Ingabe ingane yakho iziphathisa okwengane enkulu ngaphambi kweminyaka yayo? Ake sifunde nge-Precocious Toberty.

Wake wazizwa sengathi indodakazi noma indodana yakho iziphathisa okwengane encane ngaphambi kwesikhathi sayo, noma ibonisa izinguquko emzimbeni? Ezinye izingane zingabonisa izimpawu zokuthomba ngaphambi kwesikhathi sayo. Namuhla sizokhuluma ngalesi simo esibizwa ngokuthi 'ukuthomba ngaphambi kwesikhathi' noma njengoba odokotela besibiza kanjalo, '(Ukuthomba Ngaphambi Kokuqala)'. Ungakhathazeki, sizoxoxa ngalokhu kalula.

Ngakho-ke kuyini lokhu kuthomba kwasekuqaleni?

Ukuthomba yisikhathi lapho umzimba wengane ushintsha khona kakhulu futhi kancane kancane uqala ukuthuthukisa izici zomuntu omdala. Lokhu kuyinto yemvelo kakhulu. Ngokuvamile, kunengxenye encane yobuchopho bengane yakho ebizwa ngokuthi i-hypothalamus. Yilapho i-hypothalamus iqala khona. Ikhipha amakhemikhali athile abizwa ngama-hormone. Lawa ma-hormone abese ethumela isignali kwenye i-gland encane ebuchosheni ebizwa ngokuthi i-pituitary gland. I-pituitary gland ibe isikhipha olunye uhlobo lwe-hormone olubizwa ngokuthi i-gonadotropins. Lawa ma-gonadotropin aya ngqo ezindlaleni zobulili zengane, ezibizwa ngokuthi ama-gonad. Kubafana, lawa "ama-testicles." Lawa akhiqiza i-hormone ethi "testosterone." Emantombazaneni, lawa "ama-ovari." Lawa akhiqiza i-hormone ethi "estrogen."

Ngokuvamile, intombazane iqala ukuthomba ineminyaka ephakathi kuka-8 no-13. Umfana uqala ukuthomba ineminyaka ephakathi kuka-9 no-14. Kodwa-ke, kulokhu, "Ukuthomba Kwangaphambi Kokuqala", le nqubo iqala kusenesikhathi kakhulu. Okusho ukuthi, intombazane iqala ukukhombisa lezi zimpawu ingakapheli iminyaka engu-8, kanti umfana uqala ukukhombisa lezi zimpawu ingakapheli iminyaka engu-9 .

Ingabe zikhona izinhlobo eziyinhloko zokuthomba ngaphambi kwesikhathi?

Yebo, kunezinhlobo ezimbili eziyinhloko. Ake sibone ukuthi ziyini.

1. Ukuthomba Okuphakathi Kwangaphambi Kokukhulelwa

Lolu uhlobo oluvame kakhulu . Okwenzekayo lapha ukuthi ubuchopho bomntwana buqala ukukhulula i-hormone ebizwa ngokuthi 'i-Gonadotropin-releasing hormone (GnRH)' ngaphambi kwesikhathi esilindelekile. Lokhu kubangela ukuthi amasende nama-ovari akhiphe ama-hormone ocansi, njenge-'androgens', ngaphambi kwesikhathi.

2. Ukuthomba Okungakabi Khona Ngaphambi Kokuthomba

Lolu hlobo lubangelwa inkinga ngezitho zokuzala zengane, njengezitho zokuzala, amasende, noma izindlala ze-adrenal. Ngezinye izikhathi, lesi simo singabangelwa nama-hormone angena emzimbeni evela endaweni engaphandle. Lokhu kubizwa nangokuthi ukuthomba okungazibandakanyi ne-gonadotropin ngaphambi kwesikhathi.

Ubani othinteka kakhulu yilesi simo? Sivame kangakanani?

Empeleni, noma yimuphi umntwana angabhekana nalesi simo sokuthomba kwasekuqaleni. Kodwa-ke, sivame kakhulu emantombazaneni kunabafana.

Ngokuphathelene nokwanda kwalesi sifo, lesi simo sithinta amantombazane angaba ngu-20 kwangu-10,000, kodwa abafana abangaphansi kwaba-5 kwangu-10,000.

Kungani abantu befika esikhathini sokuthomba kusenesikhathi kangaka? Yiziphi izizathu?

Izizathu ziyahlukahluka kuye ngohlobo okukhulunywe ngalo ekuqaleni.

