Indlela eSebenzayo yamadoda nabesifazane abane-HIV
Ukuntuleka kwe-Testosterone kubonakala njalo kokubili amadoda nabesifazane abane- HIV . Ukukhubazeka kwe-endocrine, okungathinta ukukhiqizwa kwe-testosterone, sekuyisikhathi eside kubhekwa njengenkinga ye-HIV kusukela ezinsukwini zokuqala zesifo (nakuba ngokuvamile kuhlotshaniswa nezifo zesigaba sekwephuzile).
Kodwa-ke, ucwaningo lwamuva luveze ukuthi cishe indoda eyodwa kwabesilisa abahlanu abanesandulela ngculazi uye yabhala ukulahlekelwa kwe-testosterone, kungakhathaliseki ukuthi i- CD4 count , umthamo wegciwane , noma isimo sokwelashwa.
Ngokufanayo, ukwehluleka kwe-testosterone kubonakala komunye wabafazi abane abanegciwane lesandulela ngculazi, kaningi emkhakheni wezinkinga ezinkulu, ukulahlekelwa kwesisindo esingachaziwe ( ukuchitha i-HIV ).
Indima ye-Testosterone
I-testosterone yi-hormone ye-steroid ebaluleke kakhulu ekuthuthukiseni ama-testes (amaconta) kanye ne- prostate emadodeni kanye nokukhuthazwa kwezici zesilisa zesilisa (isb., Isisindo somzimba esifushane, isisindo samathambo, ukukhula kwezinwele). I-Testosterone ibalulekile nakwabesifazane ekulondolozeni imisipha evamile namathambo, nakuba emazingeni angaphansi kuka-10% ngaphansi kwamadoda.
Kuzo zombili amadoda nabesifazane, i-testosterone ibalulekile empilweni yakho yonke nenhlalakahle yomuntu, okufaka amandla kumuntu, amazinga wamandla, ne-libido.
Ngokuphambene, ukuchithwa kwe-testosterone kuhlotshaniswa nalokhu:
- Ukulahlekelwa kwesisindo somzimba osondayo
- I-anemia
- I-osteoporosis
- Ukuphikiswa kwe-insulin
- I-lipids eyanda (amafutha kanye / noma i-cholesterol) egazini
- Ukwandisa amafutha angaphansi kwesisu esiswini
Ukwehla kwe-Testosterone
Ukuntuleka kobufakazi be-Testosterone kubantu abane-HIV buhlobene kakhulu nokungajwayelekile kwe-endocrine okuthiwa i- hypogonadism yesilisa lapho umsebenzi we-gonads wesilisa (i-testes) ungasebenzi, okuholela ekukhiqizweni kwe-hormone yezocansi kunciphisa okungaphezu kwalokho okungalindeleke eminyakeni yobudala bomuntu.
Emphakathini jikelele, i-hypogonadism iyaziwa ukuthi iyenzeka kumuntu oyedwa kumadoda angama-25 phakathi kweminyaka engama-30 no-50, ekhuphuka kuya kweyodwa ngo-14 phakathi kweminyaka engama-50 kuya ku-79. Ngokuphambene, izigameko phakathi kwabantu abane-HIV zikhulu kakhulu izikhulu ezinhlanu.
Ukuzikhohlisa kungabangelwa yi-defect in the testes ngokwabo (okuyisisekelo) noma ukungasebenzi okuvela ngaphandle kwe-testes (eyesibili). Emadodeni amadala ane-HIV:
- I-hypogonadism eyinhloko yenza ama-25% amacala. Kungabangelwa ukulimala kwezivivinyo ngenxa yokutheleleka (kufaka phakathi ezinye izifo ezithathelanayo ), umdlavuza we-testicular , noma ukuhlukumezeka ngokomzimba kuma-testes (nakuba umonakalo ohlotsheni olulodwa olulodwa aluhlanganisi ngokunciphisa ukukhiqizwa kwe-testosterone).
