēia kumu me nā kikoʻī hou aku.

ʻO ka maʻi ovary polycystic (PCOS)

I waena o nā wāhine ʻōpio a me nā wāhine ʻelemakule, ʻo ka PCOS ke kumu maʻamau o ka hyperandrogenism mau loa ma hope o ka wā ʻōpio. Ma waena o 80% a me 90% o nā wāhine me ka hyperandrogenism he PCOS pū kekahi .

I ka PCOS, hana nā ovaries i nā androgens hou aʻe ma muli o ke kiʻekiʻe mau o ka LH a me ka insulin (hyperinsulinemia). Eia kekahi, ʻo ka piʻi ʻana o ka pae insulin e kāohi pū i ke akepaʻa mai ka hana ʻana i kahi protein i kapa ʻia ʻo Sex Hormone Binding Globulin (SHBG) . Hoʻonui kēia i ka pae o ka testosterone manuahi i loko o ke koko.

ʻO ka hyperplasia adrenal hānau `(CAH)`

ʻO ka congenital adrenal hyperplasia (CAH) kahi hui o nā kūlana genetic e hoʻopilikia i nā kelepa adrenal.

I loko o CAH, hoʻokumu nā hoʻololi genetic i kahi hemahema i loko o kahi enzyme i kapa ʻia ʻo 21-hydroxylase , kahi e kōkua ai i ke kino e hana i nā hormones. I loko o nā poʻe he nui me CAH, ʻo kēia hemahema enzyme ke kumu o nā kelepa adrenal e hana i nā hormones ʻē aʻe, e like me ka testosterone.

ʻO ke kumu maʻamau o ka hyperandrogenism i nā wahine me ka adrenal hyperplasia ʻo ia ka non-classical congenital adrenal hyperplasia . He kūlana kēia kahi i nele hapa ai ka enzyme 21-hydroxylase. Hoʻopilikia kēia kūlana i kahi 2% o nā wahine me ka hyperandrogenism.

ʻO ka maʻi Cushing

ʻO ka maʻi Cushing kahi ʻano maʻi i kapa ʻia ʻo Cushing syndrome . ʻO ka Cushing syndrome kahi maʻi kakaikahi e kū mai ana i ka wā e nui loa ai ka cortisol (he hormone hoʻi) i ke kino.

Hoʻokumu ʻia ka maʻi Cushing e kahi puʻupuʻu ʻaʻole kanesa i loko o ka pituitary gland. Hoʻopuka kēia puʻupuʻu i ka ACTH keu (adrenocorticotropic hormone), kahi e hoʻonui ai i nā pae cortisol.

ʻO ka nui o ka ACTH e hoʻokuʻu i nā androgens keu, ʻo ia ke kumu o ka hyperandrogenism.

He mau hōʻailona ʻē aʻe ko Cushing syndrome:

• Nā māka ʻōniʻoniʻo poni ma ka ʻōpū.
• Piʻi koke ke kaumaha ma ka maka, ka ʻōpū, a me ka ʻāʻī.
• Ke koko kiʻekiʻe.

Inā loaʻa iā ʻoe nā hōʻailona e like me kēia, he mea nui loa e ʻike koke i ke kauka.

Nā puʻupuʻu huna-androgen

Hiki i kekahi mau puʻupuʻu kelepa adrenal, a i ʻole nā ​​puʻupuʻu i loko o nā ovaries a i ʻole nā ​​testicles, ke hana a hoʻopuka i nā androgens. ʻO kēia ke kumu o nā pae androgen o ke kino e kiʻekiʻe aʻe ma mua o ka maʻamau. ʻO ke kūlana o ka hyperandrogenism i hoʻokumu ʻia e kēia mau puʻupuʻu he mea koʻikoʻi loa ia a hiki koke mai .

He mea kākaʻikahi ka hyperandrogenism, i hoʻokumu ʻia e nā ʻōpū ovarian a i ʻole adrenal. Hoʻopilikia wale ia ma kahi o 0.2% o nā kānaka. Eia nō naʻe, inā loaʻa koke iā ʻoe nā hōʻailona o ka hyperandrogenism, e ʻike koke i ke kauka.

