Uzizwa sengathi une-testosterone ephansi? Ake sifunde ngqo ngalolu shintsho emzimbeni wesilisa (i-Male Hypogonadism)!

Ingabe ngezinye izikhathi uzizwa ukhathele, ungenasithakazelo kunoma yini, noma unombuzo omncane ngezinto ezithile ezihlobene nobudoda? Mhlawumbe isizathu salokhu ukwehla kwe-hormone testosterone emzimbeni wakho. Namuhla, sizokhuluma ngalokhu kwehla kwamazinga e-testosterone , noma njengoba odokotela bekubiza kanjalo, isimo esibizwa ngokuthi i-Male Hypogonadism . Ungakhathazeki, lokhu kuyinto engenzeka kubantu abaningi, futhi kunezindlela zokwelapha.

Kusho ukuthini ukuthi i-testosterone ephansi?

Kalula nje, i-testosterone ephansi isho ukuthi amasende akho (izindlala ezikhiqiza isidoda emadodeni) awakhiqizi i-testosterone eyanele. Ukuze kube sobala, le testosterone ikhiqizwa amaseli e-Leydig ngaphakathi kwamasende.

Lesi simo singavela nezimpawu ezahlukene eminyakeni ehlukene. Futhi, amazinga e-testosterone ancipha ngokwemvelo njengoba amadoda ekhula. Lokhu kubizwa ngamanye amagama, isibonelo:

• I-syndrome yokuntuleka kwe-Testosterone
• Ukuntuleka kwe-testosterone
• I-hypogonadism eyinhloko
• I-hypogonadism yesibili

Kungani i-testosterone ibaluleke kangaka?

I-Testosterone yi-hormone yesilisa ebaluleke kakhulu. Ibalulekile ekuthuthukisweni kwezici zesilisa kanye nokukhiqizwa kwesidoda (i-spermatogenesis). Amadoda anamazinga aphezulu kakhulu e-testosterone emizimbeni yawo kunabesifazane.

I-Testosterone isiza ukugcina nokuthuthukisa lezi zinto emzimbeni wesilisa:

• Izitho zangasese
• Usayizi wemisipha
• Izinga lamaseli abomvu egazi elinempilo
• Ubuningi bamathambo
• Impilo yengqondo enhle
• Umsebenzi wocansi nowokuzala

Ngokuvamile, imizimba yethu ilawula izinga le-testosterone egazini lethu. Liphezulu kakhulu ekuseni futhi liyancipha kancane kancane njengoba usuku luqhubeka.

I-hypothalamus kanye ne-pituitary gland ebuchosheni bakho zilawula ukuthi amasende akho akhiqiza futhi akhipha i-testosterone engakanani.

I-hypothalamus ikhipha i-gonadotropin-releasing hormone (GnRH) . Lokhu kukhombisa ukuthi i-pituitary gland ikhipha i-luteinizing hormone (LH) . I-LH bese iya emasendeni ukuze ikhuthaze ukukhiqizwa kwe-testosterone. I-pituitary gland ikhipha ne-follicle-stimulating hormone (FSH) ukuze isize ekukhiqizeni isidoda.

Ngakho-ke, uma kunenkinga ngama-testicles akho, i-hypothalamus, noma i-pituitary gland, amazinga akho e-testosterone angase ehle.

Yiliphi izinga elibhekwa njenge-"testosterone ephansi"?

Ngokusho kwe-American Urology Association (AUA), izinga le-testosterone egazini lomuntu omdala libhekwa njengeliphansi uma lingaphansi kwama-nanogram angu-300 nge-deciliter (300 ng/dL).

Kodwa-ke, abanye abacwaningi nodokotela abavumelani ngokuphelele nalo mbono. Abanye bakholelwa ukuthi noma yini engaphansi kuka-`250 ng/dL` ibhekwa njengephansi. Kodwa-ke, odokotela bazocabangela izimpawu zakho lapho benquma ukuthi une-testosterone ephansi yini.

Ubani osengozini enkulu yokwehla kwe-testosterone?

Lesi simo singathinta amadoda anoma yimuphi ubudala, kusukela ekuzalweni kuya ebudaleni.

Kodwa-ke, laba bantu banamathuba amaningi okuba ne-testosterone ephansi:

• Kwabantu asebekhulile
• Kubantu abakhuluphele kakhulu (abakhuluphele kakhulu)
• Kubantu abanesifo sikashukela sohlobo 2 esingalawulwa kahle
• Kulabo abane-apnea yokulala evimbelayo
• Abantu abanezifo ezingamahlalakhona ezifana nokwehluleka kwezinso kanye ne-cirrhosis yesibindi
• Kulabo abaphila ne-HIV/AIDS

Sivame kangakanani lesi simo?

