Isizathu esivamile sokubonisana, i-hyperandrogenism ibhekisela ekukhiqizeni ngokweqile kwamahomoni wesilisa kowesifazane. Lokhu kubonakaliswa yizimpawu ezimakwe kakhulu noma ezingaphansi ze-virilization.

Kwabesifazane, ama-ovari kanye nezindlala ze-adrenal ngokwemvelo zikhiqiza i-testosterone, kodwa ngamanani amancane. Ngokuvamile kutholakala phakathi kwama-nanomoles angu-0,3 no-3 ilitha ngalinye legazi, uma kuqhathaniswa ne-8,2 kuya ku-34,6 nmol / L kubantu.

Sikhuluma nge-hyperandrogenism lapho izinga laleli hormone liphakeme kunejwayelekile. Izimpawu ze-virilization zingase zivele: 

• i-hyperpilosis;
• umqubuko;
• impandla;
• i-muscle hypertrophy, njll.

Umthelela awuwona wobuhle kuphela. Kungase futhi kube ngokwengqondo nezenhlalo. Ngaphezu kwalokho, ukukhiqizwa ngokweqile kwe-testosterone kungaholela ekungazali kanye nezinkinga ze-metabolism.

Ingachazwa ngezimbangela ezahlukene, ezivame kakhulu yilezi ezilandelayo.

I-ovarian dystrophy

Lokhu kuholela ku-polycystic ovary syndrome (PCOS). Lokhu kuthinta cishe owesifazane oyedwa kwabayishumi. Iziguli zithola i-pathology yazo ebusheni, lapho zibona inkinga ye-hyperpilosity kanye nezinduna ezinzima, noma kamuva, lapho zibhekene nokungazali. Lokhu kungenxa yokuthi i-testosterone eyeqile ekhiqizwa ama-ovari iphazamisa ukuthuthukiswa kwama-ovarian follicles, angavuthwa ngokwanele ukukhulula amaqanda awo. Lokhu kubonakala ngokuphazamiseka kokujikeleza kokuya esikhathini, noma ngisho nokuntuleka kwezikhathi (i-amenorrhea).

I-Congenital adrenal hyperplasia

Lesi sifo esingavamile sofuzo siholela ekungasebenzini kahle kwezindlala ze-adrenal, okuhlanganisa ukukhiqizwa ngokweqile kwamahomoni wesilisa nokukhiqizwa kancane kwe-cortisol, i-hormone edlala indima enkulu ekusetshenzisweni kwama-carbohydrate, amafutha namaprotheni. Kulokhu, i-hyperandrogenism ihambisana nokukhathala, i-hypoglycemia kanye nokwehla komfutho wegazi. Le pathology ivamise ukuzibonakalisa kusukela ekuzalweni, kodwa kwezinye izimo ezilinganiselayo ingalinda kuze kube yilapho umuntu esemdala ukuze aziveze. 

Isimila ku-adrenal gland

Akuvamile, kungaholela ekukhiqizweni ngokweqile kwamahomoni wesilisa, kodwa futhi ne-cortisol. I-hyperandrogenism ibe ihambisana ne-hypercorticism, noma i-Cushing's syndrome, umthombo we-arterial hypertension.

I-ovarian tumor ekhiqiza amahomoni wesilisa

Lesi sizathu asivamile.

menopause

Njengoba ukukhiqizwa kwamahomoni abesifazane kuncipha kakhulu, amahomoni abesilisa anendawo eyengeziwe yokuziveza. Ngezinye izikhathi lokhu kuholela ekwehliseni ukulawulwa, ngezimpawu ezibalulekile ze-virilization. Ukuhlolwa komtholampilo kuphela okuhlotshaniswa nokuhlolwa kwehomoni, ngomthamo we-androgens, kungaqinisekisa ukuxilongwa. I-ultrasound yama-ovari noma izindlala ze-adrenal nayo ingayalwa ukuze kucaciswe imbangela.