Kekahi mau lāʻau lapaʻau

Hiki i kekahi mau lāʻau lapaʻau ke hana i ka hyperandrogenism. ʻO nā lāʻau lapaʻau nui e hoʻoulu ai i kēia:

• ʻO nā steroids anabolic-androgenic (he mau ʻano synthetic kēia o ka testosterone, hoʻohana hewa ʻia e kekahi mau mea pāʻani e hoʻonui i ka hana).
• ʻO nā progestins synthetic (ʻo ia nā lāʻau lapaʻau e hoʻololi ai i ka ʻōpū a hoʻohana ʻia no nā mea like ʻole).
• Nā lāʻau antiepileptic ( nā lāʻau lapaʻau e pale ai i nā hopu ʻana ).

Pehea ʻoe e ʻike ai i kēia? (Diagnosis)

Inā he wahine ʻoe a ke manaʻo nei ʻoe he hyperandrogenism kou, e hana kāu kauka i kahi hoʻokolokolo kino a nānā i nā hōʻailona e like me ka ulu ʻana o ka lauoho makemake ʻole ʻia. E nīnau pū lākou iā ʻoe i kekahi mau nīnau e pili ana i kou mōʻaukala olakino:

• ʻO ka makahiki e hoʻomaka ai ka ulu ʻana o nā umauma.
• ʻO ka makahiki e hoʻomaka ai ka lauoho e ʻike ʻia ma kahi pilikino.
• Ka makahiki i ka wā mua o ka menstruation.
• Ke wehe nei ʻoe i ka lauoho (kahi ʻumi, ua loaʻa anei iā ʻoe ka wehe ʻana i ka lauoho laser)?
• Ua hoʻohana mua anei ʻoe i nā steroid anabolic a i ʻole testosterone me ke kauoha ʻole a ke kauka?
• Nā mea e like me ka pinepine o ka hiki ʻana mai o kou wā, ka nui o nā lā e mau ai, a me ka nui o ke koko āu e kahe ai ke koko.

Inā kānalua kāu kauka he hyperandrogenism kou, e kauoha lākou i nā hoʻāʻo koko e nānā i kekahi mau pae hormone. Hiki i kēia mau hoʻāʻo ke kōkua i ka ʻike ʻana i ke kūlana.

He aha ke ʻano o nā hoʻokolohua e hana ʻia?

Inā loaʻa iā ʻoe nā hōʻailona o ka hyperandrogenism, hiki i kāu kauka ke kauoha i nā hoʻokolohua koko e like me kēia:

• Ka nui o ka testosteroneʻO kēia ke ana i ka nui o ka testosterone i loko o kou koko. Hiki ke kiʻekiʻe iki aʻe kēia pae i nā wahine me PCOS. Inā kiʻekiʻe loa ia, hiki ke lilo i puʻupuʻu i loko o nā ovaries a i ʻole nā ​​​​testicles.
• Testosterone manuahi : ʻAʻole i hoʻopaʻa ʻia kēia testosterone i kekahi protein. He wahi liʻiliʻi kēia o ka testosterone holoʻokoʻa. Hiki ke hoʻonui ʻia kēia pae i nā wahine me PCOS.
• ʻAndrostenedione : He hormone steroid kēia nona ka hopena androgenic liʻiliʻi i ke kino. Eia nō naʻe, hana nui ia ma ke ʻano he hana waena i ka hana ʻana o ka testosterone a me ka estrogen i loko o ke kino. Inā kiʻekiʻe kona mau pae, aia paha ka PCOS.
• ʻO Dehydroepiandrosterone sulfate (DHEAS) : ʻO DHEAS kahi hormone wahine i hana ʻia e nā kelepa adrenal. No laila, he hōʻailona maikaʻi ia o ka hana ʻana o ka androgen adrenal. He mea maʻamau no nā wahine me PCOS ke loaʻa iki nā pae DHEAS i kiʻekiʻe. Inā kiʻekiʻe loa ia, he hōʻailona paha ia o kahi puʻupuʻu adrenal.
• 17-hydroxyprogesterone : ʻO ke ana ʻana i ka pae o 17-hydroxyprogesterone i loko o ke koko he hoʻāʻo maʻamau ia e nānā ai i ke alo o ka hyperplasia adrenal congenital non-classic, kahi kūlana kekahi kumu o ka hyperandrogenism.