Izimbangela Zokuthomba Okuphakathi Kwangaphambi Kokukhulelwa

Njengoba kushiwo ngaphambili, lokhu kubangelwa ukukhishwa kwe-hormone `(GnRH)` ebuchosheni kusenesikhathi. Ezimweni eziningi, ikakhulukazi emantombazaneni, kunzima ukuthola imbangela ecacile yalokhu. Kodwa-ke, ngezinye izikhathi izinto ezinjengalezi zingakubangela:

• Ukulimala kobuchopho
• Izimila zobuchopho
• Ukutheleleka kobuchopho
• Ukukhubazeka kobuchopho
• Kulashwa ngemisebe

Izimbangela Zokuthomba Ngaphambi Kokuqala

Lolu hlobo lubangelwa izinkinga ngezitho zokuzala zengane noma izindlala ze-adrenal. Isibonelo:

• Izimila ze-ovary, testes noma adrenal gland
• Amathumba akhiqiza i-hormone ebizwa ngokuthi ``Human Chorionic Gonadotropin (HCG)``
• Ezinye izimo zofuzo, isibonelo, i-McCune-Albright syndrome.
• I-hypothyroidism enzima
• Izifo zezindlala ze-adrenal, isibonelo, "i-Congenital adrenal hyperplasia".

Ngezinye izikhathi, ukuchayeka kuma-hormone avela ngaphandle komzimba wengane nakho kungaba yimbangela. Cabanga ngezinto ezifana nokhilimu, imithi, noma izithasiselo eziqukethe i-estrogen, i-testosterone, noma ama-androgen.

Yiziphi izimpawu zokuthomba ngaphambi kwesikhathi? Uzibona kanjani?

Izimpawu ezivamile ezingabonakala kwabesilisa nabesifazane zifaka phakathi induna, iphunga lomzimba elikhuphukile, kanye nokuphakama okungazelelwe . Ngaphezu kwalokho, izici zobulili nazo ziqala ukuvela kusenesikhathi.

Cabanga nje, indodakazi yakho eneminyaka eyisikhombisa ibona amabele ayo ekhula ngokuzumayo, noma izwi lendodana yakho eneminyaka eyisishiyagalombili lishintsha bese iqala ukuhluma intshebe. Lezi yizinto esizibiza ngokuthi izimpawu.

Izimpawu ezibonakala emantombazaneni:

• Ukuthuthukiswa kwebele
• Ukuya esikhathini kuyaqala
• Ukukhula kwezinwele emakhwapheni nasezindaweni zangasese

Izimpawu ezibonakala kubafana:

• Ukuhosha kwezwi
• Ukukhula kwezinwele ebusweni, emakhwapheni nasezindaweni zangasese
• Ukukhula kwepenis namasende
• Ukukhula kwemisipha

Ubani osengozini enkulu yokuthola lesi simo?

Amanye amaqembu asengozini enkulu kancane yokuthomba kwalesi sikhathi sokuqala. Lawa:

• Amantombazane
• Izingane ezikhuluphele ngokweqile noma ezikhuluphele ngokweqile
• Izingane zamaqembu athile ezinhlanga (Ucwaningo lukhombisile ukuthi lokhu kuvame kakhulu ezinganeni ezimnyama emazweni angaphandle. Lokhu kudinga ukufundwa kabanzi ezweni lethu.)

Yiziphi izinkinga ezingaba khona ngenxa yokuthomba kwasekuqaleni?

Nakuba ingane ikhula ngokuzumayo lapho ifika ekuthombeni kusenesikhathi, ukukhula kuyayeka uma inqubo yokuthombeni isiphelile. Ngakho-ke, ingaba mfushane kunezinye izingane ezineminyaka efanayo. Lokhu kungathinta ingane ngokwengqondo.

Enye into ukuthi izingane zingazizwa zinamahloni futhi zingakhululeki lapho imizimba yazo ishintsha ngokushesha kunezinye izingane. Cabanga ukuthi kunzima kangakanani ngengane ukubona imizimba yayo ishintsha kakhulu kuyilapho izingane ezifunda nazo zisengabantwana abancane.

Lezi zinkinga zingaholela ezinkingeni zokuziphatha, ngokomzwelo, kanye nezenhlalo ezinganeni. Zingase zibe nokukhathazeka nokucindezeleka. Zingase zibe sengozini enkulu yokusebenzisa kabi izidakamizwa kanye nokuzibandakanya ekuziphatheni okuyingozi.

