I-Hirsutism yisifo esithinta abesifazane kuphela, esibonakala ngokwanda koboya bentshebe, isiqu… umthombo wokuhlupheka okuvame kakhulu ngokwengqondo kwabesifazane abathintekile.

Incazelo ye-hirsutism

Lokhu ukuthuthukiswa okwedlulele kokukhula kwezinwele ezindaweni zesilisa (intshebe, i-torso, i-back, njll.) kusukela ebusheni noma ngokuzumayo kumuntu wesifazane omdala.

I-Hirsutism noma izinwele ezinde ngokweqile?

Sihlukanisa i-hirsutism ekukhuleni kwezinwele ezijwayelekile (izingalo, imilenze, njll.) okubizwa ngokuthi i-hypertrichosis. Ngakho-ke izinwele ezivela ku-hypertrichosis zithinta kuphela izindawo ezijwayelekile kwabesifazane, kodwa izinwele zinde, ziminyene futhi zikhulu kunokuvamile. 

Ngokungafani ne-hirsutism, le hyperpilosity ngokuvamile isivele ikhona ebuntwaneni futhi ithinta bobabili ubulili. I-Hypertrichosis ivamise ukuvela emndenini futhi ijwayelekile endaweni yaseMedithera nakumabala ansundu. Ngakho-ke ukwelashwa ngama-hormone akusebenzi futhi ukukhishwa kwezinwele nge-laser kuvame ukunikezwa.

I-Hirsutism iwukubonakaliswa komphumela wamahomoni wesilisa emzimbeni wesifazane. Kunezinhlobo ezintathu eziyinhloko zamahomoni ezingaba nomthelela ekukhuleni kwezinwele ezindaweni zabesilisa kwabesifazane:

Amahomoni wesilisa avela ku-ovary (testosterone ne-Delta 4 Androstenedione):

Ukwanda kwabo kungase kube ukubonakaliswa kwesimila sesibeletho esikhipha la mahomoni wesilisa noma kaningi ama-microcysts kuma-ovari akhipha la mahomoni (i-micropolycystic ovary syndrome). Uma kwenzeka ukuphakama kwe-serum testosterone noma i-Delta 4-androstenedione amazinga, udokotela ubeka i-ultrasound ye-endovaginal ukuze abheke lezi zifo ezimbili (ama-ovari amancane noma i-ovarian tumor).

Amahomoni wesilisa avela ku-adrenal gland

Lena i-SDHA ye-De Hydroepi Androsterone Sulfate ekhiqizwe yisimila se-adrenal futhi kaningi kuba yi-adrenal hyperandrogenism esebenzayo ngokunyuka okusesilinganisweni kokukhishwa kwe-17 hydroxyprogesterone (17-OHP) bese kudinga ukuhlolwa kokukhuthazwa nge-Synacthène® ukuze kuqinisekiswe ukuxilongwa. Okungavamile kakhulu, ngoba ihlolwe ngokuhlelekile ekuzalweni ngesampula yegazi kusukela esithendeni ngosuku lwe-3rd yokuphila ngokulinganisa izinga le-17 hydroxyprogesterone (17-OHP) egazini, i-anomaly ingaba yokuzalwa: yizenzo zokuzalwa. i-adrenal hyperplasia ngokuntuleka kwe-21-hydroxylase exhunywe ekuguqulweni kofuzo lwayo ku-chromosome 6.

I-Cortisol

Ukwanda kwe-cortisol egazini (Cushing's syndrome) kungase kubangelwe ukusetshenziswa isikhathi eside kwe-corticosteroids, i-adrenal tumor ekhiqiza i-cortisol, noma isimila esikhipha i-ACTH (ihomoni ekhiqiza i-cortisol endlala ye-adrenal).

Izimbangela zesimila zivame ukuqala ngokuzumayo kowesifazane osekhulile, kuyilapho i-hirsutism ekhona ebusheni ngokuvamile ibangelwa ukusebenza kahle kwe-ovarian noma i-adrenal hyperandrogenism.

Ngemithamo evamile yama-hormone kanye ne-ultrasound ye-ovarian evamile, kubizwa ngokuthi i-idiopathic hirsutism.

Ngakho-ke, ekusebenzeni, lapho kukhona i-hirsutism, udokotela ucela umthamo wegazi we-testosterone, i-Delta 4-androstenedione, i-SDHA ne-17-hydroxyprogesterone (nokuhlolwa kwe-Synacthène® uma iphakeme ngokusesilinganisweni), i-cortisoluria uma kwenzeka kusolwa uCushing. kanye ne-ovarian ultrasound.

Imithamo kufanele icelwe ngaphandle kokuthatha i-cortisone, ngaphandle kokuvimbela inzalo ngamahomoni izinyanga ezintathu. Kufanele zenziwe ekuseni ngehora lesi-8 ekuseni nangolunye lwezinsuku eziyisithupha zokuqala zomjikelezo (akufanele zicelwe phakathi neminyaka emithathu yokuqala yenkathi yobusha njengoba zingabalulekile).

Izinwele eziqinile ebusweni, isifuba, emuva… kwabesifazane.

Udokotela ubheka ezinye izimpawu ezihlobene ne-hyperandrogenism (ukwanda kwamahomoni wesilisa): i-hyperseborrhea, induna, i-androgenetic alopecia noma impandla, ukuphazamiseka kokuya esikhathini… noma i-virilization (i-clitoral hypertrophy, izwi elijulile nelihoshozelayo). Lezi zimpawu ziphakamisa ukukhuphuka kwamazinga e-hormone egazini ngakho-ke aziphikisani ne-idiopathic hirsutism.