Ma muli o ke kumu o nā hōʻailona o ka hyperandrogenism, e kauoha kāu kauka i nā hoʻāʻo koko ʻē aʻe e hoʻopau i kēlā mau kumu.

Eia kekahi, hiki ke hana ʻia nā hoʻokolohua kiʻi e like me kēia e hoʻoholo ai i ke kumu o ka hyperandrogenism:

• ʻO kahi ultrasound pelvic e nānā i nā ovarian cysts (kekahi hōʻailona o PCOS) a i ʻole nā ​​​​puʻupuʻu ʻē aʻe.
• No ka nānā ʻana i nā ʻōpū adrenal , hana ʻia nā hoʻokolohua CT scan (Computed tomography - CT) a i ʻole MRI scan (Magnetic resonance imaging - MRI) .

ʻO ka pahuhopu o nā kauka ke hōʻemi i ka hana ʻana o ka androgen mai nā ovaries a i ʻole nā ​​​​gland adrenal, e hōʻemi i nā pae androgen manuahi, a ālai i ka hana androgen.

Eia nō naʻe, ʻimi pinepine ka poʻe me ka hyperandrogenism i ka ʻōlelo aʻo lapaʻau e mālama i nā hōʻailona nui, e like me ka ulu ʻana o ka lauoho makemake ʻole ʻia, ka ʻākena, a me ka menstruation maʻamau ʻole.

He aha nā lāʻau lapaʻau no kēia?

ʻO ka lāʻau no ka hyperandrogenism e pili ana i ke kumu. Eia kekahi laʻana:

• Hiki ke hoʻoponopono ʻia ka hyperandrogenism Adrenal me nā corticosteroids haʻahaʻa.
• Inā he mau puʻupuʻu i loko o nā ovaries, testicles, a i ʻole nā ​​​​gland adrenal, pono paha e wehe ʻia lākou ma ke ʻoki kino. I nā wahine perimenopausal a menopausal paha me ka hyperandrogenism koʻikoʻi, pono paha kahi oophorectomy (wehe ʻoki kino o kekahi a i ʻole nā ​​​​ovaries ʻelua) .
• Inā hana ʻia ka hyperandrogenism e kahi lāʻau āu e lawe nei, e ʻōlelo aku kāu kauka e hoʻōki i ka lāʻau lapaʻau a hoʻololi paha i kahi lāʻau lapaʻau ʻē aʻe.

ʻO nā lāʻau lapaʻau antiandrogen kekahi lāʻau lapaʻau maʻamau no ka hyperandrogenism. Ke ālai nei lākou i nā hopena o nā androgens, e like me ka testosterone.

Aia kekahi mau ʻano lāʻau antiandrogen:

• Nā lāʻau pale hānau waha/nā pila hoʻomalu hānau e loaʻa ana ka ethinyl estradiol (estrogen) a me ka progesterone antiandrogenic: ʻO nā laʻana e komo pū me nā pila e loaʻa ana ka cyproterone acetate (e.g. Diane®-35), drospirenone (e.g. Yasmin®, Yaz®) a i ʻole dienogest (e.g. Valette®). Hiki i kēia ke mālama i ka ʻākena, ka ulu ʻana o ka lauoho makemake ʻole ʻia a me nā wā ʻōpiopio ʻole.
• Spironolactone (Spironolactone - Aldactone®) : Mālama kēia antiandrogen i ka ʻākena a me ka ulu ʻana o ka lauoho i makemake ʻole ʻia i hoʻokumu ʻia e nā hormones.
• Cyproterone : Kōkua kēia lāʻau lapaʻau i ka mālama ʻana i ka PCOS, hoʻohaʻahaʻa i nā pae testosterone, a hōʻemi i ka hana ʻana o ka ʻaila e hoʻoulu ai i ka ʻākena.

