Ukuvuthwa Kwezitho Zobulili Ngaphambi Kwexesha: Izimpawu, Izimbangela, Nokwelashwa

Ukuvuthwa kwezitho zobulili ngaphambi kwexesha kwenzeka lapho umzimba womntwana uqala ukuthuthukisa izici zobulili ngaphambi kwexesha. Kwamantombazane, lokhu kusho ukuthi ukuvuthwa kwezitho zobulili kuqala ngaphambi kweminyaka engu-8, futhi emadodaneni, kuqala ngaphambi kweminyaka engu-9.

Nakuba lokhu kungase kuzwakale kukukhathaza njengomzali, kubalulekile ukwazi ukuthi ukuvuthwa kwezitho zobulili ngaphambi kwexesha kuchaphazela cishe umntwana o-1 ku-5,000 kuya ku-10,000. Imikhakha eminingi iyizinguquko ezingavamile zokuthuthuka, futhi kukhona ukwelashwa okuphumelelayo okukhona uma kudingeka.

Ukuvuthwa kwezitho zobulili ngaphambi kwexesha yini?

Ukuvuthwa kwezitho zobulili ngaphambi kwexesha kwenzeka lapho umzimba womntwana wakho uqala ukushintsha ngokomzimba kokuvuthwa kwezitho zobulili ngaphambi kwesikhathi kunabangane bakhe. Lokhu kwenzeka lapho ubuchopho buthumela umyalo emzimbeni wokuthi uqale ukukhiqiza ama-hormone abantu abadala ngaphambi kwesikhathi.

Kukhona izinhlobo ezimbili eziyinhloko zokuvuthwa kwezitho zobulili ngaphambi kwexesha. Ukuvuthwa kwezitho zobulili ngaphambi kwexesha okuphakathi kwenzeka lapho "iswitshi" yemvelo yokuqala kokuvuthwa kwezitho zobulili ebuchophini ivula ngaphambi kwesikhathi. Ukuvuthwa kwezitho zobulili ngaphambi kwexesha okungaphandle kwenzeka lapho ama-hormone ekhishwa ezinye izindawo emzimbeni, njenge-ovari, amathethwe, noma ama-glands e-adrenal.

Isikhathi sibalulekile ngoba ukuvuthwa kwezitho zobulili ngaphambi kwexesha kungase kuchaphazele ukuphakama komuntu omdala, ukuthuthuka komzwelo, kanye namava omphakathi. Noma kunjalo, abantwana abaningi abane-precocious puberty bakhula babe ngabantu abadala abaphilile, abavamile.

Ziyini izimpawu zokuvuthwa kwezitho zobulili ngaphambi kwexesha?

Izimpawu zokuvuthwa kwezitho zobulili ngaphambi kwexesha zifana nokuvuthwa kwezitho zobulili okuvamile, kuphela kwenzeka ngaphambi kwexesha.

Emadodaneni, izimpawu zokuqala zivame ukufaka:

• Ukuqala kokukhula kwamabele (ngokuvamile yisibonakaliso sokuqala)
• Ukuqala kokukhula okusheshayo okwenza baphakeme kunabangane babo
• Ukukhula kwezinwele zomzimba endaweni yasebulili nasezandleni
• Ukunuka komzimba nokukhuluphala kokukhuluphala
• I-Acne noma ukushintsha kwesikhumba
• Isikhathi (ngokuvamile kwenzeka eminyakeni engu-1-2 ngemuva kokuthi ukuqala kokukhula kwamabele kuqale)
• Ukushintsha komoya noma ukuba nomzwelo olukhulu

Emadodaneni, ungase ubone:

• Ukuqala kokukhula kwamabele (ngokuvamile yisibonakaliso sokuqala)
• Ukuqala kokukhula okusheshayo okwenza baphakeme kunabangane babo
• Ukukhula kwezinwele zomzimba endaweni yasebulili nasezandleni
• Ukunuka komzimba nokukhuluphala kokukhuluphala
• I-Acne noma ukushintsha kwesikhumba
• Isikhathi (ngokuvamile kwenzeka eminyakeni engu-1-2 ngemuva kokuthi ukuqala kokukhula kwamabele kuqale)
• Ukushintsha komoya noma ukuba nomzwelo olukhulu

Abanye abantwana bangase babe nezicubu, izinkinga zokubona, noma ukwanda okungavamile kwesisindo. Lezi zimpawu azivamile kodwa kufanele ziqaphelwe ngudokotela ngokushesha.

Yini ebangela ukuvuthwa kwezitho zobulili ngaphambi kwexesha?