Izimpawu zomtholampilo ze-hyperandrogenism zimi kanje:

• hutsutism : izinwele zibalulekile. Ikakhulukazi, izinwele zivela ezindaweni zomzimba ezivame ukungabi nazinwele kwabesifazane (ubuso, i-torso, isisu, i-low back, izinqe, amathanga angaphakathi), okungaba nomthelela omkhulu ongokwengqondo nezenhlalakahle. ;
• induna et i-seborrhee (isikhumba esinamafutha); 
• i-alopecia impandla yephethini yowesilisa, nokuqothuka kwezinwele eziphawulwe ngaphezulu phezulu ekhanda noma kumaglobhu angaphambili.

Lezi zimpawu zingahlotshaniswa futhi:

• ukuphazamiseka kokuya esikhathini, ngokungabi bikho kwezikhathi (i-amenorrhea), noma imijikelezo emide nengavamile (spaniomenorrhea);
• ukwanda kwe-clitoral (clitoromegaly) kanye nokwanda kwe-libido;
• ezinye izimpawu ze-virilization : izwi lingase libe likhulu futhi imisipha ikhumbule i-morphology yabesilisa.

Uma imakwe kakhulu, i-hyperandrogenism ingaholela kwezinye izinkinga zesikhathi eside:

• izinkinga ze-metabolic : ukukhiqizwa ngokweqile kwamahomoni wesilisa kukhuthaza ukuzuza kwesisindo nokuthuthukiswa kokumelana ne-insulin, ngakho-ke ingozi yokukhuluphala, isifo sikashukela nesifo senhliziyo;
• izinkinga ze-gynecological, kuhlanganise nengozi eyengeziwe yomdlavuza we-endometrial.

Yingakho i-hyperandrogenism akufanele ibhekwe kuphela ngombono wezimonyo. Kungase kudinge usizo lwezokwelapha.

Ukuphatha kuncike kuqala kukho konke imbangela.

Uma kwenzeka kuba nesimila

Kudingeka ukuhlinzwa ukuze uyisuse.

Nge-polycystic ovary syndrome

Akukho ukwelashwa ukuvimbela noma ukwelapha lesi syndrome, kuphela ukwelashwa kwezimpawu zayo.

• Uma isiguli singakwenzi noma izingane eziningi, ukwelashwa kuhlanganisa ukubeka izindlala ezikhiqiza amaqanda ukuze ziphumule, ukwehlisa ukukhiqizwa kwamahomoni wesilisa. Kunqunywe iphilisi le-estrogen-progestin. Uma lokhu kungenele, umuthi we-anti-androgen unganikezwa njengesengezo, i-cyproterone acetate (Androcur®). Kodwa-ke, njengoba lo mkhiqizo usanda kuhlotshaniswa nengozi ye-meningioma, ukusetshenziswa kwawo kukhawulelwe ezimweni ezinzima kakhulu, lapho isilinganiso senzuzo / ingozi enhle;
• Uma kwenzeka isifiso sokukhulelwa nokuzala, ukukhuthazwa okulula kwe-ovulation kunconywa ngomugqa wokuqala we-clomiphene citrate. Ukuhlolwa kokuzala kwenziwa ukuze kuqinisekiswe ukungabikho kwezinye izici ezihilelekile. Uma ukugqugquzelwa kwezidakamizwa kungasebenzi, noma uma ezinye izici zokungazali zitholakala, ukufakwa kwe-intrauterine noma ukukhulelwa kwe-in vitro kucatshangelwa. 

Ukususwa kwezinwele nge-laser kungase futhi kunikelwe ukuze kuncishiswe ukukhula kwezinwele kanye nokwelashwa kwesikhumba kwendawo ngokumelene nezinduna.

Kuzo zonke izimo, umkhuba wezemidlalo kanye nokulandelwa kokudla okulinganiselayo kuyalulekwa. Uma kwenzeka ukhuluphele, ukulahlekelwa cishe kwe-10% yesisindo sokuqala kunciphisa i-hyperandrogenism nazo zonke izinkinga zayo. 

Uma kwenzeka i-adrenal hyperplasia

Uma isifo siwufuzo, kubekwa ukunakekelwa okuqondile ezikhungweni ezingongoti bezifo ezingavamile. Ukwelashwa kuhlanganisa ikakhulukazi i-corticosteroids.