Ukuqala kwalezi zimpawu kungazelelwe kukhomba isimila kuyilapho ukufakwa kwazo kancane kancane kusukela ebusheni kuvumela kakhulu ukusebenza kwe-ovarian noma i-adrenal hyperandrogenism, noma ngisho ne-idiopathic hirsutism uma ukuhlolwa kujwayelekile.

Izici zengozi

Izici eziyingozi ze-hirsutism kwabesifazane zihlanganisa:

• ukuthatha i-cortisone izinyanga ezimbalwa (i-Cushing's syndrome)
• ukukhuluphala ngokweqile: kungabonisa inkinga ye-cortisol noma kube yingxenye ye-polycystic ovary syndrome. Kodwa futhi siyazi ukuthi amafutha anomkhuba wokukhuthaza ukuguqulwa kwamahomoni wesilisa.
• umlando womndeni we-hirsutism

Ukuziphendukela kwemvelo nezinkinga kungenzeka

I-Hirsutism exhunywe nesimila sivezela abantu ezingozini ezihlobene nesimila ngokwaso, ikakhulukazi uma siyingozi (ingozi yama-metastases, njll.)

I-Hirsutism, kungakhathaliseki ukuthi i-tumor noma iyasebenza, ngaphezu kokuphazamiseka kwayo kobuhle, imvamisa iba yinkimbinkimbi yizinduna, i-folliculitis, impandla kwabesifazane ...

Ukwelashwa kwe-hirsutism kusekelwe ekwelapheni imbangela kanye nenhlanganisela yokuthatha ama-anti-androgens kanye namasu okususwa kwezinwele noma ama-depilation.

Ukwelashwa kwesizathu

Ukususwa kwesimila esibelethweni noma se-adrenal, isimila esikhiqiza i-ACTH (ngokuvamile esitholakala emaphashini)… uma kudingeka.

Inhlanganisela ye-depilation noma i-depilation technique kanye ne-anti-androgen

Ukususwa kwezinwele noma amasu okukhipha izinwele kufanele kuhlanganiswe nokwelashwa kwamahomoni okulwa ne-androgen ukuze kukhawulwe ingozi yokukhula kabusha kwezinwele ezimahhadla.

Ukususwa kwezinwele nokususwa kwezinwele

Amasu amaningi angasetshenziswa njengokwenza izinwele zibe mhlophe, ukushefa, okhilimu abasusa umzimba, ukugcoba noma ukususwa kwezinwele ngogesi ehhovisi likadokotela wesikhumba okubuhlungu futhi kuyisicefe.

Kukhona ukhilimu osuselwe ku-eflornithine, i-molecule ye-antiparasitic, esetshenziswa endaweni, inqanda i-ornithine decarboxylase, i-enzyme ehilelekile ekukhiqizeni izinwele nge-follicle yezinwele. Lena iVaniqa® esetshenziswa kabili ngosuku, enciphisa ukukhula kwezinwele.

Ukususwa kwezinwele ze-Laser kuboniswa ezimweni ze-hirsutism ebanzi. Ihlanganiswe nokwelashwa kwe-anti-androgen ukuvimbela ukuphindaphinda.

Ama-Anti androgens

Igama elithi anti-androgen lisho ukuthi i-molecule ivimbela ukubopha kwe-testosterone (ukuba ne-5-dihydrotestosterone enembile) kumamukeli wayo. Njengoba i-testosterone ingasakwazi ukufinyelela kuma-receptors ayo ezinweleni, ngeke isaba nomphumela ovuselelayo.

Kunezinhlobo ezimbili ezisetshenziswayo namuhla:

• I-cyproterone acetate (i-Androcur®) ibuyiselwa eFrance ngenkomba ye-hirsutism. Ngaphezu komsebenzi wayo wokuvimba i-anti-androgen receptor, iphinde ibe nomthelela we-antigonadotropic (yehlisa ukukhiqizwa kwama-androgens ngokunciphisa ukugqugquzelwa kwe-pituitary) kanye nokuvinjwa kwe-5-dihydrotestosterone / receptor complex ezingeni le-androgen ebopha amaprotheni. .

I-progestogen okufanele ihlanganiswe ne-estrogen ukulingisa umjikelezo wemvelo wamahomoni wabesifazane: udokotela uvame ukunikeza ithebhulethi ye-Androcur® 50 mg / ngosuku ehlanganiswe ne-estrogen yemvelo kuthebhulethi, ijeli noma isichibi, izinsuku ezingamashumi amabili. kwabangamashumi amabili nesishiyagalombili.

Ukuthuthukiswa kwe-hirsutism kubonakala kuphela ngemva kwezinyanga ezingaba ngu-6 zokwelashwa.

• I-spironolactone (i-Aldactone®), i-diuretic, inganikezwa ngaphandle kwelebula. Ngaphandle kwe-anti-androgenic receptor blocking effect yayo, ivimbela ukuhlanganiswa kwe-testosterone. Udokotela unquma amaphilisi amabili ngosuku 50 noma 75 mg ukuze kuzuzwe umthamo nsuku zonke 100 ukuze 150 mg / ngosuku, inhlanganisela, izinsuku eziyishumi nanhlanu ngenyanga, nge progestogen non-androgenic ukugwema ukuphazamiseka umjikelezo. Njenge-cyproterone acetate, umphumela uqala ukubonwa kuphela ngemva kwezinyanga ezingu-6 zokwelashwa, ngezinye izikhathi unyaka.