Indlela eSebenzayo yamadoda kunye nabafazi abane-HIV
Ukuntuleka kweTestosterone kubonakala rhoqo kubini nababhinqa abane- HIV . Ukungaqhelekanga kwe-endocrine, enokuchaphazela ukuveliswa kwe-testosterone, sele ibonwa njengengxaki ye-HIV ukususela kwiintsuku zokuqala zesifo (nangona ngokuqhelekileyo idibaniswa nesifo sexesha elide).
Nangona kunjalo, uphando lwangoku luye lwabonisa ukuba phantse indoda eyodwa kwintlanu enesifo se-HIV iye yabonisa ukusilela kwe-testosterone, kungakhathaliseki ukuba yi- CD4 count , umthamo we-viral , okanye imeko yonyango.
Ngokufanayo, ukungabikho kwe-testosterone kubonakala kwindoda yabantwana abane abane-HIV, kaninzi kwiimeko ezinzima, ukulahleka kwesisindo ( ukungatshatyalaliswa kwe-HIV ).
Indima yeTestosterone
I-Testosterone yi-hormone ye-steroid ephambili ekuphuhliseni i-testes (i-testicles) kunye ne- prostate kumadoda kwakunye nokukhuthazwa kweempawu zesini zesini (umz. I-Testosterone ibalulekile nakwabasetyhini ekugcineni isisindo esisisigxina kunye nesithambo, nangona kumanqanaba angama-10% ngaphantsi kwamadoda.
Kubabini nababhinqa, i-testosterone ibalulekile kwimpilo kunye nenhlalakahle yomntu, ebangela amandla omntu, amanqanaba emandla kunye ne-libido.
Ngokwahlukileyo, ukuchithwa kwe testosterone kudibaniswa ne:
- Ukulahlekelwa kobutyebi obubuthakathaka bomzimba
- IAnemia
- Osteoporosis
- Ukuxhathisa kwe-insulin
- Ukukhula kweepids (i-fat and / okanye i-cholesterol) egazini
- Ukunyuka kwamafutha angaphantsi kwisisu
Ulwaphulo lweTesttosterone
Ukuntuleka kweTestosterone kumadoda anesifo se-HIV kunxulumene kakhulu ne-endocrine engafaniyo ebizwa ngokuba yi- hypogonadism yesintu apho umsebenzi we-gonads (i-testes) yindoda engaphumeleli, okubangelwa ukuveliswa kwe-hormone yesini ngaphaya kokuya kulindeleka kumntu othile.
Kulo lonke uluntu, u-hypogonadism uyaziwa ukuba ayenzeka kumntu onama-25 phakathi kweminyaka engama-30 no-50, okwandayo ukuya kweyesi-14 phakathi kweminyaka eyi-50 ukuya kwe-79. Ngokwahlukileyo, iziganeko phakathi kwabantu abane-HIV zininzi zihlandlo ezihlanu.
I-Hypogonadism ingabangelwa yintsilelo kwiimvavanyo ngokwazo (eziprayimari) okanye ukukhubazeka okwenzeka ngaphandle kwee-testes (okwesibini). Kubantu abadala abadala abane-HIV:
- I-hypogonadism yeprayimari i-25% yamatyala. Inokubangelwa umonakalo kwiimvavanyo ngenxa yokusuleleka (kubandakanye nezifo ezithatha amathuba ), umdlavuza wesifo somthamo , okanye ukukhathazeka ngokomzimba kwii-testes (nangona umonakalo kwisicatshulwa esisodwa akuhambelanisi ukunciphisa ukuveliswa kwe testosterone).
- I-hypogonadism yesibini i-75%, kwaye ihlala ihambelana nokuphazamiseka kwe-neuroendocrine apho ukusebenzisana phakathi kwenkqubo ye-nervous and system endocrine kukhululeka kakhulu. Nangona kukho iimeko ezinqabileyo ze-HIV ezonakalisa umonakalo kwi-pituitary gland, i-HIV ngokwayo ayibangeli ukukhubazeka. Kunoko, u-hypogonadism uyabonakala phambi kwezifo ezininzi ezingapheliyo, ukuvuvukala okuqhubekayo kunye nokulahlekelwa kwesisindo esingapheliyo kubonwa njengezinto ezinxulumene nazo.
I-Hypogonadism inokubangelwa ubundlobongobantwana okanye ukusetyenziswa kakubi kwe-anabolic steroids. Imishanguzo ye-HIV ayibonwanga ukuba negalelo kwi-hypogonadism.
