I-PCOS kunye nezinye izizathu ezenzekayo ze-Hyperandrogenism
I-androgens ephakamileyo yenye yezinto ezintathu ezibonakalisa iimpawu ze-polycystic ovarian syndrome. Ngokomqathango oqhelekileyo wokuxilongwa, umfazi kufuneka abe neenxalenye ezimbini kwezi zilandelayo zithathu ukuba afunyaniswe ne-PCOS: imijikelezo engavumelekanga okanye engekhoyo yokuya esikhathini, i- polycystic ovaries (njengoko kubonwe kwi-ultrasound), okanye ubungqina be-hyperandrogenism.
Ziziphi i-androgens?
Kuthetha ukuthini xa ziphakanyisiwe, kwaye ziphi na i-androgen zigaba eziqhelekileyo? Ngaba i-PCOS yimiqathango kuphela ekhokelela kwi-androgens ephakamileyo kwabasetyhini?
Yintoni iAndrogens?
I-Androgens idlalwa ngokuba yi-"hormones" yamadoda, kodwa ezi hormone zikhoyo kwaye ziyimfuneko kubini nababhinqa. Zizinto ezibalulekileyo ekusebenzeni ngokuqhelekileyo kokuzala, ukuzinyamekela kwengqondo, umsebenzi wokuqonda, ukunyameka komzimba kunye nokukhula, kunye namandla esithambo. Enyanisweni, unokumangaliswa xa ufumanisa ukuba abafazi banama-androgens amaninzi kunama-estrogens ajikeleza emzimbeni wabo. (Oko kwathiwa, amadoda ngokubanzi avelisa i-androgens ngaphezulu kunabesifazane.)
Androgens badlala indima emininzi yomzimba. Ezinye iziphumo ze-hormone ze-androgen ziquka ukukhuthazwa kokukhula kweenwele zomzimba kunye ne-pubic, umnqweno wesini (libido), ukukhula kwemisipha, kunye nesenzo se-cell fat and place. Kubabini nababhinqa, i-androgens yinto elandelelanayo kwi-estrogens. Isenzo se-androgen-into-estrogen ngenye yeendima eziphambili ze-androgen hormones kubafazi.
Kwimabhinqa, i-androgen hormone yenziwe kwiingqungquthela ze-adrenal, ii-ovaries, kunye nama-fat cells.
I-hormone ye-androgen ifaka:
- Testosterone
- Androstenedione (A4)
- Dehydroepiandrosterone (DHEA)
- I-DHEA sulfate (DHEA-S)
- Androstenediol (A5)
- Androsterone
- Dihydrotestosterone (DHT)
Yintoni i-Hyperandrogenism?
I-Hyperandrogenism xa i-androgens iphakamileyo kunokuba kufuneka ibe okanye zikhona iimpawu zekliniki ezithi i-androgens ziphezulu kunokuba zimele zibe ziphezulu.
Nangona amadoda anamazinga aphezulu ase-androgens, i-hyperandrogenism inokuvela kumadoda kunye nabasetyhini.
Uninzi lwabasetyhini abane-hyperandrogenism bane-PCOS. Oko kwathiwa, kukho ezinye izizathu ezibangelwa yi-hyperandrogenism ekufuneka ilawulwe ngaphandle kokuba i-PCOS ixilongwe. (Oku ngakumbi ngezantsi.)
Kukho "iintlobo" ezimbini ze-hyperandrogenism: iiklinikhi kunye ne-biochemical. Ukuba nolunye uhlobo lungenza umfazi abe ne-PCOS. I-hyperandrogenism yekliniki yilapho kukho iimpawu ezibonakalayo okanye iimpawu ezibonisa ukuba imveliso ye-androgen ingaba phezulu kunokuba ilindeleke. Ezi zinto zingabonwa okanye zifumaneke ngaphandle kokuvavanywa kwezonyango. I-hyperandrogenism ye-biochemical yiyo xa umsebenzi weebhodi ubonisa amanqanaba aphezulu angama-hormone a-androgen ejikelezweni lwegazi.
Kunokwenzeka ukuba ube nemiqondiso yeklinikhi ye-hyperandrogenism kunye nayo yonke imisebenzi yegazi ukuze ubuyele ngokuqhelekileyo, kwaye kunokwenzeka ukuba iiLabhu zibonise i-androgens engaphezulu kodwa akukho nto ingekho kwiimpawu zekliniki.
Ziziphi iimpawu zeCliniki zeHyperandrogenism?