Kunzima ngabacwaningi ukusho ukuthi i-testosterone ephansi ivame kangakanani, ngoba izifundo ezahlukene zichaze "i-testosterone ephansi" ngendlela ehlukile.

Ngokusho kweminye imininingwane, amadoda angafika ku-2% angaba nalesi simo. Ezinye izifundo ziphakamisa ukuthi amadoda angaphezu kuka-8% aphakathi kweminyaka engu-50 no-79 anamazinga aphansi e-testosterone.

Ziyini izimpawu ze-testosterone ephansi?

Izimpawu ze-testosterone ephansi zingahluka kakhulu kumuntu nomuntu, ikakhulukazi kuye ngeminyaka.

Izimpawu kwabesilisa abadala

Uma unalezi zimpawu, kunethuba elikhulu lokuthi ungaba ne-testosterone ephansi:

• Ukuncipha kwesifiso sobulili
• Ukungasebenzi kahle kwe-Erectile
• Ukulahlekelwa izinwele emakhwapheni nasezindaweni zangasese
• Ukuncishiswa kwamasende
• Ukushisa okukhulu
• Ukuncipha noma ukungabikho kwenani lesidoda (i-Azoospermia), okungabangela ubunzima ekukhulelweni kwezingane.

Ezinye izimpawu zingase zihlanganise:

• Ukucindezeleka (ukuphazamiseka kwemizwelo)
• Ubunzima bokugxilisa ingqondo nokukhumbula
• Amafutha omzimba akhuphukile
• Ukukhula kwamabele esilisa (i-Gynecomastia)
• Ukwehla kwamandla emisipha nosayizi
• Ukunciphisa ukukhuthazela komzimba

Izimpawu ezinganeni (ngaphambi noma ngesikhathi sokuthomba)

Uma amazinga e-testosterone kumfana ehla ngaphambi noma ngesikhathi sokuthomba, angase abe nezimpawu ezifana nalezi:

• Ukukhula kobude kuhamba kancane, kodwa izitho zingase zikhule isikhathi eside ngokungalingani kunezinye izingxenye zomzimba.
• Ukukhula kwezinwele okunciphile endaweni yangasese.
• Ukukhula okunciphile kwama-testicles nama-testicles.
• Ukuncipha kokujula kwezwi.
• Ukwehla kwamandla nokukhuthazela okuhlobene nobudala.

Yiziphi izimbangela ze-testosterone ephansi?

Kunezizathu eziningana zokuthi amazinga e-testosterone angase ehle. Lesi simo siwela ezigabeni ezimbili eziyinhloko:

1. I-hypogonadism eyinhloko: Lokhu kubangelwa inkinga ngama-testicles ngokwawo.

2. I-hypogonadism yesibili: Lokhu kubangelwa ukungasebenzi kahle kwe-pituitary gland noma i-hypothalamus ebuchosheni.

Zombili lezi zinhlobo zingabangelwa yizimbangela zokuzalwa noma izimbangela ezitholwayo ezenzeka kamuva (ebuntwaneni noma ebudaleni).

Izimbangela ze-hypogonadism eyinhloko

Okwenzekayo kulokhu ukuthi kunenkinga ngama-testicles, okuwavimbela ekukhiqizeni i-testosterone ngendlela evamile.

Elinye igama lalokhu yi- hypergonadotropic hypogonadism . Lokhu kwenzeka lapho i-pituitary gland ikhiqiza ama-hormone amaningi i-LH ne-FSH (eyaziwa nangokuthi i-gonadotropins) ngenxa ye-testosterone ephansi. Ngokuvamile, uma la ma-hormone ephezulu, ama-testicles atshelwa ukuthi enze i-testosterone nesidoda esengeziwe. Kodwa-ke, uma ama-testicles onakele (ngokuvamile ngenxa ye-chemotherapy yomdlavuza) noma uma ama-testicles engekho, awakwazi ukuphendula kula ma-gonadotropin akhuphukile. Ngenxa yalokho, kukhiqizwa i-testosterone nesidoda esincane kakhulu noma asikho nhlobo.

Ngezinye izikhathi ku-hypogonadism eyinhloko, amazinga e-gonadotropin angakhuphuka yize amazinga e-testosterone ephakathi kwebanga elijwayelekile. Uchwepheshe wakho uzokuchazela lokhu nokuthi ngabe ukwelashwa kuyadingeka yini noma ngabe i-testosterone ijwayelekile.

