Hypogonadotropic hypogonadism

Hypogonadism waa xaalad ragga baaritaanka ragga ama ugxansidaha haweenku soo saaraan wax yar ama aan lahayn hormoonno galmo.

Hypogonadotropic hypogonadism (HH) waa nooc ka mid ah hypogonadism taas oo ay ugu wacan tahay dhibaatada qanjirka 'pituitary gland' ama 'hypothalamus'.

HH waxaa sababa hormoon la'aan caadi ahaan kicisa ugxanta ama xiniinyaha. Hormoonadan waxaa ka mid ah hormoonka sii deynaya gonadotropin (GnRH), hormoonka kiciya follicle (FSH) iyo hormoonka luteinizing (LH).

Caadi ahaan:

• Hypothalamus-ka maskaxda ayaa sii deynaya GnRH.
• Hormoonkani wuxuu kiciyaa qanjirka 'pituitary gland' si uu u sii daayo FSH iyo LH.
• Hormoonnadan ayaa u sheegaya ugxan-sideyaasha dumarka ama tijaabooyinka ragga inay sii daayaan hormoonno u horseeda koritaanka galmada caadiga ah ee qaan-gaarnimada, wareegyada caadada ee caadiga ah, heerarka estrogen iyo bacriminta haweenka qaan-gaarka ah, iyo soo-saarka testosterone caadiga ah iyo soo-saarka shahwada ragga waaweyn.
• Isbeddel kasta oo ku yimaada silsiladdan sii deynta hormoonkan ayaa sababa la'aanta hormoonnada galmada. Tani waxay ka hortageysaa bisaylka galmada ee caadiga ah ee carruurta iyo shaqada caadiga ah ee xiniinyaha ama ugxan sidaha dadka waaweyn.

Waxaa jira sababo dhowr ah oo keena HH:

• Waxyeellada qanjirka 'pituitary gland' ama 'hypothalamus' ee qalliinka, dhaawaca, burooyinka, infekshinka, ama shucaaca
• Cilladaha hidaha
• Qiyaaso badan ama isticmaalka muddada-dheer ee daawooyinka opioid ama steroid (glucocorticoid)
• Heerka prolactin sare (hormoon uu sii daayo pituitary)
• Cadaadis daran
• Dhibaatooyinka nafaqada (labadaba miisaan degdeg ah ama miisaan lumis labadaba)
• Cudurrada caafimaad ee muddada-dheer (daba-dheeraada), oo ay ku jiraan caabuq joogto ah ama infekshanno
• Isticmaalka daroogada, sida hirowiin ama isticmaalka ama ku xadgudubka daawooyinka opiate
• Xaaladaha caafimaad qaarkood, sida xad dhaafka birta

Cudurka 'Kallmann Syndrome' waa nooc laga dhaxlo HH. Dadka qaar ee qaba xaaladan sidoo kale waxay qabaan anosmia (luminta dareenka urta).

Carruurta:

• Horumar la'aanta xilliga qaan-gaarnimada (horumarka ayaa laga yaabaa inuu soo daaho ama aan dhameystirnayn)
  
• Gabdhaha, koritaan la'aanta naasaha iyo caadada caadada
• Wiilasha, majiro wax horumar ah oo ku saabsan astaamaha galmada, sida balaarinta xiniinyaha iyo guska, qoto dheerida codka, iyo timaha wajiga
• Awood la'aanta urta (xaaladaha qaarkood)
• Dherer gaaban (xaaladaha qaarkood)

Dadka waaweyn:

• Danta xiisaha galmada (libido) ee ragga
• Luminta caadada caadada (amenorrhea) ee haweenka
• Tamarta oo yaraatay iyo xiisaha howlaha
• Lumida muruqyada ragga
• Miisaanka oo kordha
• Isbedelada niyadda
• Madhalaysnimo
  

Bixiyaha xanaanada caafimaadka ayaa sameyn doona baaritaan jireed wuxuuna weydiin doonaa astaamahaaga.

Tijaabooyinka la qaadi karo waxaa ka mid ah:

• Tijaabooyinka dhiigga si loo cabbiro heerarka hoormoonka sida FSH, LH, iyo TSH, prolactin, testosterone iyo estradiol
• Jawaabta LH ee GnRH
• MRI ee qanjirka 'pituitary gland / hypothalamus' (si loo raadiyo buro ama koritaan kale)
• Tijaabada hidaha
• Baadhitaanada dhiigga si loo hubiyo heerka birta

Daaweyntu waxay kuxirantahay halka dhibaatada ka timaado, laakiin waxay ku lug yeelan kartaa:

• Cirbadaha testosterone (ragga)
• Baro maqaarka testosterone tartiib-tartiib ah (ragga)
• Jeermiska testosterone (ragga)
• Kiniiniyada Estrogen iyo progesterone ama maqaarka maqaarka (dheddigga)
• Cirbadaha GnRH
• Cirbadaha HCG
  

Daaweynta hoormoonka saxda ah waxay sababi doontaa qaangaadhnimada inay ka bilaabato carruurta waxayna soo celin kartaa bacriminta dadka waaweyn. Haddii xaaladdu bilaabato ka dib qaan-gaadhnimada ama qaan-gaarnimada, calaamadaha ayaa badanaa ku fiicnaanaya daaweynta.

Dhibaatooyinka caafimaad ee ka imaan kara HH waxaa ka mid ah:

• Qaangaarnimada oo daahday
• Caaddo-dayska hore (dheddigga)
• Madhalaysnimo
• Cufnaanta hoose ee lafaha iyo jabka nolosha dambe
• Is-kalsooni-darro hooseysa oo ku timaadda bilowga qaan-gaarnimada (taageerada shucuureed ayaa ku caawin karta)
• Dhibaatooyinka galmada, sida libido yar

Wac adeeg bixiyahaaga haddii:

• Ilmahaagu ma bilaabayo qaangaadhnimada waqtiga ku habboon.
• Waxaad tahay qof dumar ah oo ka yar da'da 40 oo wareeggaaga caadada ayaa joogsanaya.
• Waxaad lumisay kilkilaha kilkilaha ama maqaarka.
• Waxaad tahay nin oo waxaad yaraatay xiisihii galmada.

Yaraanshaha Gonadotropin; Hypogonadism-ka labaad

• Qanjirada 'Endocrine'
• Qanjirka 'pituitary gland'
• Gonadotropins

Bhasin S, Brito JP, Cunningham GR, iyo al. Tijaabinta testosterone ee ragga qaba hypogonadism: tilmaamaha ku-takhasuska daaweynta bulshada ee Endocrine Society. J Clin Endocrinol Metab. 2018; 103 (5): 1715-1744. PMID: 29562364 www.ncbi.nlm.nih.gov/pubmed/29562364.

Styne DM, Grumbach MM. Jirka iyo cilladaha qaan-gaarnimada. Gudaha: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, eds. Williams Buugga Buugga Endocrinology. 13aad. Philadelphia, PA: Elsevier; 2016: cutubka 25.

PC-ga cad. Horumarka galmada iyo aqoonsiga. Gudaha: Goldman L, Schafer AI, eds. Daawada Goldman-Cecil. 26aad. Philadelphia, PA: Elsevier; 2020: cutubka 220.