Ingabe nawe ukhathazekile ngokwanda kwama-hormone wesilisa emzimbeni? Ake sixoxe nge-hyperandrogenism!

Ingabe ukhathazekile ngezinguquko ezithile emzimbeni wakho? Mhlawumbe isizathu ukwanda kwenani le -androgen, uhlobo lwe-hormone yabesilisa, emzimbeni. Lesi simo ngokwezokwelapha sibizwa ngokuthi i-hyperandrogenism . Ungakhathazeki, sizoxoxa ngalokhu kalula, ngendlela ongayiqonda.

Kuyini ngempela i-hyperandrogenism?

Kalula nje, i-hyperandrogenism isho ukuthi umzimba wakho unama -androgen amaningi kakhulu, uhlobo lwe-hormone yocansi. Ama-androgen abalulekile ekukhuleni, empilweni yokuzala, kanye nokukhula komzimba.

Bheka manje, ama-hormone angamakhemikhali emizimbeni yethu. Afana nezithunywa. Ahamba egazini futhi atshele izitho zethu, imisipha, nezinye izicubu ukuthi senzeni nokuthi sikwenze nini.

Ama-Androgen akhiqizwa emzimbeni wawo wonke umuntu. Kodwa amadoda akhiqiza kakhulu. Abesifazane bakhiqiza cishe ingxenye eyodwa kweziyishumi nambili yenani elisemzimbeni wendoda. I-Testosterone iyona eyinhloko yala ma-androgen.

Ama-Androgen akhiqizwa ngama-testicles emadodeni kanye nama-ovari kwabesifazane. Lawa ma-hormone akhiqizwa nayizindlala ze-adrenal ezitholakala ngaphezu kwezinso zethu. Aphinde asize ekuguquleni ama-androgen abuthakathaka abe aqinile ezindaweni ezifana nezicubu zamafutha kanye nesikhumba.

Izimpawu zalesi simo, esibizwa ngokuthi i-hyperandrogenism, zingahluka kuye ngeminyaka yakho kanye nobulili bakho. Kunezimbangela eziningana ezingaba khona, futhi kunezindlela zokwelapha lesi simo.

Ingabe i-Hyperandrogenism ne-PCOS ziyafana?

Abantu abaningi bacabanga ukuthi i-hyperandrogenism kanye ne -polycystic ovary syndrome (PCOS) kuyisifo esifanayo. Nakuba kukhona ubuhlobo obuseduze phakathi kwalezi zinto ezimbili, azifani.

I-Hyperandrogenism iyisici esibalulekile se-PCOS. I-PCOS ukungalingani kwama-hormone okubangelwa ama-ovari akhiqiza ama-hormone amaningi kakhulu wesilisa. Ithinta abesifazane.

Ngakho-ke, yize i-PCOS iyimbangela evamile ye-hyperandrogenism, kungaba khona ezinye izimbangela ze-hyperandrogenism. Ngokufanayo, i-PCOS inezinye izimpawu, njenge-cysts yama-ovari, ngaphezu kwezimpawu ze-hyperandrogenism.

Ubani othinteka kakhulu yilesi simo? Sivame kangakanani?

I-Hyperandrogenism ingathinta noma ubani - izingane ezincane, abantu abadala, wonke umuntu. Kodwa-ke, ivame kakhulu kwabesifazane abaseminyakeni yokuzala .

Phakathi kuka-5% no-10% wabesifazane abaseminyakeni yokuzalaLesi simo siyathinta. Lokho kusho ukuthi lokhu akuyona into engavamile njengoba ungase ucabange.

Lesi simo cishe asibathinti abafana nabesilisa abadala.

Ziyini izimpawu zalokhu?

Izimpawu ze-hyperandrogenism ziyahlukahluka kuye ngobulili bakho nokuthi ngabe usudlule ebusheni.

Kodwa nansi into ebalulekile okufanele uyikhumbule. Ngisho noma unalezi zimpawu, amazinga akho e-androgen egazini angase abe ajwayelekile. Lokhu kungenxa yokuthi ngasinye salezi zimpawu singaba nezinye izimbangela. Futhi, noma ukuhlolwa kwegazi kukhombisa ukuthi amazinga akho e-androgen aphezulu, ungase ungabi nazo izimpawu ezinkulu.

Into ebaluleke kakhulu ukuthi uma lezi zimpawu zivela ngokuzumayo nangokushesha, kufanele nakanjani ubone udokotela ngokushesha okukhulu, ngoba ezimweni ezinjalo, imbangela ingaba isimila esikhipha i-androgen.