Iimpawu zonyango ziquka:
Ukukhula kweenwele ezingavumelekanga ebusweni, esifubeni, okanye ngasemva : Ukukhula kweenwele ngokuqhelekileyo kunxulumene namadoda, njengeentloko zobuso okanye iinwele zesifuba, kunokuba ngumqondiso weklinikhi we-hyperandrogenism.
Ixesha lezonyango leli yi- hirsutism . Phakathi kwama-75 no-80 ekhulwini kwabasetyhini abanokukhula kweenwele ezinjenge-PCOS, kodwa akubona bonke abafazi abane-PCOS abanamava. Abasetyhini abaninzi basusa ukukhula kweenwele ezigqithiseleyo kwaye abanako ukuqonda ukuba yintoni impawu yonyango. Qiniseka ukuxelela ugqirha wakho ukuba ufumana i-hirsutism.
I-Acne : I-acne ngexesha lokuselula liqhelekileyo kumakhwenkwe namantombazana atsha. Nangona umntu ekhulile, umlomo omnene awucatshangwanga ukuba awuqhelekanga. Nangona kunjalo, i-moderation kuya kwi-acne enzima, ingakumbi xa ihamba kunye nezinye iimpawu ezinzima, ingaba yinkcazo yee-orrogens ezingaphezulu.
Ukufakela umzekelo wesilisa : Bobabini nabasetyhini banokuphulukana neenwele xa bekhula. Nangona kunjalo, xa abafazi bafumana "ukulinganisa umzekelo wesilisa," ngokukodwa kwincinane kunokuba kulindeleke, oku kungabonakalisa uphawu lwe-hyperandrogenism yeklinikhi.
Ukuqhafaza umzekelo wesilisa kuxa ukulahleka kweenwele kuvela okanye ngeenwele, kubangele ukuba i-hairline ehambayo, okanye xa kubhalwa kwintloko yesithsaba. Oku kwahluke kunokuba i-pattern balding pattern, apho iinwele ziphosa phezulu kwintloko, kodwa inwele yezinwele yona ingatshintshi.
Ukunyanzeliswa kwempahla : Yilo xesha xa umfazi ehlawulela iimpawu ezinxulumene namadoda, njengezwi elinzulu okanye ukukhula komzimba. Nangona oku kungumqondiso wekliniki we-hyperandrogenism, akuqhelekanga kuboniswe nge-PCOS. Ezinye izizathu ezinokubangela ukuba u-hyperandrogenism kufuneka ziqwalaselwe.
Hyperandrogenism
I-hyperandrogenism ye-biochemical xa umsebenzi wegazi ubonisa ukuba amanqanaba e-androgen aphezulu kuneyona evamile. Amanqanaba e-androgen ovavanyo xa kutyunjwa kwi-PCOS kubalulekile. Nangona kukho iimpawu zeklinikhi ze-hyperandrogenism sele zibonakalisiwe, umsebenzi wegazi unokunceda ukulawula ezinye izizathu ezibangelwa yi-hyperandrogenism.
Ngezantsi zi-androgens ezingathi zivavanywe kwaye zeziphi izigaba eziqhelekileyo. Iziqhelo eziqhelekileyo ziyahlukahluka ngebhuyibhile, ngoko rhoqo qhagamshelana nodokotela wakho xa uzama ukuqonda iziphumo zakho.
I-testosterone iyonke : Amanqanaba afanele abe phakathi kwe-6.0 no-86 ng nge-dl kwabasetyhini. Kwi-PCOS, i-testosterone iyonke inokuphakanyiswa. Amanqanaba aphakamileyo kakhulu we testosterone angabonisa i-androgen-yokuvimba isisu.
I-testosterone yamahhala : Amanqanaba aqhelekileyo e-testosterone ekhululekile aphakathi kwe-0.7 no-3.6 pg nganye nge-mL. Amanqanaba e-testosterone amahhala angaphakanyiswa kwi-PCOS.
Androstenedione : Amanqanaba aqhelekileyo kwabasetyhini aphakathi kwe-0.7 ukuya ku-3.1 ng nge-mL. Amanqanaba aphakamileyo angabonisa i-PCOS.
I-DHEA-S: Amanqanaba aqhelekileyo kwabasetyhini aphakathi kwama-35 no-430 ug / dl. Abasetyhini abane-PCOS bangaba namanqanaba angaphezu kwama-200, awela phantsi kwinqanaba eliqhelekileyo kodwa eliphezulu.
Amanqanaba aphakamileyo kakhulu e-DHEA-S angabonisa i-androgen-yokuvimba i-tumor.
Ngaba Unayo i-PCOS kodwa Unamazinga aqhelekileyo aAndrogen?