Imbangela yokuvuthwa kwezitho zobulili ngaphambi kwexesha ixhomeke kuhlobo lomntwana wakho alinawo. Ukuqonda imbangela esekelwe kuyo kusiza ekutholeni indlela yokwelapha engcono kakhulu.

Ukuvuthwa kwezitho zobulili ngaphambi kwexesha okuphakathi, okuvamile kakhulu, ngokuvamile akunambangela ebonakalayo. Lokhu kubizwa ngokuthi i-idiopathic precocious puberty, futhi kusho nje ukuthi iwashi langaphakathi lomntwana wakho lihamba ngokushesha kunokujwayelekile. Lokhu kwenzeka cishe ku-90% yamantombazane no-60% yamadodana ane-early puberty.

Kodwa-ke, ukuvuthwa kwezitho zobulili ngaphambi kwexesha okuphakathi ngezinye izikhathi kungase kubangelwe yi:

• Iziphumuzo zobuchopho (nakuba lokhu kuyinselele)
• Ukulimala kwekhanda noma ukulimala
• Ukutheleleka kobuchopho njenge-meningitis
• Ukwelashwa ngomgogodla ngaphambili ekhanda
• Isimo se-genetic esichaphazela ukuthuthuka kobuchopho

Ukuvuthwa kwezitho zobulili ngaphambi kwexesha okungaphandle kwenzeka lapho okuthile ngaphandle kobuchopho kuqalisa ukukhiqizwa kwama-hormone. Lokhu kungafaka:

• I-ovarian cysts noma iziphumuzo emadodeni
• Iziphumuzo ze-testicular emadodaneni
• Izifo ze-adrenal gland
• Izinkinga ze-thyroid
• Ukuvezwa kwama-hormone angaphandle nge-creams noma imithi

Kubalulekile ukuqaphela ukuthi izici zesitayela sokuphila njengokukhuluphala ngezinye izikhathi zingase zinikeze ukuvuthwa kwezitho zobulili ngaphambi kwexesha, ikakhulukazi emadodeni. Ubuhlobo obuqondile abuluqondwa ngokugcwele, kodwa ukugcina isisindo esinempilo kungasiza.

Kufanele ubona nini udokotela ngokuvuthwa kwezitho zobulili ngaphambi kwexesha?

Kufanele uhlele i-aphoyintimenti nodokotela womntwana wakho uma ubona noma yiziphi izimpawu zokuvuthwa kwezitho zobulili ngaphambi kweminyaka engu-8 emadodeni noma iminyaka engu-9 emadodaneni. Ukuhlolwa ngokushesha kungasiza ekuqondeni ukuthi ukwelashwa kuyadingeka yini.

Funani ukunakekelwa kwezokwelapha ngokushesha uma umntwana wakho ehlushwa yi:

• Izinhlungu zikhanda ezinzima noma ukushintsha kokubona
• Ukuqala okusheshayo kwezimpawu eziningi zokuvuthwa kwezitho zobulili phakathi namasonto ambalwa
• Ukushintsha okukhulu kokuziphatha noma ukushintsha komoya
• Ukukhuluphala okungavamile noma ukulahlekelwa isisindo
• Izimpawu zokuvuthwa kwezitho zobulili ngaphambi kweminyaka engu-6 emadodeni noma iminyaka engu-7 emadodaneni

Khumbula ukuthi ukuthola ukuvuthwa kwezitho zobulili ngaphambi kwexesha ngokushesha kuvame ukuletha imiphumela emihle. Udokotela womntwana wakho angasiza ekuqondeni ukuthi ukudluliselwa kudokotela we-endocrinology yabantwana kuyadingeka yini.

Ziyini izici ezingase zikhulise ingozi yokuvuthwa kwezitho zobulili ngaphambi kwexesha?

Izici eziningi zingase zikhulise amathuba okuba nokuvuthwa kwezitho zobulili ngaphambi kwexesha, nakuba ukuba nezici ezingase zikhulise ingozi akusho ukuthi umntwana wakho uzokuthola ngokuqinisekile lesi simo.

Ubulili udlala indima, njengoba amantombazane anezikhathi ezingaba ngu-10 ezingaphezulu zokuthola ukuvuthwa kwezitho zobulili ngaphambi kwexesha kunamadodana. Uma ama-boys ethola, anezikhathi eziningi zokuba nombangela wezokwelapha osekwe kuwo.