Manje ake sibone ukuthi lokhu kubathinta kanjani abantu abahlukene.

Kwamantombazane (ngaphambi kokuthomba)

• I-clitoris ekhulisiwe .
• Isikhumba esinamafutha kanye nezinduna.
• Ukukhula okungafuneki kwezinwele zomzimba (i-hirsutism) . Lokhu kusho ukuthi "izinwele ezinsundu kancane" zithathelwa indawo izinwele eziqinile neziqinile ezindaweni ezifana nodebe olungenhla, isilevu, isifuba, isisu, kanye nomhlane.

Kwabantwana besilisa (ngaphambi kokuthomba)

• Ipenisi ekhulisiwe .
• Ukukhula kwezinwele kusenesikhathi noma ngokweqile endaweni yangasese nasemakhwapheni.
• Ukujula kwezwi.

Kwabesifazane asebekhulile

• Isikhumba esinamafutha kanye nezinduna.
• Ukukhula okungafunwa kwezinwele zomzimba ( i-hirsutism) .
• Umjikelezo wokuya esikhathini wanyanga zonke ongajwayelekile.
• Ubunzima bokuthola abantwana (ukungazali) .
• Ukulahlekelwa izinwele ngendlela yabesilisa ( i-androgenic alopecia) .

Kwabesilisa abadala

Indlela lokhu okubathinta ngayo amadoda amadala kuncike ekutheni ama-hormone engeziwe avela ezindlaleni ze-adrenal noma entweni ethathwe ngaphandle (njengemijovo ye-anabolic steroid ). Uma ama-androgens avela ezindlaleni ze-adrenal enyuka, amadoda amadala angase angaboni noma yiziphi izinguquko ezinkulu zomzimba. Kodwa-ke, kunganciphisa ukusebenza kwama-testicles futhi kwenze kube nzima ukuba nezingane.

Kungani lokhu kwenzeka? Yiziphi izizathu?

Ama-hormone e-androgen akhiqizwa ama-ovari, ama-adrenal glands, nama-fat cell kwabesifazane, kanye nama-testicles nama-adrenal glands kwabesilisa.

Kunezinye izinhlobo eziningana zama-hormone ezithinta ukukhiqizwa nokukhululwa kwala ma-androgen. Isibonelo , i-luteinizing hormone (LH) kanye ne -adrenocorticotrophic hormone (ACTH) . Womabili la ma-hormone akhishwa yi-pituitary gland.

Uma esinye noma ngaphezulu salezi zitho zomzimba, noma esinye salezi hormone, singasebenzi kahle, i-hyperandrogenism ingenzeka.

Kunezizathu eziningana eziyinhloko zalokhu:

• I-Polycystic ovary syndrome (PCOS) - Lena yimbangela evame kakhulu.
• I-Congenital Adrenal Hyperplasia (CAH) .
• Isifo sikaCushing .
• Izimila ezikhipha i-androgen.
• Eminye imithi.

Manje ake sibheke ngasinye salezi zizathu ngemininingwane ethe xaxa.

I-Polycystic ovary syndrome (i-PCOS)

Phakathi kwabesifazane abasebasha nabadala, i-PCOS iyimbangela evame kakhulu ye-hyperandrogenism eqhubekayo ngemva kokuthomba. Phakathi kuka-80% no-90% wabesifazane abane-hyperandrogenism nabo bane-PCOS .

Ku-PCOS, ama-ovari akhiqiza ama-androgen amaningi ngenxa yamazinga aphezulu e-LH kanye ne-insulin (hyperinsulinemia). Ngaphezu kwalokho, amazinga aphezulu e-insulin avimbela isibindi ekukhiqizeni iphrotheni ebizwa ngokuthi i-Sex Hormone Binding Globulin (SHBG) . Lokhu kwandisa izinga le-testosterone yamahhala egazini.

I-Congenital adrenal hyperplasia `(CAH)`

I-Congenital adrenal hyperplasia (CAH) yiqembu lezimo zofuzo ezithinta izindlala ze-adrenal.

Ku-CAH, ukuguquka kwezakhi zofuzo kubangela ukuntuleka kwe-enzyme ebizwa ngokuthi i-21-hydroxylase , esiza umzimba ukuthi wakhe ama-hormone. Kubantu abaningi abane-CAH, lokhu kuntuleka kwe-enzyme kubangela ukuthi izindlala ze-adrenal zikhiqize amanye ama-hormone amaningi, njenge-testosterone.

