I-PCOS nezinye izizathu ezenzekayo ze-Hyperandrogenism
I-androgens ephakanyisiwe ingenye yezimpawu ezintathu ezichaza izimpawu ze-polycystic ovarian syndrome. Ngokwesimo esivame ukusetshenziswa kakhulu sokuhlonza, owesifazane kufanele abe nambili kulezi ezintathu ezilandelayo ukuze atholakale ene-PCOS: imijikelezo engavamile noma engekho esikhathini sokuya esikhathini, ama- ovaries we-polycystic (njengoba kubonwe kwi-ultrasound), noma ubufakazi be-hyperandrogenism.
Ayini i-androgens?
Kusho ukuthini uma kuphakanyisiwe, futhi yiziphi amazinga we-androgen ajwayelekile? Ingabe i-PCOS yiyona kuphela into eholela e-androgens ephakeme kwabesifazane?
Kuyini i-Androgens?
I-Androgens ivame ukubhekwa ngokuthi yi "hormone" yamadoda, kodwa la mahomoni akhona futhi abalulekile kubo bobabili besilisa nabesifazane. Zibalulekile emsebenzini wokuzala ovamile, inhlalakahle engokomzwelo, umsebenzi wokuqonda, ukusebenza komzimba osondelene nokukhula nokuqina kwamathambo. Eqinisweni, ungase umangale uma ufunda ukuthi abesifazane bane-androgens ngaphezulu kunezi-estrogens ezijikelezayo emzimbeni wazo. (Lokho kusho ukuthi amadoda wonke akhiqiza ama-androgens amaningi kunabesifazane.)
U-Androgens udlala indima eminingi emzimbeni womuntu. Ezinye izimo ze-androgen ze-hormone zihlanganisa ukugqugquzela ukukhula kwezinwele zomzimba nokushicilela, isifiso socansi (libido), ukukhula kwemisipha, kanye nesenzo se-cell kanye nendawo. Kuzo zombili amadoda nabesifazane, i-androgens yiyona eyandulela ama-estrogens. Isenzo se-androgen-into-estrogen ingenye yezindima eziyinhloko zama-hormone we-androgen kubesifazane.
Kwabesifazane, ama-hormone a-androgen adalwe ezigulini ezinama-adrenal, ama-ovaries, nama-fat cell.
I-hormone ye-androgen ihlanganisa:
- Testosterone
- I-Androstenedione (A4)
- I-Dehydroepiandrosterone (i-DHEA)
- I-DHEA sulfate (i-DHEA-S)
- I-Androstenediol (A5)
- Androsterone
- I-Dihydrotestosterone (i-DHT)
Kuyini Hyperandrogenism?
I-Hyperandrogenism yilapho ama-androgens ephakeme kunalokho okufanele abe khona noma kukhona izibonakaliso zemitholampilo ukuthi i-androgens iphakeme kunalokho okufanele ibe khona.
Ngisho noma amadoda anamazinga aphezulu ngokwemvelo a-androgens, i-hyperandrogenism ingenzeka kumadoda nabesifazane.
Iningi labesifazane abane-hyperandrogenism bane-PCOS. Lokho kusho ukuthi kunezinye izimbangela ze-hyperandrogenism okumelwe zikhishwe ngaphambi kokuthi kutholakale ukuthi i-PCOS ixilongwa. (Ngaphezu kwalokho ngezansi.)
Kunezinhlobo ezimbili "zezinhlobo" ze-hyperandrogenism: imitholampilo kanye ne-biochemical. Ukuba nomusa kungenza owesifazane abe ne-PCOS. I-hyperandrogenism yomtholampilo yilapho kunezibonakaliso ezibonakalayo noma izimpawu ezibonisa ukuthi ukukhiqizwa kwe-androgen kungenzeka kube ngaphezulu kunalindelekile. Lezi yizinto ezingabonwa noma ezihlangenwe ngaphandle kokuhlolwa kwezokwelapha. I-hyperandrogenism ye-biochemical yilapho umsebenzi welabhu ubonisa amazinga ajwayelekile ngokungavamile ama-hormone a-androgen ekusakazweni kwegazi.
Kungenzeka ukuthi ube nezibonakaliso zemitholampilo ye-hyperandrogenism kanye nayo yonke imisebenzi yegazi ukuthi ibuyele evamile, futhi kungenzeka ukuthi amalabhu akhombise ama-orrogens amaningi kodwa kukhona okuncane okungekho embonini yemitholampilo.
Ziyini Izimpawu Zokwelapha Ze-Hyperandrogenism?