Ezinye izici ezingase zikhulise ingozi zifaka:

• Umlando womndeni wokuvuthwa kwezitho zobulili ngaphambi kwexesha
• Ukuba ngumkhulu noma ukukhuluphala
• Uhlanga nobuzwe (kuvamile kakhulu kubantwana base-Afrika baseMelika nabase-Hispanic)
• Ukulimala kwekhanda ngaphambili noma ukuhlinzwa kobuchopho
• Ukuvezwa ekwelapheni ngomgogodla
• Isimo se-genetic
• Izici zemvelo njengokucindezeleka noma ukuvezwa ezinto eziyingozi

Kubalulekile ukuqonda ukuthi abantwana abaningi abanamazinga okukhuluphala abakutholi ukuvuthwa kwezitho zobulili ngaphambi kwexesha. Lezi zimpawu nje kuphela ezitholwe ucwaningo njengokuthi zikhulise amathuba.

Ziyini izinselele ezingase zenzeke ngenxa yokuvuthwa kwezitho zobulili ngaphambi kwexesha?

Nakuba ukuvuthwa kwezitho zobulili ngaphambi kwexesha akuyona into eyingozi, kungase kube nezinkinga ezithinta inhlala-kahle yomntwana wakho nokuthuthuka kwakhe.

Inselele enkulu yomzimba ukunciphisa ukuphakama komuntu omdala. Abantwana abane-precocious puberty bavame ukuba nokuqala kokukhula okusheshayo, okwenza baphakeme kunabangane babo. Noma kunjalo, ama-growth plates abo avala ngokushesha, okungase kuholele ekufinyeka kokuphakama njengabantu abadala.

Izinselele zomzwelo nomphakathi zingafaka:

• Ukuzizwa behlukile kunabangane nokukhethwa komphakathi
• Ukuba nomoya obungaphansi kokuthuthuka komzimba
• Ukungathuthuki komoya noma ukukhathazeka
• Izithakazelo zothando noma zobulili ngaphambi kwesikhathi
• Ukukhathazeka ngomzimba
• Ubunzima bemisebenzi efanele iminyaka nobungane

Abanye abantwana bangase bahlushwe yi:

• Izinselele zasemfundweni ngenxa yocindezeleko lomzwelo
• Ukungathuthuki komoya noma ukukhathazeka
• Izinkinga zokuzethemba
• Ukuqalwa kobulili ngaphambi kwesikhathi ngabanye

Izindaba ezinhle ukuthi ngokusekelwa okufanele nokwelashwa uma kudingeka, abantwana abaningi bazivumelanisa kahle futhi baqhubeka bephila impilo evamile, enempilo.

Ukuvuthwa kwezitho zobulili ngaphambi kwexesha kunqunywa kanjani?

Ukunqunywa kokuvuthwa kwezitho zobulili ngaphambi kwexesha kuhilela izinyathelo eziningi zokunquma uhlobo nombangela osekwe kuwo. Udokotela wakho uzoqala ngomlando wezokwelapha ophelele nokuhlolwa komzimba.

Ukuhlolwa kokuqala kuhlanganisa ukulinganisa ukuphakama, isisindo, kanye nesilinganiso sokuthuthuka komntwana wakho ngokuhamba kwesikhathi. Udokotela wakho uzobuye ahlole isigaba sokuthuthuka komzimba usebenzisa izikali ezimisiwe ebizwa nge-Tanner stages.

Izivivinyo zegazi ngokuvamile ziyalelwa ukuze zilinganise:

• Amazinga e-hormone afaka i-LH, i-FSH, nama-hormone ebulili
• Umsebenzi we-thyroid
• Amazinga e-hormone yokukhula
• Ezinye ama-hormone angase ahileleke

Ezinye izivivinyo zingafaka:

• I-X-ray yobudala babhelu ukuze ubone ukuthi ukuthuthuka kwamathambo kuqhubeka kanjani
• I-MRI yobuchopho ukuze uhlole iziphumuzo noma ezinye izinto ezingavamile
• I-ultrasound ye-pelvis emadodeni noma amathethwe emadodaneni
• I-GnRH stimulation test ukuze unqume uhlobo lokuvuthwa kwezitho zobulili ngaphambi kwexesha

Inqubo yokuxilonga iyasiza udokotela wakho ukuqonda ukuthi ukwelashwa kuyadingeka yini nokuthi yiluphi uhlobo oluzoba oluphumelelayo kakhulu esimweni esithile somntwana wakho.

Ukuphathwa kokuvuthwa kwezitho zobulili ngaphambi kwexesha yini?

Ukuphathwa kokuvuthwa kwezitho zobulili ngaphambi kwexesha kuyahlukahluka ngohlobo, imbangela, nokuthi kuchaphazela kanjani umntwana wakho. Akuwona wonke abantwana abane-precocious puberty abadinga ukwelashwa kwezokwelapha.

