Hypogonadotropic hypogonadism

Hypogonadism wani yanayi ne wanda gwajin namiji ko kuma ƙwai mace ke haifar da ƙarancin kwayar halittar jima'i.

Hypogonadotropic hypogonadism (HH) wani nau'i ne na hypogonadism wanda ya kasance saboda matsala tare da gland din pituitary ko hypothalamus.

HH yana faruwa ne ta rashin rashin homonin da yakan motsa kwai ko gwajin jini. Wadannan kwayoyin sun hada da hormone mai sakin gonadotropin (GnRH), homon mai motsa jiki (FSH) da kuma luteinizing hormone (LH).

Kullum:

• Hypothalamus a cikin kwakwalwa yana sakin GnRH.
• Wannan hormone yana motsa glandon kwance don sakin FSH da LH.
• Waɗannan homon ɗin suna gaya wa ƙwarjin mace ko gwajin namiji su saki homonin da ke haifar da ci gaban jima'i na al'ada a lokacin balaga, al'adar al'ada, matakan estrogen da haihuwa a cikin matan manya, da kuma samar da kwayar testosterone na yau da kullun da kuma samar da maniyyi a cikin samari.
• Duk wani canji a cikin wannan sarkar sakin jikin yana haifar da karancin sinadarin jima'i. Wannan yana hana balaga ta al'ada ta al'ada cikin yara da aikin al'ada na kwayayen haihuwa ko ƙwai a cikin manya.

Akwai dalilai da yawa na HH:

• Lalacewa ga gland din pituitary ko hypothalamus daga tiyata, rauni, ƙari, kamuwa da cuta, ko radiation
• Launin kwayoyin
• Babban allurai ko amfani na dogon lokaci na magungunan opioid ko steroid (glucocorticoid)
• Babban matakin prolactin (wani hormone da pituitary ya fitar)
• Mai tsananin damuwa
• Matsalolin abinci mai gina jiki (duka riba mai sauri ko raunin nauyi)
• Cutar cututtuka na dogon lokaci (na yau da kullun), gami da kumburi na yau da kullun ko cututtuka
• Amfani da ƙwayoyi, kamar su jaruntar ko amfani da shi ko cin zarafin magungunan opiate
• Wasu yanayin lafiya, kamar yawan ƙarfe

Kallmann ciwo wani nau'i ne na HH. Wasu mutanen da suke da wannan yanayin suma suna da cutar anosmia (rashin jin warin).

Yara:

• Rashin ci gaba a lokacin balaga (ci gaba na iya yin latti ko bai cika ba)
  
• A cikin 'yan mata, rashin ci gaban mama da lokacin al'ada
• A cikin samari, babu ci gaban halayen jima'i, kamar faɗaɗa ƙwarjiyoyin azzakari da azzakari, zurfafa murya, da gashin fuska
• Rashin wari (a wasu lokuta)
• Ananan gajere (a wasu lokuta)

Manya:

• Rashin sha'awar jima'i (libido) a cikin maza
• Rashin lokacin al'ada (amenorrhea) ga mata
• Rage kuzari da sha'awar ayyukan
• Rashin ƙwayar tsoka a cikin maza
• Karuwar nauyi
• Canjin yanayi
• Rashin haihuwa
  

Mai ba da sabis na kiwon lafiya zai yi gwajin jiki kuma ya yi tambaya game da alamunku.

Gwajin da za a iya yi sun hada da:

• Gwajin jini don auna matakan hormone kamar FSH, LH, da TSH, prolactin, testosterone da estradiol
• LH amsa ga GnRH
• MRI na pituitary gland / hypothalamus (don neman ƙari ko sauran girma)
• Gwajin kwayoyin halitta
• Gwajin jini don bincika matakin ƙarfe

Jiyya ya dogara da tushen matsalar, amma na iya ƙunsar:

• Injections na testosterone (a cikin maza)
• Slow-testosterone testosterone fata faci (a cikin maza)
• Gels na testosterone (a cikin maza)
• Estrogen da kwayoyin progesterone ko facin fata (a cikin mata)
• Allurar GnRH
• Allurar HCG
  

Maganin madaidaicin ciki zai haifar da balaga ya fara a cikin yara kuma yana iya dawo da haihuwa ga manya. Idan yanayin ya fara bayan balaga ko cikin girma, alamomin cutar galibi za su inganta da magani.

Matsalolin kiwon lafiya waɗanda zasu iya haifar da HH sun haɗa da:

• Balaga da aka jinkirta
• Sauke fararen al'ada (a cikin mata)
• Rashin haihuwa
• Bonearancin kashi da karaya daga baya a rayuwa
• Lowaramin girman kai saboda ƙarshen farkon balaga (taimakon motsin rai na iya taimakawa)
• Matsalolin jima'i, kamar ƙananan libido

Kira mai ba da sabis idan:

• Childanka ba ya fara balaga a lokacin da ya dace.
• Kai mace ce da bata wuce shekaru 40 ba kuma jinin hailar ku ya tsaya.
• Kun rasa amon hannu ko gashi.
• Kai namiji ne kuma ka rage sha'awar jima'i.

Rashin Gonadotropin; Hypogonadism na biyu

• Endocrine gland
• Pituitary gland shine yake
• Gonadotropins

Bhasin S, Brito JP, Cunningham GR, et al. Magungunan testosterone a cikin maza tare da hypogonadism: jagorar aikin likita na Endocrine Society. J Clin Endocrinol Metab. 2018; 103 (5): 1715-1744. PMID: 29562364 www.ncbi.nlm.nih.gov/pubmed/29562364.

Styne DM, Grumbach MM. Ilimin halittar jiki da rikicewar balaga. A cikin: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, eds. Littafin Williams na Endocrinology. 13th ed. Philadelphia, PA: Elsevier; 2016: babi na 25.

Farin Kwamfuta. Ci gaban jima'i da asali. A cikin: Goldman L, Schafer AI, eds. Magungunan Goldman-Cecil. 26th ed. Philadelphia, PA: Elsevier; 2020: babi na 220.