Hypogonadism

Hana ʻia ka hypogonadism ke hana iki nā kino wahine o ke kino i ka liʻiliʻi a ʻaʻohe paha o nā hormoni. I nā kāne, ʻo kēia mau glands (gonads) nā mea hōʻike. I nā wahine, ʻo kēia mau gland ka ovaries.

ʻO ke kumu o ka hypogonadism hiki ke lilo i kumu (testes a ovaries paha) a i ʻole ke kula kiʻekiʻe (pilikia me ka pituitary a hypothalamus paha). I ka hypogonadism mua, ʻaʻole holo pono nā ovaries a i ʻole nā ​​hoʻāʻo iā lākou iho. ʻO nā kumu o ka hypogonadism kumu:

• Nā maʻi maʻi autoimmune
• Nā maʻi genetic a me nā hoʻomohala
• Maʻi kīnā
• ʻO ka maʻi ate a me nā hakuʻala
• Pāhawewe (i nā gonad)
• ʻOki kino
• Trauma
  

ʻO nā maʻi genetical maʻamau e kumu i ka hypogonadism mua ʻo Turner Syndrome (i nā wahine) a me Klinefelter Syndrome (i nā kāne).

Inā loaʻa iā ʻoe nā maʻi autoimmune ʻē aʻe hiki i ka nui o ka makaʻu no ka autoimmune pōʻino i nā gonad. Hiki i kēia mau mea ke hoʻopili i nā maʻi e hoʻopili i ke ake, adrenal glands, a me nā tiroid thyroid, a me ka maʻi diabetes 1.

I ka hypogonadism waena, nā kikowaena i ka lolo e kaohi i nā gonad (hypothalamus a me pituitary) ʻaʻole e holo pono. ʻO nā kumu o ka hypogonadism waena:

• Anorexia nervosa
• Kahe i ka wahi o ka pituitary
• ʻO ka lawe ʻana i nā lāʻau, e like me nā glucocorticoids a me nā opiates
• Ke kū nei i nā steroid anabolic
• Nā pilikia genetic
• Nā maʻi ʻino
• Nā hemahema ʻaiaola
• ʻOi aku ka hao (hemochromatosis)
• Radiation (i ka pituitary a i ʻole hypothalamus)
• ʻO ka wikiwiki, ka pohō kaumaha nui (me ke kaupaona ʻana ma hope o ke kahakaha bariatric)
• ʻOki kino (ʻoki poʻo iwi poʻo kokoke i ka pituitary)
• Trauma
• Nā Tumors

ʻO kahi kumu kūlohelohe o hypogonadism waena ʻo Kallmann Syndrome. Nui ka poʻe me kēia ʻano i hōʻemi i ka pilau o ka pilau.

ʻO Menopause ke kumu maʻamau o ka hypogonadism. He mea maʻamau ia i nā wahine āpau a hana ʻia ma ka awelika a puni nā makahiki 50. Hoʻemi nā pae testosterone i nā kāne i ko lākou mau makahiki, pū kekahi. ʻO ka laulā o ka testosterone maʻamau i loko o ke koko he haʻahaʻa loa ia i loko o kahi kāne he 50 a 60 paha ka makahiki ma mua o ke kanaka 20 a 30 mau makahiki paha.

ʻO nā kaikamahine i loaʻa i ka hypogonadism ʻaʻole lākou e hoʻomaka i ka menstruating. Hiki i ka hypogonadism ke hoʻopili i ko lākou ulu ʻana i ka umauma a me ke kiʻekiʻe. Inā kū ka hypogonadism ma hope o ka ʻōpio, ʻo nā ʻōuli i loko o nā wahine pū kekahi:

• ʻO nā kukuna wela
• Hoʻololi ka ikehu a me ke ʻano
• Kūleʻa a kū paha ka Menstruation

I nā keikikāne, pili ka hypogonadism i ka mākala, ʻumiʻumi, a me ka ulu ʻana o ka leo. Alakaʻi hoʻi ia i nā pilikia ulu. I nā kāne nā ʻōuli:

• Hoʻonui ākea
• Lilo ka ʻiʻo
• Hoemi i ka hoihoi i ka moekolohe (libido haʻahaʻa)

Inā loaʻa kahi pituitary a i ʻole kahi tumo lolo ʻē aʻe (hypogonadism waena), aia paha:

• Headaches a i ʻole nalo ka hihi
• Hoʻokuʻu waiū waiū (mai kahi prolactinoma)
• Nā ʻōuli o nā hemahema hormonal (e like me hypothyroidism)

ʻO nā tumors maʻamau e hoʻopili ana i ka pituitary he craniopharyngioma i nā keiki a me nā adactomas prolactinoma i nā mākua.

Pono paha ʻoe e loaʻa i nā hoʻokolohua e nānā ai:

• Pae Estrogen (wahine)
• Follicle stimulate hōmona (pae FSH) a me ka pae luteinizing hormone (LH)
• Pae testosterone (kāne) - ka wehewehe ʻana i kēia hoʻāʻo ʻana i nā kāne ʻelemakule a me nā kāne momona e hiki ke paʻakikī a no laila e kūkākūkā ʻia nā hopena me kahi loea o ka hormone (endocrinologist)
• Nā hana ʻē aʻe o ka hana pituitary

Hiki i nā hoʻokolohua ʻē aʻe ke:

• Nā ho'āʻo koko no ka anemia a me ka hao
• Nā hoʻāʻo genetic me kahi karyotype e nānā i ka hanana chromosomal
• ʻO Prolactin pae (waiū waiū)
• Heluhelu sperma
• Nā hoʻāʻo thyroid

I kekahi manawa pono nā hoʻokolohua kiʻi, e like me ka sonogram o nā ovaries. Inā manaʻo ʻia ka maʻi pituitary, hiki ke hana ʻia kahi MRI a i ʻole CT scan o ka lolo.

