Hirsutism chirwere chinobata vakadzi chete, chinoratidzwa nekuwedzera kwebvudzi rendebvu, torso ... chinokonzeresa kutambura kwakanyanya kwepfungwa kune vakadzi vakabatwa.

Tsanangudzo yehirsutism

Uku ndiko kukura kwekukura kwebvudzi munzvimbo dzevarume (ndebvu, torso, musana, nezvimwewo) kubva pakuyaruka kana kamwe kamwe mumukadzi mukuru.

Hirsutism kana kuwandisa bvudzi?

Tinosiyanisa hirsutism kubva pakuwedzera kwekukura kwebvudzi (maoko, makumbo, nezvimwewo) inonzi hypertrichosis. Bvudzi rinobva ku hypertrichosis saka rinongobata nzvimbo dzakajairwa muvakadzi, asi vhudzi rakareba, rakakura uye rakakora kupfuura nguva dzose. 

Kusiyana nehirsutism, iyi hyperpilosity kazhinji inenge iripo muhudiki uye inobata vese varume. Hypertrichosis inowanzo zivikanwa mumhuri uye inowanzoitika kunharaunda yeMediterranean basin uye mubrown. Hormonal kurapwa saka haishande uye laser kubvisa bvudzi kunowanzo kupihwa.

Hirsutism iratidziro yemhedzisiro yemahomoni echirume pamunhukadzi. Kune matatu makuru marudzi emahomoni anogona kukanganisa kukura kwebvudzi munzvimbo dzevarume muvakadzi:

Mahomoni echirume kubva muovary (testosterone uye Delta 4 Androstenedione):

Kuwedzera kwavo kunogona kunge kuri kuratidzwa kwebundu reovarian rinoburitsa aya mahomoni echirume kana kuti kazhinji kacho mamicrocysts pamaovha anoburitsa mahormone aya (micropolycystic ovary syndrome). Muchiitiko chekukwirira mu serum testosterone kana Delta 4-androstenedione mazinga, chiremba anorayira endovaginal ultrasound kutsvaga idzi pathologies (micropolycystic ovaries kana ovarian tumor).

Mahomoni echirume kubva kune adrenal gland

Iyi iSDHA yeDe Hydroepi Androsterone Sulfate yakavanzwa neadrenal bundu uye kazhinji kacho inoshanda adrenal hyperandrogenism nekuwedzera kuri pakati nepakati mu secretion ye17 hydroxyprogesterone (17-OHP) zvichizoda stimulation test neSynacthène® kusimbisa kuongororwa. Kunyanya kashoma, nekuti inoongororwa zvakarongeka pakuzvarwa nesampuli yeropa kubva pachitsitsinho pazuva re3 rehupenyu nekuyera mwero we17 hydroxyprogesterone (17-OHP) muropa, iyo inomaly inogona kuzvarwa: ndeye zviito zvekuzvarwa. adrenal hyperplasia ne 21-hydroxylase kushomeka kwakabatana nekuchinja kwejini rayo pachromosome 6.

Cortisol

Kuwedzera kwecortisol muropa (Cushing's syndrome) kungakonzerwa nekushandisa kwenguva yakareba corticosteroids, an adrenal tumor secreting cortisol, kana bundu rinobudisa ACTH (hormone inobudisa cortisol kubva muadrenal gland).

Zvikonzero zvebundu zvinowanzotanga kamwe kamwe mumukadzi mukuru, nepo hirsutism iripo mukuyaruka kazhinji nekuda kwekushanda kweovarian kana adrenal hyperandrogenism.

Nezvakajairwa mahomoni dosages uye yakajairika ovarian ultrasound, inonzi idiopathic hirsutism.

Mukuita, saka, pamberi pe hirsutism, chiremba anokumbira chiyero cheropa che testosterone, Delta 4-androstenedione, SDHA uye 17-hydroxyprogesterone (ine Synacthène® bvunzo kana yakakwira zvine mwero), cortiluria kana paine anofungidzirwa Cushing. uye ovarian ultrasound.

Mishonga inofanirwa kukumbirwa pasina kutora cortisone, pasina mahormone ekudzivirira kubata pamuviri kwemwedzi mitatu. Dzinofanirwa kuitwa mangwanani kusvika 8 am uye pane rimwe remazuva matanhatu ekutanga ekutenderera (haafanire kukumbirwa mukati memakore matatu ekutanga enguva yevechiri kuyaruka sezvo asina basa).

Mvere dzakaoma kumeso, thorax, musana… muvakadzi.

Chiremba anotarisa zvimwe zviratidzo zvine chekuita nehyperandrogenism (kuwedzera kwehomoni dzechirume): hyperseborrhea, mburwa, androgenetic alopecia kana mhanza, kusagadzikana kwekuenda kumwedzi… kana virilization (clitoral hypertrophy, yakadzika uye yakashoreka inzwi). Izvi zviratidzo zvinokurudzira kuwedzera kwemazinga ehomoni muropa uye saka usapokana uchifarira idiopathic hirsutism.