Izimpawu zomtholampilo zifaka:
Ukukhula kwezinwele ezingavamile ebusweni, esifubeni, noma emuva : Ukukhula kwezinwele ngokuvamile okuhlotshaniswa namadoda, njengezinwele zobuso noma izinwele zesifuba, kungaba uphawu lwezokwelapha lwe-hyperandrogenism.
Igama lezokwelapha kulokhu yi- hirsutism . Phakathi kwamaphesenti angama-75 no-80 abesifazane abanobunwele obufana nabesilisa abanama-PCOS, kodwa akubona bonke abesifazane abane-PCOS abazwa lesi sibonakaliso. Abesifazane abaningi basusa lokhu kukhula okungaphezulu kwezinwele futhi bangase bangaqapheli ukuthi kungabonakaliswa ukuthi kukhona inkinga yezokwelapha. Qinisekisa ukuthi utshele udokotela wakho uma uhlangabezana ne-hirsutism.
Ama-acne : Ama-acne ngesikhathi sokukhula evamile kubafana namantombazane asebasha. Ngisho nalapho esekhulile, ama-acne amancane akubhekwa njengengavamile. Kodwa-ke, okulinganiselwe ukuba kube nezicabha ezinzima, ikakhulukazi uma kuhambisane nezinye izimpawu ezinzima, kungaba yinkomba ye-androgens eyengeziwe.
Ukulinganisa umlingisi wesilisa: Bobabili abesilisa nabesifazane bangase babhekane nezinwele lapho bekhula. Kodwa-ke, uma abesifazane bethola "ukulinganisa iphathini lesilisa," ikakhulukazi ngesikhathi esincane kunalokho okungalindeleka, lokhu kungaba uphawu lwe-hyperandrogenism yomtholampilo.
Ukukhishwa kwephethini lamadoda kuyilapho ukulahleka kwezinwele kwenzeka noma yi-hairline, okuholela ekugqibeleni izinwele, noma lapho kukhishwa ibhola ekhanda. Lokhu kuhluke kunama-pattern balding female, lapho izinwele zibopha phezulu kwekhanda, kodwa izinwele zezinwele zihlala zingashintshi.
Ukuvivinya umzimba : Ngesikhathi owesifazane eveza izici ezihambisana namadoda, njengezwi elijulisayo noma ukukhula komzimba kwamadoda. Ngenkathi lokhu kungabonakaliswa kwesifo se-hyperandrogenism, ngokuvamile akubonwanga nge-PCOS. Ezinye izimbangela ze-hyperandrogenism kufanele zicatshangelwe.
Hyperandrogenism yezinto eziphilayo
I-hyperandrogenism ye-biochemical yilapho umsebenzi wegazi ubonisa ukuthi ama-androgen amazinga aphakeme kunokuvamile. Amazinga we-androgen wokuhlola uma kutholakala ukuxilongwa kwe-PCOS kubalulekile. Ngisho noma kunezibonakaliso zemitholampilo ye-hyperandrogenism kakade kubonakala, umsebenzi wegazi ungasiza ukulawula ezinye izimbangela ezibangelwa i-hyperandrogenism.
Ngezansi yi-androgens engase ihlolwe nokuthi yiziphi amazinga ajwayelekile. Izigaba ezivamile zingashintshana nelebhu, ngakho njalo buza nodokotela wakho uma uzama ukuqonda imiphumela yakho.
Ingqikithi ye-testosterone : Izinga kufanele zibe phakathi kuka-6.0 no-86 ng nge-dl kwabesifazane. Ku-PCOS, i-testosterone esiphelele ingahle ikhishwe kancane. Amazinga aphakeme kakhulu we testosterone esiphelele angabonisa ukuthi i-androgen-secreting tumor.
I-testosterone yamahhala : Amazinga avamile we-testosterone mahhala aphakathi kuka-0.7 no-3.6 pg nge-mL ngayinye. Amazinga wamahhala we-testosterone angaphakanyiswa ku-PCOS.
I-Androstenedione : Amazinga avamile kwabesifazane aphakathi kuka-0.7 kuya ku-3.1 ng nge-mL ngayinye. Amazinga aphakeme angabonisa i-PCOS.
I-DHEA-S: Amazinga avamile kwabesifazane aphakathi kuka-35 no-430 ug / dl. Abesifazane abane-PCOS bangase babe namazinga angaphezu kwe-200, awela ngaphansi kwezinga elijwayelekile kodwa eliphakeme.
