PCOS ndi Zina Zowonjezera Zomwe Zimayambitsa Hyperandrogenism
Mitundu ya androgens yowonjezera ndi imodzi mwa zitatu zomwe zikhoza kuwonetsa zizindikiro za matenda a polycystic ovarian. Malinga ndi njira zomwe zimagwiritsidwa ntchito kwambiri, mayi ayenera kukhala ndi awiri mwa atatu otsatirawa kuti awoneke ndi PCOS: nthawi yosakhalitsa kapena yochoka kumaliseche, ma polyvarioustic ovaries (monga momwe amachitira pa ultrasound), kapena umboni wa hyperandrogenism.
Kodi androgens ndi chiyani?
Kodi zikutanthauzanji pamene zakwezedwa, ndipo ndiji zanji ndiroti ndi zachilendo? Kodi PCOS ndiyo mkhalidwe wokha umene umatsogolera kwa azimayi opambana?
Kodi Androgens Ndi Chiyani?
Androgens nthawi zambiri amatchedwa mahomoni "amphongo", koma mahomoniwa alipo ndipo ndi ofunika kwa amuna ndi akazi. Iwo ndi ofunikira kuntchito yowonetsera bwino, kukhala ndi moyo wabwino, kuganizira, kugwiritsira ntchito minofu ndi kukula, ndi mphamvu ya fupa. Ndipotu, mungadabwe kudziwa kuti amayi ali ndi androgens ambiri kuposa majeremusi oyendayenda m'matupi awo. (Icho chinati, amuna ambiri amabala kwambiri androgens kuposa akazi.)
Androgens amagwira ntchito zambiri m'thupi la munthu. Zina mwa zotsatira za hormone zimaphatikizapo kukakamiza kwa thupi ndi kubereka tsitsi, chilakolako cha kugonana (libido), kukula kwa minofu, ndi kuchepa kwa mafuta ndi malo. Mu amuna ndi akazi onse, androgens ndizolowera kwa estrogens. Mankhwala a androgen-into-estrogen ndi chimodzi mwa maudindo oyambirira a mahomoni a androgen.
Kwa akazi, mahomoni a androgen amapangidwa m'matenda a adrenal, mazira, ndi ma maselo ambiri.
Mahomoni a androgen ndi awa:
- Testosterone
- Androstenedione (A4)
- Dehydroepiandrosterone (DHEA)
- DHEA sulfate (DHEA-S)
- Androstenediol (A5)
- Androsterone
- Dihydrotestosterone (DHT)
Kodi Hyperandrogenism N'chiyani?
Hyperandrogenism ndi pamene ma androgens ali apamwamba kuposa momwe ayenera kukhalira kapena pali zizindikiro zachipatala kuti androgens ndi apamwamba kuposa momwe ayenera kukhalira.
Ngakhale kuti anthu ali ndi madigiridwe ambiri apamwamba, hyperandrogenism ikhoza kuchitika mwa amuna ndi akazi.
Ambiri mwa amayi omwe ali ndi hyperandrogenism ali ndi PCOS. Izi zinati, pali zina zomwe zingayambitse hyperandrogenism zomwe ziyenera kuchitidwa musanadziwe kuti PCOS ingapangidwe. (Zowonjezera pamunsimu.)
Pali "mitundu" iwiri ya hyperandrogenism: kuchipatala ndi zamagetsi. Kukhala ndi mtundu uliwonse kungapangitse mkazi kukhala ndi PCOS. Kachilombo ka hyperandrogenism ndi pamene pali zizindikiro zoonekeratu zomwe zikuwonetsa kuti androgen yopanga ingakhale yoposa yomwe ikuyembekezeredwa. Izi ndi zinthu zomwe zingawoneke kapena kuzidziwa popanda kuyesedwa kwachipatala. Matenda a hyperandrogenism ndi pamene ntchito ya labu imasonyeza machitidwe akuluakulu a mahomoni a androgen m'magazi.
N'zotheka kukhala ndi zizindikiro za matenda a hyperandrogenism ndi ntchito yonse ya magazi kuti abwererenso mwachizolowezi, ndipo n'zotheka kukhala ndi mababu akuwonetsa mavitrog ochulukirapo koma pali zochepa zozizwitsa zamagetsi.
Kodi Zizindikiro Zachizindikiro za Hyperandrogenism Ndi Ziti?
