Hypogonadism

Hypogonadism yana faruwa lokacinda glandar jima'i ta jiki ke haifar da ƙarancin kwayoyi ko kuma babu. A cikin maza, waɗannan ƙwayoyin cuta (gonads) sune gwajin. A cikin mata, waɗannan gland shine ovaries.

Dalilin hypogonadism na iya zama na farko (gwaji ko ovaries) ko sakandare (matsala tare da pituitary ko hypothalamus). A tsarin hypogonadism na farko, kwayayen kwai ko gwajin kansu ba suyi aiki yadda yakamata ba. Sanadin hypogonadism na farko sun hada da:

• Wasu cututtukan autoimmune
• Kwayoyin halitta da ci gaban cuta
• Kamuwa da cuta
• Ciwon hanta da koda
• Radiation (zuwa gonads)
• Tiyata
• Rauni
  

Cutar cututtukan da aka fi sani da ke haifar da hypogonadism na farko sune cututtukan Turner (a cikin mata) da kuma Klinefelter syndrome (a cikin maza).

Idan kun riga kun sami wasu rikice-rikice na autoimmune kuna iya kasancewa cikin haɗari mafi girma don lalacewar autoimmune ga gonads. Waɗannan na iya haɗawa da cututtukan da suka shafi hanta, gland, da glandar glandar jiki, da kuma ciwon sukari na 1.

A tsakiyar hypogonadism, cibiyoyin cikin kwakwalwa da suke sarrafa gonads (hypothalamus da pituitary) basa aiki yadda yakamata. Abubuwan da ke haifar da hypogonadism na tsakiya sun hada da:

• Raunin rashin abinci
• Zubar jini a yankin na pituitary
• Shan magunguna, kamar su glucocorticoids da opiates
• Tsayawa magungunan anabolic
• Matsalolin kwayar halitta
• Cututtuka
• Karancin abinci
• Excessarfin ƙarfe (hemochromatosis)
• Radiation (ga pituitary ko hypothalamus)
• Sauri, rashi mai nauyi (gami da asarar nauyi bayan tiyatar bariatric)
• Yin aikin tiyata (tiyatar ƙashin kai kusa da pituitary)
• Rauni
• Ƙari

Dalilin kwayar cutar hypogonadism shine cutar Kallmann. Mutane da yawa masu wannan yanayin suma suna da ƙarancin ƙamshi.

Cutar menopause ita ce mafi yawan dalilai na rashin ƙarfi. Abu ne na al'ada a cikin dukkan mata kuma yana faruwa kusan shekaru 50. Matakan testosterone suna raguwa ga maza yayin da suke tsufa, haka kuma. Matsakaicin testosterone na yau da kullun a cikin jini ya ragu sosai a cikin mutum mai shekaru 50 zuwa 60 fiye da yadda yake tsakanin saurayi ɗan shekara 20 zuwa 30.

'Yan matan da ke da cutar hypogonadism ba za su fara al'ada ba. Hypogonadism na iya shafar ci gaban nono da tsawo. Idan hypogonadism ya faru bayan balaga, alamomi a cikin mata sun haɗa da:

• Hasken walƙiya
• Makamashi da canjin yanayi
• Haila tana zama mara tsari ko tsayawa

A cikin yara maza, hypogonadism yana shafar tsoka, gemu, al'aura da ci gaban murya. Hakanan yana haifar da matsalolin haɓaka. A cikin maza alamun sune:

• Kara girman nono
• Rashin tsoka
• Rage sha'awar jima'i (low libido)

Idan pituitary ko wasu cututtukan ƙwaƙwalwa suna nan (hypogonadism na tsakiya), akwai:

• Ciwon kai ko rashin gani
• Fitar nono na madara (daga prolactinoma)
• Kwayar cututtukan cututtukan cututtukan hormonal (kamar hypothyroidism)

Mafi yawan ciwace-ciwacen da ke shafi pituitary sune craniopharyngioma a cikin yara da kuma prolactinoma adenomas a cikin manya.

Kuna iya buƙatar gwaje-gwaje don bincika:

• Tsarin Estrogen (mata)
• Tsarin hormone mai motsa jiki (matakin FSH) da matakin kwayar cutar luteinizing (LH)
• Matakan testosterone (maza) - fassarar wannan gwajin a cikin tsofaffi maza da maza waɗanda ke da kiba na iya zama da wahala saboda haka ya kamata a tattauna sakamako tare da ƙwararren masanin hormone (endocrinologist)
• Sauran matakan aikin pituitary

Sauran gwaje-gwaje na iya haɗawa da:

• Gwajin jini don rashin jini da baƙin ƙarfe
• Gwajin kwayoyin halitta gami da karyotype don duba tsarin chromosomal
• Matakan Prolactin (madarar hormone)
• Yawan maniyyi
• Gwajin thyroid

Wasu lokuta ana buƙatar gwajin hoto, kamar sonogram na ƙwai. Idan ana tsammanin cutar pituitary, ana iya yin hoton MRI ko CT na ƙwaƙwalwa.