- I-hypogonadism yesibili ilandisa ngamanye angu-75%, futhi ivame ukuhlobene nokuphazanyiswa kwe-neuroendocrine lapho ukusebenzisana phakathi kwesimiso sezinzwa kanye nesistimu ye-endocrine kuphazamiseka kakhulu. Nakuba kunezimo ezingavamile ze-HIV ezibangela ukulimala emgodini we-pituitary, i-HIV ngokwayo ayibangeli ukukhubazeka. Kunalokho, i-hypogonadism ibonakala phambi kwezifo eziningi ezingapheliyo, ukuvuvukala okuqhubekayo nokulahleka kwesisindo okungavamile kubonakala njengezici zokuhlangana.
Ukuzikhohlisa kungabangelwa ukuqubuka komntwana noma ukuhlukunyezwa kwe-anabolic steroids. Imishanguzo ye-HIV ayizange iboniswe ukuthi ibambe iqhaza ku-hypogonadism.
Izimpawu Zokuzikhohlisa Kwamadoda
Ukuzikhohlisa kwamadoda amadala kubonakala ngezinga eliphansi le-serum (igazi) le-testosterone, kanye neyodwa noma eziningana zezibonakaliso ezilandelayo:
- Ukuhlukumeza ama-muscle
- Amandla anciphisa amandla
- Ukucindezeleka, ukucasula, ubunzima ukugxila
- Ukwandiswa kwezicubu zesifuba (gynecomastia)
- Ukunciphisa izinwele zomzimba nobuso
- Ukwandisa ngamafutha esiswini
- Ukulahlekelwa kwe-bone mass (ukuphefumula kwamathambo)
- I-shrinkage yobufakazi
- Ukukhubazeka ngokocansi (isib. Ukukhubazeka kwe-erectile, i-ejaculate encishisiwe, i-libido ephansi, ubunzima bokuthola i-orgasm)
Ukuhlola nokuhlola
Ukuxilongwa kwenziwa ngokulinganisa inani le-testosterone egazini, okukhona khona ama-subtypes amathathu ahlukene. Uma kuvivinywa, imiphumela izoveza zombili testosterone yomuntu (wonke ama-subtypes) kanye nenye ye-subtypes ebizwa ngokuthi i- testosterone mahhala .
I-testosterone yamahhala ingumhlobo we-testosterone okungekho amaprotheni onamathele kuwo, okuvumela ukungena kwamaseli futhi kusebenze ama-receptors amanye ama-subtypes ayikwazi. Kucatshangwa ukuthi kunesilinganiso esinembile kakhulu sokuntuleka kwe-testosterone, naphezu kokumelela u-2-3% kuphela inani labantu. Ngokwakhe, i-testosterone esiphezulu ibhekwa njengenembile encane ngoba imiphumela ingavela evamile uma amanye ama-subtypes angewona amahhala ephakanyisiwe.
Ukuhlola kufanele kwenziwe ekuseni kakhulu ngoba amazinga angashintsha ngokufika ku-20% phakathi nesikhathi sosuku. Amazinga "avamile" amane nje angaphakathi kwebala lokubhekisela lebhu. Lezi zigaba zingahluka, kodwa, ngenhloso yokufanisa, ziphakathi
- 250-800 ng / dL we-testosterone esiphelele, futhi
- 50-200 pg / mL ye-testosterone yamahhala.
Noma kunjalo, ukuhlolwa kwe "okuvamile" akunakwenziwa ngezinombolo zodwa. Amazinga e-Testosterone athambekela ekuhlaleni cishe ngo-1-2% njalo ngonyaka ngemuva kweminyaka engama-40. Ngakho-ke, yini engaba "evamile" yendoda eneminyaka engu-60 ubudala ngeke ifane nomuntu oneminyaka engu-30 ubudala. Ukuhlolwa kufanele kwenziwe ngesisekelo somuntu ngamunye nodokotela wakho wokuphatha.