Amazinga aphakeme kakhulu e-DHEA-S angabonisa ukuthi i-androgen-secreting tumor.
Ungabe Usenayo I-PCOS Kodwa Unamazinga E-Androgen Normal?
Mhlawumbe udokotela wakho uthole ukuthi une-PCOS, kodwa ubona ukuthi ama-lab wakho akhombisa amazinga avamile we-androgens. Ingabe lokhu kusho ukuthi awunayo i-PCOS? Lona umbuzo onzima kakhulu, ngoba akuwona wonke umuntu ovumelana nendlela yokuxilongwa kwe-PCOS.
Iningi labachwepheshe bathi amazinga we-androgen ayandawo akudingekile ukuthi atholakale ene-PCOS. Kodwa-ke, i-Androgen Excess (AE) ne-PCOS Society iphikisana ngokuthi imijikelezo engavamile kanye nama-ovaries we-polycystic, ngaphandle kwama-androgen amaningi, akwanele ukuba afinyelele ukuhlolwa kwe-PCOS.
Nokho, nansi ezinye izinto okufanele uzikhumbule. Enye, indlela ejwayelekile yokuxilonga esetshenziselwa i-PCOS-i-Rotterdam criteria-ibonisa ukuthi izimpawu ze-biochemical noma zomtholampilo ze-hyperandrogenism ziyafaneleka.
Ngamanye amagama, isibonelo, asho ukuthi unesifo sobuso noma isifuba. Lesi isibonakaliso somtholampilo se-hyperandrogenism. Awudingi futhi ukuthi ube namalebhu aphakanyisiwe ukuze uthole ukuhlolwa kwe-PCOS. Okwesibili, futhi ngokusho komgomo we-Rotterdam, akudingeki ube ne-androgens ephakanyisiwe ukuthi ifakwe ne-PCOS.
Uma unenkathi engavamile (noma engekho) nama-ovaries we-polycystic, futhi akekho enye incazelo efunyenwe ngezikhathi zakho ezingavamile, ungathola ukuxilongwa kwe-PCOS ngisho noma ungenayo i-androgens ephakeme noma yiziphi izimpawu zomtholampilo ze-hyperandrogenism.
Ezinye izifo nemibandela ene-Androgens ephakanyisiwe kwabesifazane
I-PCOS ixilongwa kancane ngokuqedwa. Ngaphambi kokuba udokotela wakho angasho ukuthi une-PCOS, udinga ukuqinisekisa ukuthi izimpawu zakho azikwazi ukuchazwa ngenye ingozi ye-hormonal . Ngokuqondile, uma kuziwa ku-androgens, kunezinye izimbangela ezimbili ze-hyperandrogenism ukuthi udokotela wakho uzofuna ukuhlola: i- congenital adrenal hyperplasia nesifo sikaCushing .
I-congenital adrenal hyperplasia (CAH) yisifo esithatha njengefa esiholela ekusebenzeni okungavamile kwezigulane eziyingozi. Amadoda nabesifazane abane-CAH abalahlekelwa i-enzyme ebalulekile ephazamisa ukukhiqizwa nokulawulwa kwama-hormone athile. Enye ye-hormone engenzeka iphathwe yi-androgens.
Iningi labantu abazalwa ne-CAH liyabonakala lapho lisencane, kodwa kukhona ukuhluka okuphawulekayo kwalesi sifo futhi akuvezi izimpawu ezibonakalayo kuze kube yilapho ezayo ekuphileni. Lokhu ngezinye izikhathi kuthiwa yi-CAH ephuzile noma i-CAH engeyona ye-classic. Izimpawu ze-CAH ezingezona ezivamile zingafana ne-PCOS. Ngaphambi kokuba udokotela wakho angakuxilonga nge-PCOS, i-CAH engeyona ye-classic kufanele ikhishwe kuqala.
Isifo sikaCushing esinye isifo esingabangela izimpawu ezifana ne-PCOS. Isifo sikaCushing senzeke lapho umzimba uvuleka emazingeni aphezulu e-cortisol esikhathini esengeziwe. Lokhu kungenzeka ngenxa yokusetshenziswa komlomo we-steroid yesikhathi eside, noma kungenzeka futhi uma umzimba ngokwawo udala i-cortisol eyedlulele.
Lapho umzimba ngokwayo ubangela i-Cushing's syndrome, kungase kubangelwe isisu esingenayo umdlavuza emgodini we-pituitary noma i-adrenal gland. Lokhu kukhula kungenza amazinga aphezulu angavamile we-androgen hormone, i- horrenone ye-adrenocorticotropic (ACTH) .