Zizindikiro zachipatala zikuphatikizapo:
Kukula kwa tsitsi kumaso, chifuwa, kapena kumbuyo : Kukula kwa tsitsi kumaphatikizapo amuna, monga tsitsi la nkhope kapena chifuwa, lingakhale chizindikiro cha matenda a hyperandrogenism.
Mawu azachipatala chifukwa cha ichi ndi hirsutism . Pakati pa 75 ndi 80 peresenti ya amayi omwe ali ndi tsitsi lakula ngati tsitsi ali ndi PCOS, koma si amayi onse omwe ali ndi PCOS amakumana ndi chizindikiro ichi. Amayi ambiri amachotsa kukula kwa tsitsili ndipo sangadziwe kuti ndizo chizindikiro cha matenda. Onetsetsani kuuza dokotala ngati mukukumana ndi hirsutism.
Zodzoladzola : Zikodzo pa nthawi yachinyamata zimakhala zachilendo kwa anyamata ndi atsikana. Ngakhale mutakula, thupi lofewa silinali lopanda kanthu. Komabe, kuchepa kwambiri kwa acne, makamaka ngati ikutsatidwa ndi zizindikiro zina zovuta, zingakhale zizindikiro za mavitamini owonjezera.
Kujambula kwa amuna: Amuna ndi akazi amatha kutaya tsitsi pamene akukalamba. Komabe, pamene amayi akuwona "kusinthana kwa amuna," makamaka pa msinkhu wachinyamata kusiyana ndi momwe tingayembekezere, izi zikhoza kukhala chizindikiro cha matenda a hyperandrogenism.
Kujambula kazithunzi kwa amuna ndi pamene tsitsi limatuluka chifukwa cha tsitsi, zomwe zimapangitsa kuti tsitsi likhale lokhazikika, kapena ngati kupaka tsitsi kumapezeka pamutu wa mutu. Izi ndi zosiyana ndi zojambula zazimayi, zomwe tsitsi limatuluka pamwamba pa mutu, koma tsitsi lokha limakhala losasintha.
Virilization : Izi ndi pamene mkazi amalimbikitsa makhalidwe okhudzana ndi amuna, monga mau ozama kapena kukula kwa minofu yamwamuna. Ngakhale ichi ndi chizindikiro chotheka cha hyperandrogenism, sizimawoneka ndi PCOS. Zina zomwe zingayambitse hyperandrogenism ziyenera kuganiziridwa.
Hyperandrogenism
Matenda a hyperandrogenism ndi pamene ntchito ya magazi imasonyeza kuti mayendedwe a androjeni ndi apamwamba kusiyana ndi achibadwa. Kuyeza mazira a androjeni pakudziwika kwa PCOS n'kofunika. Ngakhale pali zizindikiro za hyperandrogenism zowonekeratu, ntchito yamagazi ingathandize kuthetsa zifukwa zina zomwe zimayambitsa hyperandrogenism.
M'munsimu muli androgens omwe angayesedwe ndi zomwe zimakhala zachibadwa. Mipiringi yoyenera imasiyana ndi labu, choncho nthawi zonse funsani dokotala wanu poyesera kumvetsa zotsatira zanu.
Chiwerengero cha testosterone : Miyeso iyenera kukhala pakati pa 6.0 ndi 86 ng pa dl kwa akazi. Mu PCOS, testosterone yonse ikhoza kukwera. Matenda apamwamba kwambiri a testosterone angasonyeze chotupa chotsekemera cha androgen.
Testosterone yaulere : Maselo ovomerezeka a testosterone ali pakati pa 0.7 ndi 3.6 pg pa mL. Mafunde a testosterone amatha kukhala okwera mu PCOS.
Androstenedione : Maselo ochiritsira azimayi ali pakati pa 0.7 ndi 3.1 ng pa mL. Mawindo okwera angasonyeze PCOS.
DHEA-S: Makhalidwe ambiri mwa akazi ali pakati pa 35 ndi 430 ug / dl. Azimayi omwe ali ndi PCOS akhoza kukhala ndi miyeso yoposa 200, yomwe imakhala yochepa koma yapamwamba.
Maseŵera apamwamba kwambiri a DHEA-S angasonyeze chotupa chotsekemera cha androgen.