Mhlawumbi ugqirha wakho ufumanise ukuba une-PCOS, kodwa ubona ukuba ii-lab yakho zibonisa amanqanaba aqhelekileyo kunye nee-orrogens. Ngaba oku kuthetha ukuba awunayo i-PCOS? Lo ngumbuzo onzima kakhulu, kuba akusiwo wonke umntu ovumelana nendlela yokuxilonga i-PCOS.
Uninzi lweengcali zithi amazinga aphezulu kwaye androgen ayimfuneko ukuba athathwe nge-PCOS. Nangona kunjalo, i-Androgen Excess (AE) kunye ne-PCOS Society ithi i-cycles irregular kunye nama-polycystic ovaries, ngaphandle kwee-orrogens ezingaphezulu, akwanele ukufumana ukuxilongwa kwe-PCOS.
Nangona kunjalo, nakhu ezinye izinto zokugcina engqondweni. Enye, inqobo yokusetyenziswa kwe-diagnostic esebenzisa i-PCOS-i-Rotterdam imigaqo-ibonisa ukuba impawu zezinto eziphilayo okanye izikliniki ze-hyperandrogenism ziyafaneleka.
Ngamanye amagama, umzekelo, masithi uneswele somzimba okanye isifuba. Lo ngumqondiso wekliniki we hyperandrogenism. Akunakufuneka ukuba ube neelabhu eziphakanyisiweyo kumgangatho wokuxilongwa kwe-PCOS. Okwesibini, ngokunjalo neenqobo zeRotterdam, akudingeki ukuba ube neerrogens ephakamileyo ukuba ufumane i-PCOS.
Ukuba unamaxesha angaqhelekanga (okanye engekhoyo) kunye nama-ovaries e-polycystic, kwaye akukho nanye inkcazo efunyenwe kwixesha lakho elingavumelekanga, unokufumana ukuxilongwa kwe-PCOS nangona ungenayo i-androgens ephakamileyo okanye nayiphi na impawu zeklinikhi ze-hyperandrogenism.
Ezinye izifo kunye neemeko kunye ne-Androgens ephakamileyo kwabasetyhini
I-PCOS inokuxilongwa ngokukhawuleza kokupheliswa. Ngaphambi kokuba ugqirha wakho angatsho ukuba unayo i-PCOS, kufuneka uqinisekise ukuba iimpawu zakho azikwazi ukuchazwa ngenye ingxaki ye-hormonal . Ngokukodwa, xa kuziwa kwi-androgens, kukho ezimbini ezibangela ezinye zezinto ezibangelwa yi-hyperandrogenism oza kugqirha ugqirha: i- congenital adrenal hyperplasia kunye nesifo sikaCushing .
I-congenital adrenal hyperplasia (CAH) isifo esizuze njengefa esiphumela ekusebenzeni okungavumelekanga kweengqungquthela ze-adrenal. Amadoda nabasetyhini abane-CAH basweleka i-enzyme ebalulekileyo ephazamisa ukuveliswa nokulawulwa kwamahomoni athile. Enye yeemodemoni ezichaphazelekayo zi-androgens.
Uninzi lwabantu abazalwa ngo-CAH bafunyaniswa xa bebancinci, kodwa kukho ukuhluka okutshatyalaliswa kwesi sifo kwaye akuvelisi iimpawu ezibonakalayo kude kube sekuseni ebomini. Ngezinye izihlandlo zibizwa ngokuba yi-CAH okanye i-CAH engekho yeklasi. Iimpawu ze-CAH ezingaqhelekanga zifana ne-PCOS. Ngaphambi kokuba ugqirha wakho angakuxilonga nge-PCOS, i-CAH engekho yeklasi kufuneka ilawulwe ngaphandle.
Isifo sikaCushing sisinye isifo esinokubangela iimpawu ezifana ne-PCOS. Isifo sikaCushing senzeke xa umzimba uvelele kumazinga aphezulu e-cortisol ngaphezu kwexesha elide. Oku kuya kwenzeka ngenxa yokusetyenziswa komlomo we-steroid yomlomo wesikhathi eside, okanye kuya kwenzeka nokuba umzimba ngokwawo udala i-cortisol engaphezulu.
Xa umzimba ngokwawo ubangela i-Cushing's syndrome, inokubangelwa yi-tumor engeyiyo umdlavuza kwi-pituitary gland okanye kwi-adrenal gland. Olu khuleni lunokuvelisa amanqanaba aphezulu ngokungavumelekanga kwi-androgen hormon, i- adrenocorticotropic hormone (ACTH) .