Izimbangela zokuzalwa:

• Ukungabikho kwamasende ngesikhathi sokuzalwa (i-Anorchia)
• I-Cryptorchidism (ukwehluleka kwamasende ukwehla kusuka esikhumbeni)
• Ukuthuthukiswa okungaphelele kwamaseli e-Leydig emasendeni (i-Leydig cell hypoplasia)
• I-Klinefelter's syndrome (abesilisa bazalwa bene-chromosome X eyengeziwe esikhundleni se-XY - XXY)
• I-Noonan syndrome (isifo esingavamile sofuzo, singabangela ukuthomba okulibazisekile, amasende angakhuli, noma ukungazali)
• I-Myotonic dystrophy (iqembu lezifo zobuthakathaka bemisipha ezizuzwe njengefa)

Izimbangela ezitholiwe:

• Ukulimala noma ukususwa kwamasende.
• Ukuvuvukala kwesende elilodwa noma womabili (orchitis). Lokhu kuvame ukubangelwa ukutheleleka ngamagciwane (isib. izifo ezithathelwana ngocansi), noma kungabangelwa ukutheleleka ngegciwane njenge-mumps.
• Ukunikeza amasende ukwelashwa ngamakhemikhali noma ngemisebe.
• Ezinye izinhlobo zomdlavuza.
• Ukusetshenziswa kwama-steroid e-anabolic.

Izimbangela ze-hypogonadism yesibili

I-hypogonadism yesibili ibangelwa yizimo ezithinta ukusebenza kwe-hypothalamus kanye/noma i-pituitary gland. Lokhu kubizwa ngokuthi i-hypogonadotropic hypogonadism.Kubizwa nangokuthi "i-testosterone ephansi" ngoba amazinga ama-hormone athi `LH` kanye ne-`FSH` aphansi lapha. La mazinga aphansi abangela ukwehla kokukhiqizwa kwe-testosterone kanye nesidoda.

Izimbangela zokuzalwa:

• I-hypogonadotropic hypogonadism ehlukanisiwe (amazinga aphansi e-GnRH kusukela ekuzalweni)
• I-Kallmann syndrome (isimo esingavamile sofuzo, ukwehluleka ukwakha amangqamuzana ezinzwa ku-hypothalamus akhiqiza i-GnRH. Ukulahlekelwa yiphunga nakho kungase kwenzeke)
• I-Prader-Willi syndrome (isifo esingavamile sezakhi zofuzo eziningi esingaphazamisa ukusebenza kwe-hypothalamus)

Izimbangela ezitholiwe:

• I-Hypopituitarism (lokhu kungabangelwa isimila se-pituitary (adenoma), ukutheleleka, ukulimala, ukwelashwa ngemisebe, noma ukuhlinzwa)
• I-Hyperprolactinemia (amazinga akhuphukile e-hormone prolactin)
• Insimbi eningi emzimbeni (i-Hemochromatosis)
• Ukulimala kobuchopho noma kwekhanda
• I-Cushing's syndrome
• I-cirrhosis yesibindi
• Ukwehluleka kwezinso
• I-HIV/AIDS
• Inkinga yokusebenzisa utshwala
• Isifo sikashukela esingalawulwa kahle
• Ukukhuluphala ngokweqile (ukuba mkhulu kakhulu)
• Ukuphefumula kobuthongo okuvimbelayo
• Imithi ethile (isib. i-estrogen, imithi eshintsha imizwa, i-metoclopramide, ama-opioid, eminye imithi yomdlavuza wendlala)

I-hypogonadism eqala ngasekupheleni (i-LOH) uhlobo lwe-hypogonadism yesibili eyenzeka ngokuguga okuvamile. Njengoba amadoda ekhula, ukukhiqizwa kwe-testosterone kanye/noma isidoda kwehla ngenxa yokusebenza kabi kwe-hypothalamic-pituitary kanye nokusebenza kweseli le-Leydig.

I-LOH kanye ne-testosterone ephansi kuvamile phakathi kwamadoda anesifo sikashukela sohlobo 2, ukukhuluphala ngokweqile, kanye/noma ukukhuluphala ngokweqile.

Kokunye ukuhlola, ama-30% amadoda akhuluphele ngokweqile ayenamazinga aphansi e-testosterone, uma kuqhathaniswa nama-6% kuphela amadoda anesisindo esijwayelekile. Kokunye ukuhlola, ama-25% amadoda anesifo sikashukela sohlobo lwesibili ayenamazinga aphansi e-testosterone, uma kuqhathaniswa nama-13% kuphela amadoda angenayo isifo sikashukela.

Ungazi kanjani ukuthi une-testosterone ephansi?