Iimpawu zoBuchule boMntu
I-Hypogonadism kubantu abadala bayabonakala ngezinga eliphantsi le-serum (igazi) i-testosterone, kunye nesinye seziganeko ezilandelayo:
- Ukulahleka kwemizimba
- Ukunciphisa amandla kunye nesigxina
- Ukuxinezeleka, ukukhubeka, ubunzima bokugxila
- Ukwandiswa kwezicubu zebele (gynecomastia)
- Ubunwele bomzimba obuncitshisiweyo
- Ukwandiswa kwamathambo esiswini
- Ukulahlekelwa kwesithambo samathambo (i-osteoporosis)
- I-shrinkage yobungqina
- Ukungasebenzi kwezesondo (umz. I-erectile dysfunction, i-ejaculate enciphise, i-libido ephantsi, ubunzima bokufumana i-orgasm)
Ukuvavanywa nokuxilongwa
Uxilongo lwenziwe ngokulinganisa inani le-testosterone egazini, apho kukho iintlobo ezintathu ezihlukeneyo. Xa uvavanyo luqhutyelwa, iziphumo ziza kubonakalisa zombini i- testosterone yomntu (zonke ii-subtypes) kunye nenye ye-subtypes ebizwa ngokuthi i- testosterone yamahhala .
I-testosterone yamahhala yinto nje yohlobo lwe testosterone olungenanto iprotheni eqhotyoshelweyo, ukuvumela ukungena kwiiseli kwaye kusebenze i-receptors enye i-subtypes ayikwazi. Kucingwa njengendlela echanekileyo yokunqongophala kwe-testosterone, nangona emele 2-3% yabemi bonke. Ngokwalo, i-testosterone iyonke ibonwa njengento echanekileyo kuba iziphumo zingabonakala ziqhelekileyo ukuba ezinye i-subtypes ezingenanto ziphakanyisiwe.
Uvavanyo lufanele lwenziwe kusasa ekuseni kuba amazinga angatshintshwa ngokufikelela kuma-20% ngexesha lemihla. Amanqanaba "aqhelekileyo" alula nje abo bangaphakathi kwirejista yokubhaliweyo. Ezi zigaba zingahluka, kodwa, ngenjongo yokubonisa, ziphakathi
- 250-800 ng / dL yee testosterone ngokupheleleyo, kunye
- 50-200 pg / mL ye-testosterone yamahhala.
Nangona kunjalo, uvavanyo "oluqhelekileyo" alukwazi ukwenza ngamanani kuphela. Amanqanaba aseTesttosterone athambe ukuhla malunga ne-1-2% ngonyaka emva kweminyaka engama-40. Ngoko ke, into enokuba yinto "eqhelekileyo" yindoda eneminyaka engama-60 ayiyi kuba yinto efanayo kumntu oneminyaka engama-30 ubudala. Iimvavanyo kufuneka zenziwe kumntu ngamnye kunye nogqirha wakho wokunyanga.
Unyango o lu khuthazwe
Ukuba ukuxilongwa kwe-hypogonadism kuqinisekisiwe, unyango lwe-testosterone olutshintsho lungabonakaliswa. Iingxube ze-testosterone ze-intramuscular zivame ukucetyiswa, ezinika iziphumo eziphantsi eziphantsi ukuba izilingo zomzimba zisetyenzisiwe kwaye zihlengahlengiswa ngugqirha wophatha. Izinketho ezivunyelwe yi-FDA ziquka iDepo-testosterone (testosterone cypionate) kunye noDelatestryl (i-testosterone enanthate).
Ngokomyinge, iilenki zinikwe iiveki ezimbini ukuya kwezine. Ukukhusela imiphumo yokuguqulwa kwamanqanaba e-testosterone-oku kunokubangela ukuba ngezinye izikhathi ukuguquka okuphawulekayo kwimizi, amandla, kunye nomsebenzi wesini-amanani amancinci kunye nezikhathi ezincinci zokulandelwa zivame ukusetyenziswa.
Imiphumo emibi yonyango ingaquka:
- I-acne kunye / okanye isikhumba seoli
- Ukulahleka kweenwele okanye ukunqunyulwa kweenwele
- Ukuvuvukala kweenyawo, ama-ankle okanye umzimba
- Ukulala ngomoya
- Ukuphuhliswa kweethambo zesisu (gynecomastia)
- Amacwecwe egazi
- Ukwandiswa kweprotrate
I-Testosterone yonyango yokutshintshwa nayo ingabangela ukukhawuleza komhlaza wesibeleko esele ukhona . Ngenxa yoko, amanqanaba e- prostate-specific antigen (PSA) aya kuvavanywa kwaye ahlolwe ngexesha loqeqesho.