Imbangela evame kakhulu ye-hyperandrogenism kwabesifazane abane-adrenal hyperplasia yi -non-classical congenital adrenal hyperplasia . Lesi yisimo lapho i-enzyme engu-21-hydroxylase ishoda khona kancane. Lesi simo sithinta cishe u-2% wabesifazane abane-hyperandrogenism.

Isifo sikaCushing

Isifo sikaCushing uhlobo lwesimo esibizwa ngokuthi i-Cushing syndrome . I-Cushing syndrome yisimo esingavamile esenzeka lapho umzimba une -cortisol eningi kakhulu (futhi i-hormone).

Isifo sikaCushing sibangelwa isimila esingeyona umdlavuza endlaleni ye-pituitary. Lesi simila sikhipha i-ACTH (i-adrenocorticotropic hormone) eningi, ekhulisa amazinga e-cortisol.

I-ACTH eningi ibangela ukuthi izindlala ze-adrenal zikhiphe ama-androgen amaningi, okuyikho okubangela i-hyperandrogenism.

I-Cushing syndrome inezinye izimpawu:

• Amabala okwelula ansomi esiswini.
• Ukukhuluphala okusheshayo ebusweni, esiswini, nasentanyeni.
• Umfutho wegazi ophezulu.

Uma unezimpawu ezinjengalezi, kubaluleke kakhulu ukubona udokotela ngokushesha okukhulu.

Izimila ezikhipha i-androgen

Amanye amathumba e-adrenal gland, noma amathumba kuma-ovari noma emasendeni, angakhiqiza futhi akhiphe ama-androgen. Lokhu kubangela ukuthi amazinga e-androgen emzimbeni abe phezulu kunokuvamile. Isimo se-hyperandrogenism esibangelwa yila mathumba sivame ukuba sibi kakhulu futhi sivele ngokuzumayo .

I-Hyperandrogenism, ebangelwa izimila ze-ovarian noma ze-adrenal, ayivamile. Ithinta abantu abangaba ngu-0.2% kuphela. Kodwa-ke, uma uvele waba nezimpawu ze-hyperandrogenism ngokuzumayo, bheka udokotela ngokushesha.

Eminye imithi

Eminye imithi ingabangela i-hyperandrogenism. Imithi eyinhloko ebangela lokhu yile:

• Ama-steroid e-Anabolic-androgenic (lezi ziyizinhlobo zokwenziwa ze-testosterone, ezisetshenziswa kabi abanye abasubathi ukuthuthukisa ukusebenza).
• Ama-progestin okwenziwa (lena imithi ebangela izinguquko esibelethweni futhi esetshenziselwa izinto ezahlukene).
• Imithi yokulwa nesifo sokuwa ( imithi yokuvimbela ukuwa ).

Ukuthola kanjani lokhu? (Ukuxilongwa)

Uma ungowesifazane futhi usola ukuthi une-hyperandrogenism, udokotela wakho uzokwenza ukuhlolwa ngokomzimba futhi abheke izimpawu ezifana nokukhula kwezinwele okungafuneki. Bazokubuza nemibuzo embalwa mayelana nomlando wakho wezokwelapha:

• Ubudala lapho amabele eqala ukukhula khona.
• Ubudala lapho izinwele ziqala ukuvela endaweni yangasese.
• Ubudala ekuqaleni kokuya esikhathini.
• Ingabe uyazisusa izinwele (ukugunda izinwele, ingabe wake wasuswa izinwele nge-laser)?
• Wake wasebenzisa ama-anabolic steroids noma i-testosterone ngaphandle kwencwadi kadokotela?
• Izinto ezifana nokuthi isikhathi sakho sokuya esikhathini sifika kangaki, ukuthi sihlala izinsuku ezingaki, nokuthi wopha igazi elingakanani.

Uma udokotela wakho esola ukuthi une-hyperandrogenism, uzoyala ukuhlolwa kwegazi ukuze kuhlolwe amazinga athile ama-hormone. Lokhu kuhlolwa kungasiza ekuxilongeni lesi simo.

Hlobo luni lokuhlolwa okwenziwayo?