I-androgens engaphezu kwesidingo ingaba iphutha nge-PCOS. Yingakho isifo sikaCushing kufanele sithathwe kuqala.
Ezinye izinkinga zezempilo ezibangelwa ama-Androgens aphakanyisiwe
Amazinga we-androgen akhula angabangela imijikelezo engavamile, izimpawu ezihlazo (njengokukhula kwezinwele ebusweni), nokungabikho kwabesifazane. Kodwa nabo banomthwalo wezinye izici eziyingozi ezivame ukuhamba ne-PCOS.
Ukusatshalaliswa kwamafutha: I-Androgens ibonakala idlala indima lapho amafutha agcinwe khona emzimbeni. Wake waqaphela ukuthi amadoda athambekele ekuthwaleni amanoni ikakhulukazi esifundeni sabo esiswini, futhi abesifazane bavame ukuthwala amafutha emathangeni nasemathangeni? I-androgens ephakanyisiwe ingaholela abesifazane ukuba baphathe amafutha amaningi esifundeni sabo esiswini.
Ukukhuluphala kuyinto engozini ye-PCOS. Lokho kusho ukuthi kungenzeka abesifazane besisindo noma abavamile besisindo sokuba ne-PCOS .
Ukuphikiswa kwe-insulini : ukumelana kwe- insulini kuyisici esiyingozi se-PCOS. Ama-androgens amaningi angadlala indima. Kutholakale ukuthi abesifazane abanamazinga aphakeme a-androgens nabo bavame ukuba engozini enkulu yokumelana ne-insulin.
Ingabe amazinga aphezulu a-androgen enza ukuphikiswa kwe-insulin? Lokho akucaci okwamanje. Kodwa-ke, ezinye izifundo ziye zabonisa ukuthi ukunciphisa amazinga aphezulu e-testosterone kwabesifazane nakho kusiza ukunciphisa / ukuthuthukisa ukumelana kwe-insulin.
Izinkinga ze-cardiovascular : Ukuba namazinga aphezulu aphansi noma aphansi ahlobene nenengozi eyandayo ezinkingeni zenhliziyo kubantu besifazane .
Izwi elivela
I-Hyperandrogenism yimbangela yezinye izimpawu eziphoqisayo nezibonakalayo ze-PCOS . Kungenzeka ukuthi wayengazi ukuthi isifuba sakho noma izinwele zobuso bekungenzeka izimpawu zenkinga yezokwelapha. Qiniseka ukuthi uvumele udokotela wakho wazi ukuthi unenkinga efana nalezi. Lolu lwazi lungasiza ekwenzeni ukuxilongwa.
I-PCOS ayinayo ikhambi, kodwa kunezokwelapha ezitholakalayo ukunciphisa izimpawu zakho. Ezinye zalezi zonyango ziyisimonyo futhi zitholakala phezu kwe-counter, njengezicucu ze-acne nezindlela zokususa izinwele. Kodwa udokotela wakho angakwazi ukunikeza ama-creams noma imithi ukusiza, futhi.
Kwezinye izimo, amaphilisi okulawula ukubeletha angasiza ekunciphiseni izimpawu zakho. Kukhona nemithi enganciphisa amazinga e-testosterone, angasiza nge-acne, ukulahlekelwa izinwele, nokukhula kwezinwele ezingadingeki. Khuluma nodokotela wakho mayelana nezinketho zakho.
> Imithombo:
> Alpañés, Macarena; UFernández-Durán, u-Elena; Escobar-Morreale, uHéctor F. Androgens kanye nePolycystic Ovary Syndrome. https://www.medscape.org/viewarticle/754292
> Armenia E1, Lambrinoudaki I2. "Androgens kanye nesifo senhliziyo emadodeni nakwabesilisa. "Maturitas. 2017 Oct; 104: 54-72. doi: 10.1016 / j.maturitas.2017.07.010. I-Epub 2017 Jul 29.
> Karrer-Voegeli S1, Rey F, Reymond MJ, Meuwly JY, Gaillard RC, Gomez F. "Ukuxhaswa kwe-Androgen, i-acne, ne-alopecia kwabesifazane: ukuhlaziywa okuphindaphindiwe kweziguli ezingu-228 eziphenywe nge-hyperandrogenism. "Imithi (Baltimore). 2009 Jan; 88 (1): 32-45. i-doi: 10.1097 / md.0b013e3181946a2c.
> USimoni, uJakobe. Androgen. HealthyWomen.org. http://www.healthywomen.org/condition/androgen