Kungoerekana kwatanga kwezviratidzo izvi kunongedza bundu apo kuiswa kwavo zvishoma nezvishoma kubva mukuyaruka kunonyanya kufarira kushanda kweovarian kana adrenal hyperandrogenism, kana kunyange idiopathic hirsutism kana bvunzo dzakajairika.

Zvinhu zvinotyisa

Zvinokonzera njodzi zve hirsutism muvakadzi zvinosanganisira:

• kutora cortisone kwemwedzi inoverengeka (Cushing's syndrome)
• kufutisa: inogona kuratidza dambudziko recortisol kana kuve chikamu chepolycystic ovary syndrome. Asi isu tinoziva zvakare kuti mafuta ane tsika yekusimudzira metabolization yehomoni dzechirume.
• nhoroondo yemhuri ye hirsutism

Evhangeri uye zvinetso zvinogoneka

Hirsutism yakabatana nebundu inoisa vanhu munjodzi dzine chekuita nebundu racho pacharo, kunyanya kana rakashata (njodzi yemametastases, nezvimwewo)

Hirsutism, ingave yebundu kana inoshanda, mukuwedzera kune yekusagadzikana kwayo, inowanzoomeswa neacne, folliculitis, mhanza muvakadzi ...

Kurapa kwe hirsutism kunobva pakurapa kwechikonzero uye kusanganiswa kwekutora anti-androgens uye kubvisa bvudzi kana depilation maitiro.

Kurapa kwechikonzero

Kubviswa kwemaovarian kana adrenal tumor, ACTH-secreting bundu (kazhinji inowanikwa mumapapu)… kana zvichidikanwa.

Kusanganiswa kwedepilation kana depilation technique uye anti-androgen

Kubvisa bvudzi kana nzira dzekubvisa dzinofanirwa kusanganiswa ne-anti-androgen hormonal kurapwa kudzikamisa njodzi yekukura kwebvudzi.

Kubvisa bvudzi uye depilation

Nzira dzakawanda dzinogona kushandiswa dzakadai sekuchenesa bvudzi, kuveura, depilatory creams, waxing kana kunyange kubviswa kwebvudzi remagetsi muhofisi yedermatologist izvo zvinorwadza uye zvinonetesa.

Kune kamu cream yakavakirwa pa eflornithine, antiparasitic molecule iyo, inoshandiswa munharaunda, inhibits ornithine decarboxylase, enzyme inobatanidzwa mukugadzirwa kwebvudzi nebvudzi rebvudzi. Iyi iVaniqa® iyo, inoshandiswa kaviri pazuva, inoderedza kukura kwebvudzi.

Kubviswa kwebvudzi reLaser kunoratidzwa mune zviitiko zvehirsutism yakakura. Inosanganiswa ne-anti-androgen therapy kudzivirira kudzokorora.

Anti androgens

Izwi rokuti anti-androgen rinoreva kuti molecule inodzivisa kusungirirwa kwe testosterone (kuti ive chaiyo 5-dihydrotestosterone) kune receptor yayo. Sezvo testosterone isingachakwanisi kuwana ma receptors mubvudzi, haichagoni kuva nemigumisiro inokurudzira.

Kune maviri anoshandiswa mukuita kwezvino:

• cyproterone acetate (Androcur®) inodzorerwa muFrance nokuda kwechiratidzo che hirsutism. Pamusoro peiyo anti-androgen receptor blocking chiitiko, zvakare ine antigonadotropic mhedzisiro (inoderedza kugadzirwa kwe androgens nekudzikisa pituitary stimulation) uye inhibition ye5-dihydrotestosterone / receptor complex pamwero we androgen inosunga protein. .

Iyo progestogen iyo inofanirwa kazhinji kusanganiswa neestrogen kutevedzera echisikigo mahomoni kutenderera kwevakadzi: chiremba anowanzo nyora piritsi reAndrocur® 50 mg / zuva rakasanganiswa neakasikwa estrogen muhwendefa, gel kana chigamba, mazuva makumi maviri. kubva makumi maviri nemasere.

Kuvandudzwa kwehirsutism kunongoonekwa mushure memwedzi mitanhatu yekurapa.

• spironolactone (Aldactone®), diuretic, inogona kupihwa off-label. Kunze kweiyo anti-androgenic receptor blocking effect, inhibits testosterone synthesis. Chiremba anonyora mahwendefa maviri pazuva re50 kana 75 mg kuti awane dhigirii yezuva nezuva ye100 kusvika 150 mg / zuva, pamwe chete, mazuva gumi nemashanu pamwedzi, ine isiri-androgenic progestogen kudzivirira kutenderera kutenderera. Sezvakaita cyproterone acetate, mhedzisiro inotanga kuonekwa chete mushure memwedzi mitanhatu yekurapa, dzimwe nguva gore.