Kuna iya buƙatar shan magunguna masu amfani da hormone. Ana amfani da Estrogen da progesterone don 'yan mata da mata. Magungunan suna zuwa ne a cikin tsari kamar kwaya ko facin fata. Ana amfani da Testosterone don yara maza da maza. Za a iya ba da maganin azaman facin fata, gel na fata, wani bayani da ake shafawa a gaɓaɓɓiyar fata, facin da ake shafawa a saman cingam, ko ta allura.

Ga matan da ba a cire mahaifar su ba, hada magani tare da estrogen da progesterone na iya rage damar kamuwa da cutar kansa ta endometrial. Mata masu hypogonadism waɗanda ke da ƙarancin jima'i kuma za a iya ba su odar testosterone mai ƙarancin ƙarfi ko wani hormone na maza da ake kira dehydroepiandrosterone (DHEA).

A wasu matan, ana iya amfani da allurai ko ƙwayoyin cuta don ta da ƙwaya. Ana iya amfani da allurar homon na pituitary don taimakawa maza su samar da maniyyi. Sauran mutane na iya buƙatar tiyata da maganin fuka-fuka idan akwai raunin jiki ko kuma hypothalamic na rashin lafiyar.

Yawancin nau'ikan hypogonadism ana iya magance su kuma suna da kyakkyawan fata.

A cikin mata, hypogonadism na iya haifar da rashin haihuwa. Al'adar jinin al'ada na maza wani nau'in hypogonadism ne wanda ke faruwa a dabi'a. Zai iya haifar da walƙiya mai zafi, bushewar farji, da kuma rashin hankali yayin da matakan estrogen suka faɗi. Rashin haɗarin sanyin kashi da cututtukan zuciya yana ƙaruwa bayan gama al'ada.

Wasu mata masu fama da cutar hypogonadism suna shan maganin estrogen, galibi wadanda suke yin al'ada da wuri. Amma amfani da dogon lokaci na maganin hormone na iya ƙara haɗarin cutar sankarar mama, toshewar jini da cututtukan zuciya (musamman a cikin tsofaffin mata). Mata yakamata suyi magana da mai kula da lafiyarsu game da haɗari da fa'idojin maganin hormone menopausal.

A cikin maza, hypogonadism yana haifar da asarar sha'awar jima'i kuma yana iya haifar da:

• Rashin ƙarfi
• Rashin haihuwa
• Osteoporosis
• Rashin ƙarfi

Maza suna da ƙananan testosterone yayin da suka tsufa. Koyaya, raguwar matakan hormone ba abin ban mamaki bane kamar na mata.

Yi magana da mai ba ka idan ka lura:

• Fitar nono
• Kara girman nono (maza)
• Hasken zafi (mata)
• Rashin ƙarfi
• Rashin gashin jiki
• Rashin jinin al'ada
• Matsalar samun ciki
• Matsaloli game da sha'awar jima'i
• Rashin ƙarfi

Dukansu maza da mata ya kamata su kira mai ba su idan suna da ciwon kai ko matsalolin gani.

Kula da dacewa, nauyin jiki na yau da kullun da halaye masu kyau na iya taimakawa a wasu yanayi. Sauran dalilai bazai zama abin hanawa ba.

Rashin Gonadal; Rashin gwaji; Gazawar Ovarian; Testosterone - hypogonadism

• Gonadotropins

Ali O, Donohoue PA. Rashin aiki na gwajin. A cikin: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Littafin koyar da ilimin yara. 21st ed. Philadelphia, PA: Elsevier; 2020: babi 601.

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 pubmed.ncbi.nlm.nih.gov/29562364/.

Styne DM. Ilimin halittar jiki da rikicewar balaga. A cikin: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Littafin koyar da ilimin yara. 21st ed. Philadelphia, PA: Elsevier; 2020: babi na 26.

Swerdloff RS, Wang C. Gwajin jikin mutum da hypogonadism, rashin haihuwa, da lalata jima'i. A cikin: Goldman L, Schafer AI, eds. Magungunan Goldman-Cecil. 26th ed. Philadelphia, PA: Elsevier; 2020: babi na 221.

van den Beld AW, Lamberts SWJ. Endocrinology da tsufa. A cikin: Melmed S, Auchus RJ, Goldfine AB, Koenig RJ, Rosen CJ, eds. Littafin Williams na Endocrinology. 14th ed. Philadelphia, PA: Elsevier; 2020: babi na 28.