Uma unezimpawu ze-testosterone ephansi, udokotela uzokwenza ukuhlolwa ngokomzimba. Bazokubuza nemibuzo mayelana nomlando wakho wezokwelapha, imithi oyiphuzayo noma oyisebenzisile, ukuthi uyabhema yini, nanoma yiziphi izimpawu zamanje. Bazobe sebeyala ukuhlolwa kwegazi okuningana.

Ukuze athole isifo, udokotela uzocabangela izimpawu zakho kanye nemiphumela yokuhlolwa kwegazi.

Hlobo luni lokuhlolwa okwenziwayo?

Lezi zivivinyo zingasiza ekuqinisekiseni i-testosterone ephansi nokuthola imbangela:

• Ukuhlolwa kwegazi kwezinga le-testosterone eliphelele: Lokhu kuvame ukudinga ukuthi kuthathwe amasampula egazi amabili phakathi kuka-8 no-10 ekuseni, njengoba kulapho amazinga e-testosterone ephezulu khona. Kufanele utshele udokotela wakho uma uke wagula noma usanda kululama ekuguleni. Uma kwenzeka isimo esiphuthumayo, imiphumela ingase ibe phansi ngokungeyikho.
• Ukuhlolwa kwegazi kwe-Luteinizing hormone (LH): Lokhu kusiza ekunqumeni ukuthi inkinga nge-pituitary gland iyimbangela ye-testosterone ephansi.
• Ukuhlolwa kwegazi le-prolactin: Amazinga aphezulu e-prolactin angaba uphawu lwenkinga noma isimila e-pituitary gland.

Iyini indlela yokwelapha i-testosterone ephansi?

Odokotela belapha i-testosterone ephansi nge -Testosterone Replacement Therapy (TRT) . Kunezindlela eziningana zokwenza lokhu:

• Ijeli ye-Testosterone (efakwa esikhumbeni): Le jeli kufanele ifakwe nsuku zonke esikhumbeni esihlanzekile, esomile njengoba kuqondiswe udokotela wakho. Okubaluleke kakhulu, ungavumeli ijeli ithintane nanoma ubani ngesikhumba. Lena yindlela evame ukusetshenziswa e-United States.
• Imijovo ye-testosterone yemisipha: Wena noma udokotela angakunika lo mjovo emisipheni njalo ngemva kwesonto eli-1-2. Kukhona nemijovo ye-testosterone esebenza isikhathi eside enikezwa njalo ngemva kwamasonto ayi-10. Kukhona nemijovo engaphansi kwesikhumba enikezwa ngaphansi kwesikhumba.
• I-Testosterone patch (i-skin patch): Le patch kufanele ifakwe esikhumbeni nsuku zonke njengoba kuqondiswe udokotela wakho. Indawo yokufaka kufanele ijikeleziswe njalo ukuze kuvinjelwe ukusabela kwesikhumba.
• Ama-pellet e-Testosterone (angaphansi kwesikhumba): Uchwepheshe uzofaka la ma-pellet ngaphansi kwesikhumba izinyanga ezintathu kuya kweziyisithupha. Lawa ahlinzeka ngomthamo ozinzile we-testosterone isikhathi eside.
• Amaphilisi e-Buccal testosterone: Lawa amaphilisi anamathelayo afakwa ezinsinini kabili ngosuku. I-Testosterone imuncwa ngokushesha egazini ngezinsini.
• Ijeli yekhala ye-Testosterone: Le jeli kufanele ifakwe kuzo zombili izimpumulo kathathu ngosuku.
• I-testosterone yomlomo: Uhlobo lwe-testosterone olubizwa ngokuthi i-undecanoate lunikezwa amadoda ane-testosterone ephansi ngenxa yezimo ezithile zezokwelapha, njenge-Klinefelter syndrome, noma izimila ezonakele i-pituitary gland.

Kodwa-ke, ungase ungakwazi ukuthola ukwelashwa kokufaka esikhundleni se-testosterone uma unomlando wanoma yiziphi izimo ezilandelayo:

• Umdlavuza we-prostate.
• Iqhubu le-prostate elingahlolwanga. (Wonke umuntu kufanele ahlolwe i-prostate yakhe ngaphambi kokuqala ukwelashwa nge-testosterone.)
• Umdlavuza webele.
• Ukwehluleka kwenhliziyo okungalawulwa.
• I-apnea yokulala engapheli engelashwa.

Iyini imiphumela emibi yokwelashwa kokufaka esikhundleni se-testosterone?