Odokotela bakuthola kanjani lokhu?

Uma uyisa ingane yakho kudokotela, izoqala ngokuyihlola kahle. Izophinde ikubuze ngomlando wezokwelapha wengane yakho nokuthi ngabe kukhona yini emndenini wakho oke waba nezimo ezifanayo.

Ngemuva kwalokho kungenzeka ukwenza izivivinyo ezinjengalezi:

• I-X-ray yesandla nesihlakala: Lokhu kuhlola ubudala bamathambo engane. Uma umzimba ukhiqiza ama-hormone amaningi ocansi, amathambo avuthwa ngaphambi kwesikhathi esijwayelekile. Lokhu kuyisibonakaliso sokuthomba ngaphambi kwesikhathi.
• Ukuhlolwa kwegazi: Lokhu kuhlola amazinga ama-hormone engane. Ngokukhethekile, kuhlola amazinga ama-hormone athi ``Luteinizing Hormone (LH)`` kanye nethi ``Follicle-Stimulating Hormone (FSH)``, akhiqizwa yi-pituitary gland. Lawa ama-hormone alawula ukuthomba. Kuhlola futhi amazinga ama-hormone ocansi.
• Ukuskena kwe-Brain MRI: Lokhu kuhlolwa kusiza ekususeni noma yiziphi izinkinga ezifana nezimila zobuchopho.
• I-ultrasound ye-pelvic: Lokhu kuhlolwa kungenziwa uma usola ukuthi ingane yakho inesikhathi sokuthomba ngaphambi kwesikhathi. Lokhu kuhlolwa kuhlola izimila ezitholakala emaqanda noma ezindlala ze-adrenal emantombazaneni, njengoba lokhu ngezinye izikhathi kungabangela ukuthomba kwasekuqaleni.

Kuye ngemiphumela yalezi zivivinyo, udokotela wakho angakudlulisela kudokotela we-endocrinologist wezingane, udokotela ogxile ezifweni ezihlobene nama-hormone ezinganeni.

Yiziphi izindlela zokwelapha lokhu?

Izindlela zokwelapha zincike ohlotsheni lokuthomba ngaphambi kwesikhathi.

Ukwelashwa Kokuthomba Okuphakathi Kwangaphambi Kokukhulelwa

Umgomo oyinhloko walolu hlobo ukumisa ukukhiqizwa kwama-hormone `LH` kanye ne-`FSH` yi-pituitary gland. Lokhu kunciphisa ijubane lezimpawu zokuthomba futhi kungaze kubambezele ukuya esikhathini. Lokhu kuvame ukwenziwa ngomuthi obizwa ngokuthi `GnRH agonist`. Lokhu kubizwa nangokuthi `Puberty Blocker`. Lena yi-hormone yokwenziwa ekhiqizwa yindoda. Lokhu kwenzelwa ukumisa ukukhiqizwa kwama-hormone okuzala noma ama-hormone okukhula. Udokotela uzonikeza ingane lo muthi njengomjovo ngezikhathi ezithile. Lokhu kwelashwa kufanele kuqhubeke kuze kube yisikhathi esifanele sokuqala kokuthomba.

Ukwelashwa Kokuthomba Kwangaphambi Kokuqala

Lolu hlobo lwesimo luphathwa ngokususa umthombo wama-hormone ocansi. Ezinye izingane zingadinga ukuhlinzwa ukuze kususwe isimila noma olunye uhlobo lomdlavuza olubangela ukuthomba kwasekuqaleni. Ezinye zingadinga imithi ye-steroid, njenge-glucocorticoids. Ngezinye izikhathi, lesi simo singalawulwa ngokususa umthombo we-hormone yangaphandle, njenge-estrogen creams.

Ingabe ukuthomba kusenesikhathi kungavinjelwa?

Lesi simo ngokuvamile kunzima ukusivimbela. Kodwa-ke, singavinjelwa ngezinga elithile ngokunciphisa ukuchayeka kwengane kuma-hormone ocansi avela emithonjeni yangaphandle. Isibonelo, kubalulekile ukugcina okhilimu, ama-lotion, noma eminye imithi equkethe i-estrogen noma i-testosterone kude nezingane.

Liyoba njani ikusasa labantwana abanalesi simo?