Pono ʻoe e lawe i nā lāʻau i hoʻokumu ʻia i ka hōmona. Hoʻohana ʻia ka Estrogen a me ka progesterone no nā kaikamahine a me nā wahine. Hele mai nā lāʻau i ke ʻano o ka pill a i ʻole ka ʻili. Hoʻohana ʻia ka testosterone no nā keikikāne a me nā kāne. Hiki ke hāʻawi ʻia i ka lāʻau ma ke ʻano o ka ʻili, ʻili gel, kahi hopena i hoʻopili ʻia i ka ʻāpana lima, kahi pā i hoʻopili ʻia i ka gum o luna, a i ʻole nā ​​ʻoki.

No nā wahine i hoʻoneʻe ʻole ʻia i kā lākou kōpū, hoʻoliʻiliʻi ka hoʻowalewale me ka estrogen a me ka progesterone i ka manawa kūpono e ulu i ka maʻi ʻaʻai endometrial. ʻO nā wahine me ka hypogonadism ka mea hoʻohaʻahaʻa moekolohe hiki ke kauoha ʻia i testosterone haʻahaʻa a i ʻole kekahi kāne kāne i kapa ʻia dehydroepiandrolone (DHEA).

I kekahi mau wahine, hiki ke hoʻohana i nā injection a i ʻole nā ​​pila i mea e hoʻoulu ai i ka ovulation. Hiki ke hoʻohana ʻia nā kuʻina o ka hormone pituitary e kōkua i nā kāne e hana i ka sperm. Pono nā kānaka ʻē aʻe i kahi ʻoki a me ka radiation radiation inā aia kekahi pituitary a hypothalamic kumu paha o ka maʻi.

ʻO nā ʻano o ka hypogonadism ka mea hiki ke mālama ʻia a loaʻa kahi nānā maikaʻi.

I nā wahine, hiki i ka hypogonadism ke kumu i ka infertility. ʻO Menopause kahi ʻano hypogonadism e kū kūlohelohe. Hiki iā ia ke kumu i nā kukuna wela, ka maloʻo ʻana o ka ʻōpū, a me ka huhū i ka hāʻule ʻana o ka pae o ka estrogen. Hoʻonui ka makaʻi no ka osteoporosis a me nā maʻi puʻuwai ma hope o ka menopause.

Lawe kekahi mau wahine me ka hypogonadism i ka estrogen therapy, ʻo ka mea pinepine i ka menopause mua. Akā hiki i ka hoʻohana wā lōʻihi o ka hoʻōla hormonona ke hoʻonui i ka makaʻu no ka maʻi ʻaʻai umauma, ke koko a me nā maʻi puʻuwai (ʻoi aku i nā wahine makua). Pono nā wahine e kamaʻilio me kā lākou kahu mālama ola e pili ana i nā pilikia a me nā pōmaikaʻi o ka menopausal hormone therapy.

I nā kāne, hopena ka hypogonadism i ka lilo o ka hoʻokele wahine a hiki ke kumu:

• Impotence
• Hoʻoipo
• Osteoporosis
• Nawaliwali

Loaʻa ka haʻahaʻa o ka testosterone i nā kāne i ko lākou mau makahiki. Eia nō naʻe, ʻaʻole like ka haʻahaʻa o ka pae o ka hormone e like me ka wahine.

E kamaʻilio i kāu mea hāʻawi inā ʻike ʻoe:

• Hoʻokuʻu umauma
• Hoʻonui i ka umauma (kāne)
• Pākuʻi wela (wahine)
• Impotence
• Lilo ka lauoho o ke kino
• Lilo o ka manawa menstrual
• Nā pilikia e hāpai ana
• Nā pilikia me kāu hoʻokele moekolohe
• Nawaliwali

E kāhea nā kāne a me nā wahine i kā lākou mea hāʻawi inā he ʻeha poʻo poʻo a ʻike paha i nā pilikia.

ʻO ka mālama ʻana i ke olakino, ke kaupaona o ke kino maʻamau a me nā ʻano hana olakino olakino ke kōkua i kekahi mau hihia. ʻAʻole hiki ke pale ʻia nā kumu ʻē aʻe.

Hemahema o Gonadal; Hewa testicular; Manuia ʻole o ovarian; Testosterone - hypogonadism

• ʻO Gonadotropins

Ali O, Donohoue PA. Hypofunction o nā hōʻike. I: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. ʻO Puka Textbook of Pediatrics ʻo Nelson. 21st ed. Piladelapia, PA: Elsevier; 2020: chap 601.

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 pubmed.ncbi.nlm.nih.gov/29562364/.

ʻO Styne DM. Physiology a me nā maʻi o ka wā ʻōpio. I: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. ʻO Puka Textbook of Pediatrics ʻo Nelson. 21st ed. Piladelapia, PA: Elsevier; 2020: chap 26.

Swerdloff RS, Wang C. ʻO nā hōʻike a me nā kāne hypogonadism, infertility, a me ka moe kolohe. I: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 26th ed. Piladelapia, PA: Elsevier; 2020: chap 221.

van den Beld AW, Lamberts SWJ. Endocrinology a me ka ʻelemakule. I: Melmed S, Auchus RJ, Goldfine AB, Koenig RJ, Rosen CJ, eds. ʻO Williams Textbook of Endocrinology. 14th ed. Piladelapia, PA: Elsevier; 2020: chap 28.