Okulandelayo kungenzeka njengemiphumela emibi yalokhu kwelashwa:

• Isikhumba esivame ukuba nama-acne noma amafutha.
• Ukuvuvukala kweqakala ngenxa yokuqongelela okuncane koketshezi emzimbeni.
• Izimpawu ezinjengobunzima bokuchama ngenxa yokukhuthazwa yi-prostate.
• Ukukhula kwebele noma ubuhlungu.
• Ukuwohloka kwe-apnea yokulala.
• Amasende amancane.
• Uma usebenzisa i-testosterone esetshenziswa esikhumbeni, ungase uzwe ukulunywa kwesikhumba nokuvuvukala.

Izinguquko ezingabonakala emibikweni yelabhorethri:

• Ukwanda kwe-prostate-specific antigen (PSA).
• Ukwanda kwenani lamaseli abomvu egazi.
• Inani eliphansi lesidoda, okuholela ekungazalini (ukungakwazi ukuba nabantwana). Lokhu kubaluleke kakhulu kwabesilisa abasebasha abazama ukuba nabantwana.

Ingabe ukwehla kwe-testosterone kungavinjelwa?

Odokotela nabacwaningi abakayazi indlela yokuvimbela ukwehla kwe-testosterone, kungaba ngenxa yezimbangela zofuzo noma ukulimala kwamasende, i-hypothalamus, noma i-pituitary gland.

Kodwa-ke, le mikhuba yokuphila ingasiza ekugcineni amazinga e-testosterone ejwayelekile:

• Ukudla ukudla okunempilo.
• Ukuzivocavoca umzimba.
• Ukulawula isisindo.
• Gwema ukusebenzisa utshwala ngokweqile kanye nezidakamizwa.

Kwenzekani uma une-testosterone ephansi? Yini ongayilindela?

Asikho ikhambi elifanelana kahle ne-testosterone ephansi. Kodwa-ke, ngokuqhubeka nokwelashwa kokufaka esikhundleni sama-hormone, ungathuthukisa isifiso sakho sobulili, unciphise izimpawu zokucindezeleka, futhi wandise amandla akho. Ukwelashwa kungakhulisa nobukhulu bemisipha kanye nokuqina kwamathambo.

Amadoda anesifo se-testosterone anezinga lokufa eliphakeme kakhulu kunamadoda anamazinga ajwayelekile e-testosterone. Kodwa-ke, akucaci ukuthi ukubuyisela amazinga e-testosterone emazingeni ajwayelekile kuzonciphisa yini leli zinga lokufa elikhuphukile. Ukwelashwa kugxile kakhulu ekuphatheni izimpawu, hhayi ekugxileni emazingeni e-testosterone.

Ezimweni ze-hypogonadism yokuzalwa, ukwelashwa kokufaka esikhundleni se-testosterone kuvame ukusiza ekuvimbeleni izinkinga ezihlobene nokubambezeleka kokuthomba.

Kufanele ubonane nini nodokotela mayelana ne-testosterone ephansi?

Uma usebenzisa ukwelashwa kokushintsha ama-hormone, kubaluleke kakhulu ukubona udokotela wakho njalo ukuze ahlolwe.

Uma unezimpawu ze-testosterone ephansi, njengokuncipha kwesifiso socansi noma ukushisa komzimba, khuluma nodokotela. Uzokuhlola bese eyala ukuhlolwa kwegazi.

Uma ingane yakho ingabonisi izimpawu zokuthomba lapho ineminyaka engu-14, khuluma nodokotela wezingane.

Abantu abaningi bayayilahla izimpawu ze-testosterone ephansi njengengxenye evamile yokuguga. Kodwa-ke, uma unezimpawu ezithinta ikhwalithi yempilo yakho, kufanelekile ukunaka. Uma ubhekene nezimpawu ezikhathazayo ze-testosterone ephansi, bona udokotela ukuze uxoxe ngezindlela zokwelapha.

Into ebaluleke kakhulu okufanele uyikhumbule kulesi sihloko (Umyalezo Wokuya Ekhaya)

I-testosterone ephansi yisimo esingathinta amadoda. Singabangela izinkinga eziningi zomzimba nezengqondo. Into engcono kakhulu ongayenza ukungesabi noma ukuzizwa unamahloni ngakho, kodwa ukufuna iseluleko sezokwelapha. Uma unezimpawu, ungazinaki njengokuguga okuvamile.

Uma uhlolwa kahle futhi uthola ukwelashwa okufanele, ungaphila impilo ekhululekile. Khumbula, awuwedwa, futhi usizo luyatholakala.

I- Testosterone, ama-hormone wesilisa, i-hypogonadism, impilo yocansi, ukwelashwa kwama-hormone, impilo yamadoda, ukuntuleka kwamandla