Yonke into echazwe, iinjenisi ze-intramuscular zinikezela ukhetho olunokusebenza ngokunyanga ukunyanga u-hypogonadism, ngokunyuka kwamaqabane ekuqaphelweni, impilo, i-libido, ubunzima bemisipha kunye nokukwazi ukulungiswa. Iintsilelo zibandakanya ukutyelela rhoqo ugqirha kunye nokulawulwa kwe-dosing.
I-odal, i-transdermal, kunye nee-agents ze-gel zengqungquthela nazo ziyafumaneka, kwaye zinokusebenza kwiimeko ezithile. Xoxa ngezi ngogqirha wakho.
Ukunyaniseka kwiNtsholongwane kaGawulayo
Kwimabhinqa, i-testosterone ikhiqizwa kuma-ovari kunye nama-adrenal glands. Njengabantu, i-hormone ebalulekileyo yokugcina isisindo esisisiseko kunye neethambo, kunye namandla, amandla kunye ne-libido.
Ngoxa i-hypogonadism ayifanelekanga kakhulu kubasetyhini abane-HIV, inokuthi ivele kwaye ihlala ihlala kwimeko yokutshatyalaliswa kwe-HIV kunye nezifo eziphambili. Ukuphunyezwa kwe-ART kunokuphelisa ukutshabalalisa kunye ne-hypogonadal imeko kwiimeko ezininzi.
Kukho akukho migaqo echanekileyo yokunyangwa kwe-hypogonadism yabasetyhini, kwaye ukhetho lwezokwelapha aluphelelanga. I-hormone yonyango yokuguqula (HRT) ingafanelekile kwabanye, ngelixa i-short-term usetyenziso lwe testosterone lungenza ngcono i-sex drive, ubukhulu bomzimba obukhulu kunye namanqanaba emandla.
Nangona kunjalo, idatha ayisaphelelanga ekusebenziseni i-testosterone ukunyanga i-hypogonadism kumabhinqa angaphambi kwe-menopausal abane-HIV. Thetha kunye nomboneleli wakho wezempilo malunga nemiphumo emibi. I-Testosterone ayikhuthazwa ngabasetyhini abakhulelweyo okanye abanqwenela ukuba bakhulelwe.
Imithombo:
Rietschel, P .; Corcoran, C .; Stanley T; okqhubekayo. "Ukuxhaphaka kwe-hypogonadism phakathi kwamadoda anesisindo sokulahleka okuhlobene nokutheleleka komzimba kwintsholongwane ka-anti-immunodeficiency virus." Izifo ezithathelwanayo zonyango. Novemba 2, 2000; 31 (5): 1240-1244.
UHugh Jones, T. "Ixesha elide lokuhlaziywa kwe-Hypogonadism." IBritish Medical Journal. NgoFebruwari 13, 2009; 338: b352.
Huang, J .; UWilkie, uS .; IDolan, iS .; okqhubekayo. "Amanqanaba e-testosterone anciphisa amanqanaba e-HIV-infected women's infunodeficiency virus-weight loss and weight weight." Izifo ezithathelwanayo zonyango. NgoJanuwari 28, 2003; 36 (4): 499-506.
I-Grinspoon, S. "Ukusetyenziswa kwe-Androgens kwi-Men-Infected Men and Women". I-Physicians Research Network I-Notebook. Matshi 2005.
Kalyani, R .; Gavini, S .; kunye neDobs. A. "I-Hypogonadism yamadoda kwisifo sesistim." I-Endocrinology I-Metabolism Clinic yaseNyakatho Melika Yombhalo. Juni 2007; 36 (2): 333-48.
UCarnegie, C. "Ukuchongwa kwe-Hypogonadism: Uvavanyo lweKliniki kunye novavanyo lweLebhu." Ukuphononongwa kwi-Urology. 2004; 6 (6): s3-8.
Kumar, P .; Kumar, N .; Patidar, A .; okqhubekayo. "I-Hypogonadism yamadoda: Izimpawu kunye nonyango." Umbhalo we-Advanced Pharmacological Technology kunye noPhando. Julayi-Septemba 2010; 1 (3): 297-302.
Mylonakis, E .; Koutkia, P .; kunye ne-Grinspoon, S. "Ukuxilongwa kunye nokunyangwa kwe-androgen ukusilela kumadoda kunye nabasetyhini abane-HIV." Izifo ezithathelwanayo zonyango. NgoSeptemba 15, 2001; 33 (6): 857-64.