ʻO Polycystic ovary syndrome

ʻO Polycystic ovary syndrome (PCOS) kahi kūlana kahi i hoʻonui ai ka wahine i nā kiʻekiʻe o nā kāne kāne (androgens). Kūpono nā pilikia he nui ma muli o kēia hoʻonui ʻana o nā hormones, me:

• Nā kūleʻa Menstrual
• Hoʻoipo
• Nā pilikia o ka ʻili e like me ka huehue a hoʻonui i ka ulu ʻana o ka lauoho
• Hoʻonui i ka helu o nā cist liʻiliʻi i nā ovaries

Pili ʻo PCOS i nā loli i nā pae hormonone e paʻakikī ai i nā ovaries ke hoʻokuʻu i nā hua piha (oʻo). ʻAʻole maopopo nā kumu o kēia mau loli. ʻO nā hormona e pili ana:

• ʻO Estrogen a me progesterone, nā hormones wahine e kōkua i nā ovaries o ka wahine e hoʻokuʻu i nā hua
• Androgen, kahi kāne kāne i loaʻa i nā liʻiliʻi i nā wahine

ʻO ka maʻamau, hoʻokuʻu ʻia hoʻokahi a ʻoi paha mau hua i ka wā o ka pōʻaiapuni wahine. ʻIke ʻia kēia ʻo ka ovulation. I ka hapanui o nā hihia, kū kēia hoʻokuʻu ʻana o nā hua manu ma kahi o 2 mau pule ma hope o ka hoʻomaka ʻana o kahi wā menstrual.

I PCOS, ʻaʻole hoʻokuʻu ʻia nā hua makua. Akā, noho lākou i nā ovaries me kahi liʻiliʻi o ka wai (cyst) a puni lākou. Hiki ke nui o kēia mau mea. Eia naʻe, ʻaʻole nā ​​wahine me ke ʻano e loaʻa nā ovaries me kēia hiʻohiʻona.

Loaʻa nā wahine me PCOS i nā pōʻaiapuni kahi e kū ʻole ai ka ovulation i kēlā me kēia mahina i hiki ke kōkua i ka infertility ʻO nā ʻōuli ʻē aʻe o kēia maʻi ma muli o ke kiʻekiʻe o nā homone kāne.

ʻO ka hapanui o nā manawa, ʻike ʻia ʻo PCOS i nā wahine i ko lākou 20 a 30 paha. Eia nō naʻe, pili paha ia i nā kaikamahine ʻōpio. Hoʻomaka pinepine nā ʻōuli ke hoʻomaka nā wā o ke kaikamahine. Loaʻa i nā wahine me kēia maʻi pinepine ka makuahine a kaikuahine paha i loaʻa nā hōʻailona like.

Pākuʻi ʻia nā ʻōuli o PCOS me nā loli i ka pōʻai menstrual, e like me:

• ʻAʻole loaʻa kahi manawa ma hope o kāu loaʻa ʻana i hoʻokahi a ʻoi paha mau mea maʻamau i ka wā ʻōpio (amenorrhea lua)
• Hiki i nā wā kūpono ʻole ke hele mai a hele, a māmā loa i ke kaumaha loa

ʻO nā ʻōuli ʻē aʻe o PCOS me:

• ʻO nā lauoho keu e ulu ma ka umauma, ʻōpū, helehelena, a puni ka nipples
• Huehue ma ka maka, umauma, a i hope paha
• Hoʻololi ka ʻili, e like me ka maka o ka ʻili a ʻeleʻele paha a hoʻopaʻa ʻia a puni nā ʻūlima, ʻū, ka ʻāʻī, a me nā umauma

ʻO ka hoʻomohala ʻana i nā ʻano kāne ʻaʻole kūlike i ka PCOS a hōʻike paha i kahi pilikia ʻē aʻe. Hōʻike paha nā hoʻololi aʻe i kahi pilikia ʻē aʻe ma kahi o PCOS.

• ʻO ka lauoho lahilahi ma ke poʻo ma nā luakini, i kapa ʻia he ʻōhule kāne
• Ka hoʻonui ʻana o ka clitoris
• Hoʻoneʻe ʻana i ka leo
• Hoʻoemi i ka nui o ka umauma

E hana i kāu mea mālama ola i kahi hoʻokolohua kino. E hoʻopili kēia i kahi hōʻike pelvic. Hōʻike paha ka hōʻike:

• Hoʻonui ʻia nā ovaries me nā cist liʻiliʻi he nui i kākau ʻia ma ultrasound
• Hoʻonui clitoris (kākaʻikahi loa)

ʻO nā kūlana olakino aʻe e maʻa mau i nā wahine me PCOS:

• Ke kūpaʻa o ka insulin a me ka maʻi kō
• Piʻi koko kiʻekiʻe
• Kolesterol kiʻekiʻe
• Loaʻa kaupaona a me ka momona

E nānā kāu mea hāʻawi i kou kaupaona a me ka helu nui o ke kino (BMI) a ana i kou nui ʻōpū.

