Hypogonadotropic hypogonadism

ʻO ka Hypogonadism kahi kūlana kahi e hōʻike ai nā kāne a i ʻole nā ​​ovaries wahine e hana i kahi liʻiliʻi a i ʻole nā ​​hormones sex.

ʻO hypogonadotropic hypogonadism (HH) kahi ʻano hypogonadism ma muli o kahi pilikia me ka pituitary gland a hypothalamus paha.

Hoʻokumu ʻia ʻo HH e ka nele o nā hormoni e hoʻoulu maʻamau i nā ovaries a i ʻole nā ​​hōʻike. ʻO kēia mau homone e pili pū ana me ka hormone hoʻokuʻu hoʻokuʻu gonadotropin (GnRH), hormone hoʻouluulu follicle (FSH) a me ka hormone luteinizing (LH).

Maʻamau:

• ʻO ka hypothalamus i ka lolo e hoʻokuʻu iā GnRH.
• Hoʻoulu kēia hormonone i ka pituitary gland e hoʻokuʻu iā FSH a me LH.
• ʻLelo kēia mau homona i nā ovaries wahine a i ʻole nā ​​hōʻike kāne kāne e hoʻokuʻu i nā homone e alakaʻi ai i ka ulu ʻana o ka moekolohe ma ka wā ʻōpio, nā wā maʻamau, nā pae estrogen a me ka momona o nā wahine makua, a me ka hana testosterone maʻamau a me ka hana sperm i nā kāne makua.
• ʻO nā hoʻololi i kēia kaulahao hoʻokuʻu hormone ke kumu o ka nele o nā hormones sex. Pale kēia i ke kūlana moekolohe maʻamau i nā keiki a me ka hana maʻamau o nā testicle a i ʻole nā ​​ovaries i nā mākua.

Nui nā kumu o HH:

• ʻO ka hōʻino i ka pituitary gland a i ʻole hypothalamus mai ke ʻoki ʻana, ka hōʻeha, ka maʻi tumo, ka maʻi, a i ʻole ka radiation
• Nā kīnā genetic
• ʻO nā kaha kiʻekiʻe a hoʻohana lōʻihi paha o ka opioid a i ʻole steroid (glucocorticoid) lāʻau
• ʻO ka pae prolactin kiʻekiʻe (kahi hormone i hoʻokuʻu ʻia e ka pituitary)
• Kaha koʻikoʻi
• Nā pilikiaʻai (ʻo ka loaʻa wikiwiki a me ka pohō kaumaha)
• Nā maʻi olakino lōʻihi (mau), e like me ka mumū mau a i ʻole nā ​​maʻi
• Hoʻohana lāʻau, e like me heroin a hoʻohana a hoʻomāinoino paha i nā lāʻau lapaʻau opiate kuhikuhi
• ʻO kekahi mau kūlana olakino, e like me ka nui o ka hao

ʻO Kallmann syndrome kahi ʻano hoʻoilina o HH. Kekahi poʻe me kēia ʻano loaʻa pū kekahi anosmia (nalo o ke ʻano o ka pilau).

Keiki:

• Ka nele o ka hoʻomohala ʻana i ka wā ʻōpio (lohi paha a lawa ʻole paha ka hoʻomohala ʻana)
  
• I nā kaikamahine, ka nele o ka ulu ʻana o ka umauma a me nā wā paʻapaʻa
• I nā keikikāne, ʻaʻohe hoʻomohala i nā ʻano moekolohe, e like me ka hoʻonui ʻana i nā hōʻike a me ka peni, ka hohonu o ka leo, a me ka lauoho maka.
• Hiki ʻole ke honi (i kekahi mau hihia)
• ʻO ke kino pōkole (i kekahi mau manawa)

Makua:

• Loaʻa ka hoihoi i ka moekolohe (libido) i nā kāne
• ʻO ka nalo ʻana o nā wā menstrual (amenorrhea) i nā wahine
• Hoemi i ka ikehu a me ka hoihoi i nā hana
• Loaʻa ka nui o nā mākala i nā kāne
• Kaumaha hoʻonui
• Hoʻololi ke ʻano
• Hoʻoipo
  

E hana ka mea mālama ola i kahi hoʻokolohua kino a nīnau e pili ana i kāu mau hōʻailona.

ʻO nā hoʻāʻo e hana ʻia ana paha:

• Nā ho'āʻo koko e ana i nā pae hormonone e like me FSH, LH, a me TSH, prolactin, testosterone a me estradiol
• LH pane iā GnRH
• MRI o ka pituitary gland / hypothalamus (e nānā i kahi tumo a i ʻole ulu ʻē aʻe)
• Ke hoʻāʻo genetic
• Nā ho'āʻo koko e nānā i ka pae hao

Pili ka mālama ʻana i ke kumu o ka pilikia, akā pili pū paha:

• Nā inikua o ka testosterone (i nā kāne)
• Pākuʻi ʻili testosterone hoʻokuʻu lohi (i nā kāne)
• Nā testosterone gels (i nā kāne)
• ʻO nā lāʻau Estrogen a me nā progesterone a i ʻole nā ​​ʻili ʻili (i nā wahine)
• Nā inikua GnRH
• Nā kōkō HCG
  

ʻO ka mālama ʻana i ka hormona pono ka mea e hoʻomaka ai ka ʻōpio i nā keiki a hoʻoliʻiliʻi paha i ka momona i nā mākua. Inā hoʻomaka ke ʻano ma hope o ka ʻōpio a i ʻole i ka wā makua, e hoʻomaikaʻi pinepine nā hōʻailona me ka lāʻau.

ʻO nā pilikia olakino i hopena ʻia ma muli o HH nā:

• Hoopaneeia ka manawa makua
• Menopause mua (i nā wahine)
• Hoʻoipo
• ʻO ka iwi haʻahaʻa a me nā haki ma hope o ke ola
• Ka manaʻo haʻahaʻa haʻahaʻa ma muli o ka lohi o ka hoʻomaka ʻana o ka ʻōpio (hiki ke kōkua i ke kākoʻo naʻau)
• Nā pilikia moekolohe, e like me ka libido haʻahaʻa

Kāhea i kāu mea hāʻawi inā:

• ʻAʻole hoʻomaka kāu keiki i ka wā ʻōpio i ka wā kūpono.
• He wahine ʻoe ma lalo o ka 40 mau makahiki a kū kou mau pōʻai hae.
• Ua lilo ʻoe i ka lauoho o ka armpit a i ʻole ka pubic.
• He kāne ʻoe a ua hōʻemi ʻoe i ka hoihoi i ka moekolohe.

Ka hemahema o Gonadotropin; Hypogonadism lua

• Nānā Endocrine
• Kelepona pituitary
• ʻO Gonadotropins

Bhasin S, Brito JP, Cunningham GR, et al. Hoʻomaʻamaʻa testosterone i nā kāne me ka hypogonadism: kahi papa hana hoʻomaʻamaʻa ʻo Endocrine Society. ʻO J Clin Endocrinol Metab. 2018; 103 (5): 1715-1744. PMID: 29562364 www.ncbi.nlm.nih.gov/pubmed/29562364.

ʻO Styne DM, Grumbach MM. Physiology a me nā maʻi o ka wā ʻōpio. I: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, eds. ʻO Williams Textbook of Endocrinology. 13th ed. Piladelapia, PA: Elsevier; 2016: chap 25.

Keʻokeʻo PC. Hoʻolālā moekolohe a me ka ʻike. I: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 26th ed. Piladelapia, PA: Elsevier; 2020: chap 220.