Kodi Mungathebe Kukhala ndi PCOS Koma Mukhale ndi Maonekedwe Okhazikika a Androgen?
Mwinamwake dokotala wanu akupeza kuti muli ndi PCOS, koma mukuwona kuti ma labbu anu amasonyeza machitidwe oyenera a androgens. Kodi izi zikutanthauza kuti mulibe PCOS? Ili ndi funso lovuta kwambiri, chifukwa si aliyense amene amavomereza momwe angadziwireko PCOS.
Akatswiri ambiri amati kuwonjezeka kwa mayendedwe a androjeni si kofunikira kupezeka ndi PCOS. Komabe, a Androgen Excess (AE) ndi PCOS Society amanena kuti mazira osasintha ndi ma polycystic ovaries, popanda mavitamini owonjezera, sali okwanira kuti adziwe ngati ali ndi kachilombo ka PCOS.
Komabe, pali zinthu zina zomwe muyenera kukumbukira. Chimodzi, njira zambiri zomwe zimagwiritsidwa ntchito pa PCOS-zowonongeka za Rotterdam-zikuwonetsa kuti kaya zamoyo zam'thupi kapena zizindikiro za hyperandrogenism ziyenerera.
M'mawu ena, mwachitsanzo, tiyeni tinene kuti muli ndi nkhope kapena chifuwa. Ichi ndi chizindikiro cha chithandizo cha hyperandrogenism. Simukufunikiranso kukhala ndi mabala apamwamba kuti mukhale ndi khalidwe la PCOS. Chachiwiri, komanso motsatira ndondomeko ya Rotterdam, simusowa kuti mukhale ndi androgens okwera kuti mupezepo ndi PCOS.
Ngati muli ndi nthawi zosawerengeka (kapena zosaoneka) ndi ma polyvarioustic ovaries, ndipo palibe tsatanetsatane yowonjezera ya nthawi yanu yosasinthasintha, mukhoza kupeza kachilombo ka PCOS ngakhale mulibe mapepala ovomerezeka kapena zizindikiro zina za hyperandrogenism.
Matenda Ena ndi Machitidwe a Androgens Okwanira Akazi
PCOS ikudziŵika pang'ono kuti ikuwonongedwa. Dokotala wanu asananene kuti muli ndi PCOS, ayenera kutsimikizira kuti zizindikiro zanu sizingathe kufotokozedwa ndi matenda ena . Mwachindunji, pankhani ya androgens, pali zifukwa ziwiri zomwe zimayambitsa hyperandrogenism zomwe dokotala wanu akufuna kuyang'ana: congenital adrenal hyperplasia ndi matenda a Cushing .
Congenital adrenal hyperplasia (CAH) ndi matenda omwe anabadwa nawo omwe amachititsa kuti zisamaliro zosavomerezeka zisagwire ntchito. Amuna ndi akazi omwe ali ndi CAH akusowa chithandizo choyambitsa mavitamini omwe amachititsa kuti asapangidwe ndi kupanga mahomoni ena. Imodzi mwa mahomoni omwe angathe kuthandizidwa ndi androgens.
Anthu ambiri obadwa ndi CAH amapezeka kuti ali aang'ono, koma pali kusiyana kwakukulu kwa matendawa ndipo sizimapereka zizindikiro zoonekera mpaka m'tsogolo mwa moyo. Izi nthawi zina zimadziwika kuti CAH yam'mbuyo kapena CAH yosakhala yachikale. Zizindikiro za CAH zomwe si zachilendo zingakhale zofanana ndi PCOS. Dokotala wanu asanayambe kukudziwani kuti muli ndi PCOS, CAH yosakhala yachikale iyenera kulamulidwa poyamba.
Matenda a Cushing ndi matenda ena omwe angapangitse zizindikiro zofanana ndi PCOS. Matenda a Cushing amapezeka pamene thupi likuwonekera ku cortisol kwa nthawi yaitali. Izi zikhoza kuchitika chifukwa cha nthawi yaitali yogwiritsira ntchito oral steroid, kapena ikhoza kuchitika ngati thupi palokha limapanga cortisol yochuluka.
Pamene thupi lenileni limayambitsa matenda a Cushing, ikhoza kuyambitsa chifuwa chosakhala ndi khansa pamtenda wamatenda kapena adrenal gland. Kukula kumeneku kungabweretse mahomoni ambiri a orrogen , adrenocorticotropic hormone (ACTH) .