Ama-androgens angaphezulu kwaye angaphoswa nge-PCOS. Yingakho isifo sikaCushing kufuneka sigqitywe kuqala.
Ezinye iiNgxaki zezeMpilo ezibangelwa yi-Androgens ephakamileyo
Ukwandiswa kwamanqanaba e-androgen kunokudala izijikelezo ezingaqhelekanga, iimpawu ezinamahloni (njengokukhula kweenwele zobuso), nokungabikho kwabantwana abasetyhini. Kodwa nabo banembopheleleko kwezinye iimeko ezinobungozi ezihlala zihamba nePCOS.
Ukusabalalisa amafutha: I-Androgens ibonakala idlala indima apho i-fat egcinwe khona emzimbeni. Ngaba wakha waphawula ukuba amadoda athambekele ekuthwaleni amaninzi kwiindawo zabo zesisu, kwaye abafazi bathanda ukuthwala amanqatha emathangeni nasemathangeni? I-androgens ephakamileyo ingakhokelela abafazi ukuba bathathe amanqatha amaninzi kummandla wabo wesisu.
Ukunyameka kuyinkalo yengozi ye-PCOS. Oko kwathetha, kunokwenzeka nokuba ngabafazi abancinci okanye abaqhelekileyo abanomthwalo wokuba babe ne-PCOS .
Ukuxhatshazwa kwe-insulin : Ukunganyangeki kwe-insulin yinto engozi yobungozi be-PCOS. Ama-androgens angaphezulu angadlala indima. Kuye kwafunyanwa ukuba abafazi abanamazinga aphezulu kunye nee-orrogens bavame ukuba nabo basengozini ephezulu yokuxhatshazwa kwe-insulin.
Ingaba amanqanaba aphezulu kunye ne-androgen abangela ukunganyangeki kwe-insulin? Oku akucaci ngokucacileyo. Nangona kunjalo, uphando oluthile lubonise ukuba ukunciphisa amanqanaba aphakamileyo e-testosterone kubasetyhini kunceda ukunciphisa / ukuphucula ukunyanzeliswa kwe-insulin.
Iingxaki ze-Cardiovascular : Ukuba namazinga aphezulu okanye aphantsi a-androgens adibene nomngcipheko okhulayo kwiingxaki zeengqondo kwiintombi .
ILizwi
I-hyperandrogenism yimbangela yezinye iimpawu ezihlazo kunye nebonakalayo ze-PCOS . Usenokungazi ukuba isifuba sakho okanye ubunwele bezinwele zibonakaliswe iimpawu zengxaki yonyango. Qiniseka ukuba uvumele ugqirha wakho ukuba wazi ukuba unengxaki ezinje. Le ngcaciso inokunceda ekwenzeni ukuxilongwa.
I-PCOS ayinayo ikhambi, kodwa kukho unyango olukhoyo ukunciphisa iimpawu zakho. Ezinye zezi zonyango zizonyuka kwaye ziyafumaneka kwi-counter, ezifana ne-acne creams kunye neendlela zokususa iinwele. Kodwa ugqirha wakho unokukwazi ukumisela amayeza okanye amayeza ukunceda, naye.
Kwezinye iimeko, iipilisi zokulawula ukuzalwa zingakunceda ukunciphisa iimpawu zakho. Kukho namachiza anokunciphisa amanqanaba e-testosterone, anokunceda nge-acne, ukulahleka kweenwele kunye nokukhula kweenwele ezingafunekiyo. Thetha nogqirha wakho malunga nokukhetha kwakho.
> Imithombo:
> Alpañés, Macarena; UFernández-Durán, u-Elena; Escobar-Morreale, uHéctor F. Androgens kunye nePolycystic Ovary Syndrome. https://www.medscape.org/viewarticle/754292
> Armenia E1, Lambrinoudaki I2. "Androgens kunye nesifo senhliziyo kumabhinqa namadoda. "Maturitas. 2017 Oct; 104: 54-72. i-doi: 10.1016 / j.maturitas.2017.07.010. Epub 2017 Julayi 29.
> Karrer-Voegeli S1, Rey F, Reymond MJ, Meuwly JY, Gaillard RC, Gomez F. "Ukuxhomekeka kwe-Androgen ye-hirututism, i-acne, ne-alopecia kwabasetyhini: ukuhlalutya ngokuphindaphindiweyo kwezi-228 izigulane zophando nge-hyperandrogenism. "Amachiza (iBaltimore). 2009 Jan; 88 (1): 32-45. i-doi: 10.1097 / md.0b013e3181946a2c.
> USimon, uYakobi. Androgen. HealthyWomen.org. http://www.healthywomen.org/condition/androgen