Ka mālama ʻana i nā hōʻailona

Hiki i nā kānaka me ka hyperandrogenism ke ʻimi i ka lāʻau lapaʻau no kā lākou mau hōʻailona:

• ʻAkika : ʻO nā lāʻau lapaʻau no ka ʻakika e komo pū me nā lāʻau lapaʻau topical, nā antibiotic waha e like me tetracycline , antiandrogens (me ka hormone therapy, nā pila hoʻomalu hānau), a me nā pila isotretinoin .
• Hirsutism (ulu lauoho makemake ʻole ʻia) : Hoʻohana ka nui o nā wahine me ka hirsutism i nā ʻano hana e like me ka waxing, ka ʻumiʻumi, a me ka wehe ʻana i ka lauoho laser. Hiki iā lākou ke lawe i nā pila hoʻomalu hānau.
• Nā wā ʻōpiopio kūpono ʻole : Hiki i nā wahine ke hoʻohana i nā ʻano kaohi hānau hormonal e hoʻoponopono i kā lākou mau pōʻaiapuni menstrual.

Ke pane ʻole kēia mau hōʻailona i nā lāʻau lapaʻau maʻamau ma muli o ke kaulike ʻole o ka hormonal, hiki i kāu kauka ke noʻonoʻo i nā lāʻau antiandrogen ikaika aʻe.

ʻAʻole anei hiki ke pale ʻia kēia?

ʻO ka mea pōʻino, ʻaʻohe ala maopopo e pale aku ai i ka hyperandrogenism.

ʻAʻohe ala i hōʻoia ʻia e pale aku ai i ka PCOS, ke kumu maʻamau o ka hyperandrogenism. Akā hiki iā ʻoe ke hana i nā ʻanuʻu liʻiliʻi e hōʻemi i kāu mau hōʻailona. No ka laʻana, ʻo ka ʻai ʻana i kahi meaʻai momona,ʻO ka hoʻoikaika kino mau a me ka kaohi ʻana i kou kaumaha e hiki ke kōkua i ka hōʻemi ʻana i nā hopena o ka PCOS a me ka hyperandrogenism.

He aha ka mea e hiki mai ana? (Wānana)

Pono ka mālama ʻana i nā maʻi he nui e hoʻoulu ai i ka hyperandrogenism no ke ola holoʻokoʻa. I kekahi manawa, e emi nui ke kaumaha o nā wāhine me ka hyperandrogenism ma muli o ka PCOS a e nalowale ana ko lākou PCOS. Eia nō naʻe, pono ka hapa nui o ka poʻe i ka mālama ʻana no ke ola holoʻokoʻa e hōʻemi i nā hōʻailona o ka hyperandrogenism.

Hiki i nā hōʻailona hyperandrogenism ke hoʻopilikia i kou manaʻo ponoʻī a me ke olakino noʻonoʻo. Inā ʻo kēia mau hōʻailona ke kumu o kou hopohopo, hopohopo, a/a kaumaha paha, he mea nui e ʻimi i ke kōkua mai kahi kauka noʻonoʻo a i ʻole ke kākāʻōlelo.

Āhea wau e ʻike ai i ke kauka?

Inā ua ʻike ʻia ʻoe me ka hyperandrogenism a ke lawe nei ʻoe i ka lāʻau lapaʻau no ia mea, pono ʻoe e ʻike pinepine i ke kauka e hōʻoia i ka hana pono ʻana o kāu lāʻau.

Inā hoʻopilikia ka hyperandrogenism i kou olakino noʻonoʻo, he mea nui e ʻike i kahi kauka psychiatrist a kākā'ōlelo paha no ke kōkua.

ʻO ka mea hope loa, leka lawe i ka home:

He maʻi maʻamau ka hyperandrogenism i waena o nā wāhine. Hiki i kona mau hōʻailona ke hoʻohilahila iā ʻoe a hoʻoluhi ʻole. Akā e hoʻomanaʻo, ʻaʻole ʻoe hoʻokahi, a hiki ke mālama ʻia kēia maʻi. E kamaʻilio me kāu kauka e pili ana i nā koho lapaʻau. Eia kekahi, inā e hoʻopilikia ana i kou olakino noʻonoʻo, e ʻike pono i kahi kauka noʻonoʻo a i ʻole ke kākāʻōlelo. ʻO ka mālama ʻana i kou olakino ka mea nui loa.

ʻO ka Hyperandrogenism, Androgen, Testosterone, PCOS, Hirsutism, ʻAkika, Kaulike ʻole o ka Hormone, Ola Kino Wahine, Kaulike ʻole o ka Hormone