Hiki ke hana i nā hoʻokolohua koko e nānā i nā pae hormonone. Pili pū paha kēia mau hoʻāʻo:

• Pae Estrogen
• Pae FSH
• Pae LH
• Pākuʻi kāne (testosterone) pae

ʻO nā hoʻokolohua koko ʻē aʻe e hana ʻia e komo pū me:

• ʻO ka hoʻokēʻai glucose (ke kō i ke kō) a me nā hoʻokolohua ʻē aʻe no ka hoʻomanawanui ʻole o ka glucose a me ke kūpaʻa o ka insulin
• Papa lipid
• Hōʻike hāpai hāpai (hCG serum)
• Pae Prolactin
• Nā hoʻāʻo ʻana o ka hana thyroid

E kauoha paha kāu mea hāʻawi i ka ultrasound o kou pelvis e nānā i kāu mau ovaries.

ʻO ka loaʻa ʻana o ka paona a me ka momona ka mea maʻamau i nā wahine me PCOS. ʻO ka lilo ʻana i kahi kaupaona o ke kaupaona hiki ke kōkua i ka mālama ʻana:

• Hoʻololi ka Hormone
• Nā kūlana e like me ka maʻi diabetes, ke koko kiʻekiʻe, a i ʻole ke kiʻekiʻe o ka cholesterol

Kauoha paha kāu mea hāʻawi i nā lāʻau hoʻomalu hānau e hana maʻamau i kāu mau wā. Hiki i kēia mau pila ke kōkua i ka hōʻemi ʻana i ka ulu ʻana o ka lauoho a me ka huehue inā lawe ʻoe iā lākou i mau mahina. ʻO nā hana hana lōʻihi o nā hormones contraceptive, e like me Mirena IUD, hiki ke kōkua i ka hōʻoki ʻana i nā wā kūpono ʻole a me ka ulu pono ʻole ʻana o ka uhi ʻana o ka uterus.

Kākau ʻia kahi lāʻau diabetes e kapa ʻia ʻo Glucophage (metformin) i:

• Hana i kāu mau manawa maʻamau
• Kāohi i ka maʻi diabetes 2
• Kōkua iā ʻoe e lilo i ka paona

ʻO nā lāʻau ʻē aʻe i kuhikuhi ʻia e kōkua i ka hana maʻamau o kāu manawa a kōkua iā ʻoe e hāpai.

• Hoʻohālikelike ka LH-hoʻokuʻu ʻana i nā hōmona (LHRH)
• ʻO Clomiphene citrate a i ʻole letrozole, i ʻae ai i kāu mau ovaries e hoʻokuʻu i nā hua manu a hoʻomaikaʻi i kou manawa o ka hāpai ʻana

ʻOi aku ka maikaʻi o ka hana ʻana o kēia mau lāʻau inā he 30 a ʻoi aku ka liʻiliʻi o kāu helu papa kuhikuhi kino (BMI) (ma lalo o ka pae momona).

Hōʻike paha kāu mea hāʻawi i nā lapaʻau ʻē aʻe no ka ulu lauoho lauoho ʻole. ʻO kekahi:

• Spironolactone a i ʻole flutamide pills
• Pālima Eflornithine

ʻO nā hana kūpono o ka hemo lauoho me electrolysis a me ka wehe ʻana i ka lauoho laser. Eia nō naʻe, pono paha i nā hōʻailona he nui. He pipiʻi nā mālama ʻana a ʻaʻole mau nā hopena.

Hana ʻia kahi pelvic laparoscopy e kāpae a hoʻololi paha i kahi ovary e mālama ai i ka infertility. Hoʻomaikaʻi kēia i nā manawa o ka hoʻokuʻu ʻana i kahi hua manu. Kūlohelohe nā hopena.

Me ka lāʻau lapaʻau, hiki i nā wahine me PCOS ke hāpai pinepine. I ka wā hāpai, nui aʻe ka makaʻu o:

• Hāʻule hāʻule
• Piʻi koko kiʻekiʻe
• ʻO ka maʻi kō Gestational

ʻO nā wahine me PCOS e hoʻomohala aʻe:

• Maʻi ʻaʻai Endometrial
• Hoʻoipo
• Diabetes
• Nā pilikia pili i ka momona

Kāhea i kāu mea hāʻawi inā loaʻa iā ʻoe nā ʻōuli o kēia maʻi.

Nā ovaries Polycystic; ʻO ka maʻi ovary Polycystic; Stein-Leventhal maʻi maʻi; ʻO ka maʻi ovarian Polyfollicular; PCOS

• Nānā Endocrine
• Pelvic laparoscopy
• Anatomia hānau wahine
• ʻO Stein-Leventhal syndrome
• Uterus
• Hoʻolālā Follicle

Bulun SE Physiology a me nā pathology o ka wahine hānau axis. Ma Melmed S, Auchus RJ, Goldfine AB, Loenig RJ, et al, eds. ʻO Williams Textbook of Endocrinology. 14th ed. Piladelapia, PA: Elsevier; 2020: chap 17.

ʻO Catherino WH. Reproductive endocrinology a me ka infertility. I: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 26th ed. Piladelapia, PA: Elsevier; 2020: chap 223.

Lobo RA. ʻO Polycystic ovary syndrome. I: Lobo RA, Gershenson DM, Lentz GM, Valea FA, eds. Gynecology Comprehensive. ʻEpekema 7 Piladelapia, PA: Elsevier; 2017: chap 41.

ʻO Rosenfield RL, Barnes RB, Ehrmann DA. ʻO Hyperandrogenism, hirsutism, a me polycystic ovary syndrome. I: Jameson JL, De Groot LJ, de Kretser DM, et al, eds. Endocrinology: Makua a Pediatric. ʻEpekema 7 Piladelapia, PA: Elsevier Saunders; 2016: chap 133.