Kunconywe Ukwelashwa
Uma ukuxilongwa kwe-hypogonadism kuqinisekisiwe, ukwelashwa esikhundleni se-testosterone kungaboniswa. Izijovo ze-testosterone ze-intramuscular ngokuvamile zinconywa, ezinikeza imiphumela emibi uma izifo zomzimba zisetshenziselwa futhi zilungiswa udokotela olaphayo. Izinketho ezivunyelwe i-FDA zifaka i-Depo-testosterone (testosterone cypionate) no-Delatestryl (i-testosterone enanthate).
Ngokwesilinganiso, ama-injection anikezwa njalo emavikini amabili kuya kwamane. Ukuze ugweme imiphumela yokushintsha kwamazinga e-testosterone-okungabangela ngezinye izikhathi ukuguquka okuphawulekayo kwemizwa, amandla, nomsebenzi wezocansi-ukulinganisa okuphansi kanye nezikhathi zokuthatha isikhathi esifushane kuvame ukusetshenziswa.
Imiphumela emibi yokwelashwa ingafaka:
- I-acne kanye / noma isikhumba samafutha
- Ukulahlekelwa izinwele noma ukunqunywa kwezinwele
- Ukuvuvukala kwezinyawo, ama-ankle noma umzimba
- I-apnea yokulala
- Ukuthuthukiswa kwezicubu zebele (gynecomastia)
- Ama-clots egazi
- Ukwandiswa kwe-prostate
I-testosterone yokwelashwa esikhundleni singase futhi ibangele ukusheshisa komdlavuza we-prostate okhona ngaphambili. Ngenxa yalokhu, amazinga e- prostate-specific antigen (PSA) wesiguli azohlolwa futhi ahlolwe ngenkathi yokwelapha.
Konke okukhulunywe ngakho, ukujova kwe-intramuscular inikeza ukhetho olubiza izindleko zokwelapha u-hypogonadism, ngokunyuka okuhambisanayo ekuqapheleni, enhlalakahle, e-libido, emzimbeni wesisindo obuqinile, nangokwazi ukulungiswa. Ukungahleleki kufaka ukuvakashelwa kodokotela njalo nokuphathwa kwe-dosing.
Izithunywa ze-gel zomsindo, ezithinta izidakamizwa, nezama-geltiki nazo ziyatholakala, futhi zingasebenza ezimweni ezithile. Xoxa ngalokhu nodokotela wakho.
Ukuzikhohlisa ku-HIV-Abesifazane Abahle
Kwabesifazane, i-testosterone ikhiqizwa emaqanda ama-ovari nama-gland adrenal. Njengamadoda, i-hormone ebalulekile yokugcina imisipha evamile kanye nethambo, kanye namandla, amandla, kanye ne-libido.
Nakuba i-hypogonadism ingavamile kangako kwabesifazane abanesandulela ngculaza, kungenzeka futhi njalo kuvame ukubhebhetheka kwegciwane lesandulela ngculazi kanye nezifo eziphambili. Ukuqaliswa kwe-ART kungadlulisela ukuchitha nokususa isimo se-hypogonadal ezimweni eziningi.
Okwamanje akakho imihlahlandlela ehleliwe yokwelashwa kwe-hypogonadism yabesifazane, kanti ukhetho lwezokwelapha lulinganiselwe. I-hormone-substitution therapy (i-HRT) ingase ibe efanele kwabanye, kuyilapho ukusebenzisa okwesikhashana kwe-testosterone kungathuthukisa ukushayela ucansi, ubukhulu besisindo somzimba, namazinga wamandla.
Kodwa-ke, idatha ayisaphelelanga ekusebenziseni ubufakazi be-testosterone ukuphatha i-hypogonadism kumama angaphambi kwe-menopausal abane-HIV. Khuluma nomhlinzeki wakho wezempilo mayelana nemiphumela emibi engenzeka. I-Testosterone ayikhuthazwa ngabesifazane abakhulelwe noma abafisa ukukhulelwa.
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