Uma unezimpawu ze-hyperandrogenism, udokotela wakho angayala ukuhlolwa kwegazi okufana nalokhu:

• I-testosterone ephelele: Lokhu kulinganisa inani eliphelele le-testosterone egazini lakho. Leli zinga lingase libe phezulu kancane kwabesifazane abane-PCOS. Uma liphezulu kakhulu, kungaba isimila esisemaqanda noma emasendeni.
• I-testosterone yamahhala : Le testosterone ayiboshelwe kunoma iyiphi iphrotheni. Lokhu kuyinani elincane le-testosterone iyonke. Leli zinga lingakhuphuka nakwabesifazane abane-PCOS.
• I-Androstenedione : Lena yi-hormone ye-steroid enomthelela omncane we-androgenic emzimbeni. Kodwa-ke, isebenza kakhulu njengesinyathelo esiphakathi ekukhiqizweni kwe-testosterone ne-estrogen emzimbeni. Uma amazinga ayo ephezulu, i-PCOS ingase ibe khona.
• I-Dehydroepiandrosterone sulfate (DHEAS) : I-DHEAS iyi-hormone yocansi ekhiqizwa yizindlala ze-adrenal. Ngakho-ke, iyisibonakaliso esihle sokukhiqizwa kwe-androgen ye-adrenal. Kujwayelekile ukuthi abesifazane abane-PCOS babe namazinga e-DHEAS aphakeme kancane. Uma ephezulu kakhulu, kungaba uphawu lwesimila se-adrenal.
• I-17-hydroxyprogesterone : Ukulinganisa izinga le-17-hydroxyprogesterone egazini kuyindlela yokuhlola ukuthi kukhona yini i-non-classic congenital adrenal hyperplasia, isimo esiyimbangela ye-hyperandrogenism.

Njengoba kungaba nezinye izimbangela zezimpawu ze-hyperandrogenism, udokotela wakho uzoyala ukuhlolwa kwegazi okunye ukuze akhiphe lezo zimbangela.

Ngaphezu kwalokho, ukuhlolwa kwezithombe ezinjengalezi kungenziwa ukuze kutholakale imbangela ye-hyperandrogenism:

• Ukuhlolwa kwe-ultrasound kwe-pelvic ukuhlola ama-cyst esibeletho (olunye uphawu lwe-PCOS) noma amanye amaqhubu.
• Ukuze kuhlolwe izimila ze-adrenal gland , kwenziwa ukuhlolwa kwe-CT scan (i-Computed tomography - CT) noma i-MRI scan (i-Magnetic resonance imaging - MRI) .

Odokotela bahlose ukunciphisa ukukhiqizwa kwe-androgen kusuka kuma-ovari noma kuma-adrenal glands, ukunciphisa amazinga e-androgen amahhala, nokuvimba ukusebenza kwe-androgen.

Kodwa-ke, abantu abane-hyperandrogenism bavame ukufuna iseluleko sezokwelapha ukuze belaphe izimpawu eziyinhloko, njengokukhula kwezinwele okungafuneki, induna, kanye nokuya esikhathini okungajwayelekile.

Yiziphi izindlela zokwelapha lokhu?

Ukwelashwa kwe-hyperandrogenism kuncike embangela. Isibonelo:

• I-adrenal hyperandrogenism ingalawulwa nge- corticosteroids ephansi.
• Uma kukhona izimila ezitholakala kuma-ovari, emasendeni, noma kuma-adrenal glands, kungadingeka zisuswe ngokuhlinzwa. Kwabesifazane abaseminyakeni yokuthomba noma abaseminyakeni yokuthomba abane-hyperandrogenism enzima, i-oophorectomy (ukususwa ngokuhlinzwa kwe-ovari eyodwa noma zombili) nayo ingadingeka.
• Uma i-hyperandrogenism ibangelwa umuthi owuthathayo, udokotela wakho uzoncoma ukuthi uyeke umuthi noma ushintshele komunye umuthi.

Imithi yokulwa ne-androgen nayo iyindlela evamile yokwelapha i-hyperandrogenism. Ivimba imiphumela ye-androgens, njenge-testosterone.

Kunezinhlobo eziningana zemithi yokulwa ne-androgen:

• Amaphilisi okuvimbela inzalo/okuvimbela inzalo aqukethe i-ethinyl estradiol (i-estrogen) kanye ne-progesterone elwa ne-androgenic: Izibonelo zifaka phakathi amaphilisi aqukethe i-cyproterone acetate (isib. Diane®-35), i-drospirenone (isib. Yasmin®, Yaz®) noma i-dienogest (isib. Valette®). Lawa angalapha induna, ukukhula kwezinwele okungafunwa kanye nokuya esikhathini okungajwayelekile.
• I-Spironolactone (Spironolactone - Aldactone®) : Le antiandrogen yelapha izinduna kanye nokukhula kwezinwele okungafuneki okubangelwa ama-hormone.
• I-Cyproterone : Lo muthi usiza ekwelapheni i-PCOS, wehlise amazinga e-testosterone, futhi wehlise ukukhiqizwa kwamafutha abangela induna.