Mankhwalawa amatha kulakwa chifukwa cha PCOS. Ichi ndi chifukwa chake matenda a Cushing ayenera kutayika poyamba.
Zovuta Zina Zachipatala Zimayambitsidwa ndi Androgens Wapamwamba
Mavuto a androgen angapangitse nthawi zosawerengeka, zizindikiro zochititsa manyazi (monga kukula kwa tsitsi la nkhope), ndi kusabereka kwa amayi. Koma amakhalanso ndi zina mwazifukwa zina zomwe zimaphatikizapo PCOS.
Kugawa kwa mafuta : Zikuoneka kuti androgens zimathandiza kuti mafuta asungidwe m'thupi. Kodi munayamba mwazindikirapo kuti amuna amakonda kunyamula mafuta makamaka m'mimba mwawo, ndipo akazi amanyamula mafuta m'matako ndi ntchafu? Mitundu ya androgens yowonjezereka ingapangitse akazi kuti azitenga mafuta ambiri m'mimba mwawo.
Kunenepa kwambiri ndi vuto la PCOS. Izi zanenedwa, ndi kotheka kwa amayi oonda kapena olemerera kuti akhale ndi PCOS .
Insulin kukana : Insulin kukana ndi chinthu choopsa cha PCOS. Zomwe zimakhala zovuta kwambiri. Zapezeka kuti amayi omwe ali ndi mavitanidomu apamwamba amakhala ndi chiopsezo chachikulu choteteza insulini.
Kodi miyezo ya azitrogeni yapamwamba imayambitsa matenda a insulini? Izi siziri zomveka bwino panobe. Komabe, kafukufuku wina wasonyeza kuti kuchepetsa kuchuluka kwa testosterone mwa amayi kumathandiza kuchepetsa / kuchepetsa kuthamanga kwa insulini.
Mavuto a m'mtima : Kukhala ndi mitu yapamwamba kapena yochepa ya androgens kumakhala ndi chiopsezo chowonjezeka m'mabvuto a mtima mwa amayi .
Mawu Ochokera
Hyperandrogenism ndi chifukwa cha zizindikiro zina zochititsa manyazi ndi zooneka za PCOS . Mwinamwake simunadziwe kuti chifuwa chanu kapena tsitsi la nkhope likutheka zizindikiro za matenda odwala. Onetsetsani kuti dokotala wanu adziwe ngati mwakhala mukukumana ndi mavuto ngati awa. Zomwezi zingathandize kuthandizira.
PCOS ilibe mankhwala, koma pali mankhwala omwe alipo kuti athe kuchepetsa zizindikiro zanu. Zina mwa mankhwalawa ndi zodzikongoletsera ndipo zimapezeka pa tsambali, monga mavitamini a mavitamini ndi njira zothandizira tsitsi. Koma adokotala akhoza kupereka mankhwala kapena mankhwala kuti athandizenso.
Nthawi zina, mapiritsi oletsa kubereka angathandize kuchepetsa zizindikiro zanu. Palinso mankhwala omwe angachepetse mayendedwe a testosterone, omwe angathandize ndi ziphuphu, tsitsi, ndi tsitsi losafunikira. Lankhulani ndi dokotala wanu za zomwe mungasankhe.
> Zotsatira:
> Alpañés, Macarena; Fernández-Durán, Elena; Escobar-Morreale, Héctor F. Androgens ndi Polycystic Ovary Syndrome. https://www.medscape.org/viewarticle/754292
> Armenia E1, Lambrinoudaki I2. "Androgens ndi matenda a mtima mwa amayi ndi abambo. "Maturitas. 2017 Oct; 104: 54-72. lembani: 10.1016 / j.maturitas.2017.07.010. Epub 2017 Jul 29.
> Karrer-Voegeli S1, Rey F, Reymond MJ, Meuwly JY, Gaillard RC, Gomez F. "Androgen amadalira hirsutism, acne, ndi alopecia mwa amayi: retrospective kusanthula kwa 228 odwala omwe amafufuza za hyperandrogenism. "Medicine (Baltimore). 2009 Jan; 88 (1): 32-45. lembani: 10.1097 / md.0b013e3181946a2c.
> Simon, James. Androgen. HealthyWomen.org. http://www.healthywomen.org/condition/androgen