Ikusasa lomntwana lincike ezintweni eziningana:

• Ubudala bamathambo
• Iminyaka yengane lapho izimpawu zaqala khona
• Yeka ukuthi lesi simo sathuthuka ngokushesha kangakanani
• Uhlelo lokwelashwa kwengane

Kodwa akukho okufanele ukwesabe. Uma kutholakala kusenesikhathi futhi kwelashwa ngemithi noma, uma kudingeka, ngokuhlinzwa, lesi simo ngokuvamile singalawulwa. Ingane ingakhula ngesivinini esijwayelekile futhi ifinyelele ebudaleni.

Kufanele ngikhulume nini nodokotela ngalokhu?

Uma ingane yakho ibonisa noma yiziphi izimpawu zokuthomba ngaphambi kwesikhathi, ikakhulukazi uma ingane ingaphansi kweminyaka engu-8 (uma iyintombazane) noma eneminyaka engu-9 (uma ingumfana), bheka udokotela ngokushesha.

Yimiphi imibuzo okufanele ngiyibuze udokotela?

Ungabuza imibuzo efana nale:

• Ingabe ingane yami isheshe ifinyelele ezingeni lokuthomba?
• Kungani lokhu kwenzeke enganeni yami?
• Yikuphi ukwelashwa okuncoma ingane yami?
• Ingabe ingane yami iyayidinga imithi yokulawula lesi simo?
• Ingabe akhona amaqembu okusekelana asiza izingane ezifika esikhathini sokuthomba zisencane?
• Ingabe kufanele siye kudokotela we-endocrinologist wezingane?

Kungani amantombazane ebonakala sengathi aqala ukuthomba kulezi zinsuku?

Emazweni afana ne-United States, kuthiwa kunomkhuba wamantombazane aqala ukuthomba kusenesikhathi. Esinye isizathu salokhu singabangelwa ukwanda kwesilinganiso sokukhuluphala kulawo mazwe. Ngokusho kwabacwaningi, kukhona ukuxhumana phakathi kokuba ne-Body Mass Index (BMI) ephezulu kanye nokukhula kwebele kusenesikhathi. Kukhona futhi inkolelo yokuthi ukudla ukudla okucutshungulwe kakhulu, okunamafutha amaningi nakho kungabangela ukuthomba kusenesikhathi.

Futhi, kuthiwa uhlanga lunomthelela kulokhu. Isibonelo, amantombazane amnyama namaHispanic e-United States kubikwa ukuthi afinyelela ukuthomba ngaphambi kwesikhathi kunezinye izinhlanga. Njengoba ukukhuluphala kuvame kakhulu kula maqembu, lokho kungaba yimbangela yalokhu kwanda kokuthomba kwasekuqaleni.

Kodwa-ke, lezi zivame ukuba izifundo ezenziwa kwamanye amazwe. Isimo ezweni lethu singase sihluke. Ngakho-ke , uma unokungabaza ngengane yakho, into engcono kakhulu ongayenza ukufuna iseluleko sezokwelapha.

Ngakho-ke, yiziphi izinto ezibaluleke kakhulu okufanele sizikhumbule kule ndaba?

Ukuthomba kwasekuqaleni kungaba umthwalo omncane enganeni nakubazali. Kodwa kubalulekile ukuqaphela lokhu.

• Uma ubona izimpawu zokuthomba ngaphambi kwesikhathi (ngaphambi kweminyaka engu-8 kwamantombazane nangaphambi kweminyaka engu-9 kwabafana), ungakuthathi kalula. Bheka udokotela ngokushesha.
• Kungaba nezizathu eziningana zalokhu. Ngezinye izikhathi, imbangela ecacile ingase ingatholakali. Kodwa-ke, ukuhlolwa kwezokwelapha kungasiza ekutholeni.
• Kunezindlela zokwelapha ezisebenzayo. Uma zitholakale kusenesikhathi futhi zelashwa, ukukhula kwengane kungagcinwa ngendlela evamile.
• Qaphela impilo yengqondo yengane yakho futhi. Bangase bakuthole kunzima ukwamukela lolu shintsho. Banike uthando nokusekelwa. Bathumele ekwelulekweni uma kudingeka.

Into ebaluleke kakhulu ukwazi ukuthi awuwedwa. Odokotela bakhona ukukusiza wena nomntwana wakho. Ngakho-ke ungesabi, futhi funa iseluleko sezokwelapha njalo uma ungabaza.

Ukuthomba kwangaphambi kwesikhathi, ama-hormone, intuthuko yengane, ukuthomba, amantombazane, abafana