Ukwelashwa kwezimpawu

Abantu abane-hyperandrogenism bangase bafune ukwelashwa ngqo ngenxa yezimpawu zabo:

• I-acne : Ukwelashwa kwe-acne kufaka phakathi imithi yokwelapha esetshenziswa endaweni yomlomo, ama-antibiotic asetshenziswa ngomlomo njenge- tetracycline , ama-antiandrogens (kufaka phakathi ukwelashwa ngama-hormone, amaphilisi okuvimbela inzalo), kanye namaphilisi e -isotretinoin .
• I-Hirsutism (ukukhula kwezinwele okungafuneki) : Abesifazane abaningi abane-hirsutism basebenzisa izindlela ezinjengokugcotshwa nge-wax, ukushefa, kanye nokususwa kwezinwele nge-laser. Bangase baphuze namaphilisi okuvimbela inzalo.
• Ukuya esikhathini okungajwayelekile : Abesifazane bangasebenzisa izindlela zokuvimbela inzalo zama-hormone ukulawula imijikelezo yabo yokuya esikhathini.

Uma lezi zimpawu zingasabeli ekwelashweni okujwayelekile ngenxa yokungalingani kwama-hormone, udokotela wakho angase acabangele imithi enamandla kakhulu yokulwa ne-androgen.

Lokhu akunakuvinjelwa?

Ngeshwa, ayikho indlela ecacile yokuvimbela i-hyperandrogenism.

Ayikho indlela eqinisekisiwe yokuvimbela i-PCOS, imbangela evame kakhulu ye-hyperandrogenism. Kodwa ungathatha izinyathelo ezincane zokunciphisa izimpawu zakho. Isibonelo, ukudla ukudla okunempilo,Ukuzivocavoca njalo nokulawula isisindo sakho kungasiza ekunciphiseni imiphumela ye-PCOS kanye ne-hyperandrogenism.

Ikusasa lizosiphathelani? (Isibikezelo)

Izimo eziningi ezibangela i-hyperandrogenism zidinga ukwelashwa impilo yonke. Ngezinye izikhathi, abesifazane abane-hyperandrogenism ngenxa ye-PCOS bazolahlekelwa isisindo esiningi futhi i-PCOS yabo izophela. Kodwa-ke, abantu abaningi bazodinga ukwelashwa impilo yonke ukuze kuncishiswe izimpawu ze-hyperandrogenism.

Izimpawu ze-hyperandrogenism zingathinta ukuzethemba kwakho kanye nempilo yakho yengqondo. Uma lezi zimpawu zikwenza uzizwe ucindezelekile, ukhathazekile, kanye/noma ucindezelekile, kubalulekile ukufuna usizo kudokotela wezifo zengqondo noma umeluleki.

Kufanele ngimbone nini udokotela?

Uma kutholakala ukuthi une-hyperandrogenism futhi uphuza imithi yayo, kuzodingeka ubonane nodokotela njalo ukuqinisekisa ukuthi ukwelashwa kwakho kusebenza kahle.

Uma i-hyperandrogenism ithinta impilo yakho yengqondo, kubalulekile ukubona udokotela wezifo zengqondo noma umeluleki ukuze akusize.

Ekugcineni, umyalezo okufanele uwuthathe uye ekhaya:

I-Hyperandrogenism yisimo esivame kakhulu kwabesifazane. Izimpawu zayo zingakwenza uzizwe unamahloni futhi ungakhululekile. Kodwa khumbula, awuwedwa, futhi lesi simo singelashwa. Khuluma nodokotela wakho mayelana nezinketho zokwelapha. Futhi, uma kuthinta impilo yakho yengqondo, qiniseka ukuthi ubona udokotela wezifo zengqondo noma umeluleki. Ukunakekela impilo yakho kuyinto ebaluleke kakhulu.

` I-Hyperandrogenism, i-Androgen, i-Testosterone, i-PCOS, i-Hirsutism, i-Acne, ukungalingani kwama-Hormonal, Impilo Yabesifazane, ukungalingani kwama-Hormonal