Ngokuvuthwa kwezitho zobulili ngaphambi kwexesha okuphakathi, ukwelashwa okuyinhloko yi-GnRH agonist therapy. Le mithi isebenza ngokuvimba okwesikhashana imiyalezo yobuchopho eyaqalisa ukuvuthwa kwezitho zobulili, okwenza ukuvuthwa kwezitho zobulili kuyeke kuze kube yisikhathi esifanele.

I-GnRH agonists inganikwa njenge:

• Izinjoloba zenyanga zonke
• Izinjoloba zenyanga zonke
• Izinjoloba zenyanga zonke
• I-sprays yempumulo yansuku zonke (ayisetshenziswanga ngokuvamile)

Ngokuvuthwa kwezitho zobulili ngaphambi kwexesha okungaphandle, ukwelashwa kugxile ekunqobeni imbangela esekelwe kuyo. Lokhu kungafaka:

• Ukususa i-ovarian noma i-testicular cysts noma ama-masses
• Ukuphatha izifo ze-thyroid
• Ukuphatha izinkinga ze-adrenal gland
• Ukuyeka ukuvezwa kwama-hormone angaphandle

Udokotela wakho uzolandelela umntwana wakho eduze ngesikhathi sokwelashwa, ahlole ukuthuthuka, amazinga e-hormone, kanye nokuthuthuka okujwayelekile njalo ngenyanga engu-3-6. Abantwana abaningi bayaphendula kahle ekwelapheni futhi bangase baqhubeke nokuvuthwa kwezitho zobulili okujwayelekile uma imithi iyeke.

Unganikeza kanjani ukwesekwa ekhaya ngesikhathi sokuvuthwa kwezitho zobulili ngaphambi kwexesha?

Ukusekela umntwana wakho ngesikhathi sokuvuthwa kwezitho zobulili ngaphambi kwexesha kuhilela ukunakekelwa okuqondile nokusekelwa komzwelo. Indima yakho njengomzali ibalulekile ekusizeni ukuthi aqonde lesi sikhathi esinzima.

Qala ngokuba nezingxoxo ezifanele iminyaka ngokuthi kwenzekani emzimbeni wakhe. Sebenzisa ulimi oluqondile, oluqondile futhi umqinisekise ukuthi uphilile futhi uvamile, kuphela ukuthuthuka ngaphambi kwabangane bakhe.

Ukusekelwa okuqondile kuhlanganisa:

• Ukubonelela ngezingubo ezifanele nezingubo zangaphansi zomzimba wakhe oqhubekayo
• Ukufundisa imikhuba yokuhlanzeka efanele efaka ukusetshenziswa kwe-deodorant
• Ukusiza ukuphatha noma yikuphi ukushintsha kwesikhumba ngezindlela zokuhlanza ezimnene
• Ukuqinisekisa ukuthi uthola ukulala okwanele nokudla
• Ukugcina i-aphoyintimenti yokwelashwa njalo

Amasu okusekela komzwelo afaka:

• Ukuqinisekisa imizwa kanye nezinkinga zabo
• Ukuxhumanisa nabo ngokwelashwa uma kudingeka
• Ukuxhumana nothisha ngezidingo zabo
• Ukukhuthaza ubungane nemisebenzi efanele iminyaka
• Ukubavikela ecindezweni lomphakathi ngaphambi kwesikhathi

Khumbula ukuthi umntwana wakho useneminyaka yakhe yomzwelo, ngisho noma umzimba wakhe ushintsha. Qhubeka umaphathe njengomntwana onjalo ngenkathi uqaphela ukuthuthuka kwakhe komzimba.

Kufanele ulungiselele kanjani i-aphoyintimenti yakho nodokotela?

Ukulungiselela i-aphoyintimenti yakho kungasiza ekuqinisekiseni ukuthi uthola ukuxilongwa okuchane kakhulu kanye nenqubo yokunakekelwa efanele yomntwana wakho.

Ngaphambi kokuya, butha ulwazi olubalulekile olufaka amarekhodi okuthuthuka komntwana wakho okuvela ekuvakasheni kwangaphambili kudokotela. Qaphela isikhathi kanye nokuhleleka kwanoma yikuphi ukushintsha komzimba oyibonile, kufaka phakathi lapho kuqale ukubonakala khona.

Letha uhlu lwe:

• Yonke imithi kanye nezinye izinto umntwana wakho azithathayo
• Umlando womndeni wokuvuthwa kwezitho zobulili ngaphambi kwexesha noma kamuva
• Noma yikuphi ukulimala kwekhanda ngaphambili noma izimo zezokwelapha
• Izinkinga noma imibuzo ethile onayo
• Izithombe ezibonisa ukuthuthuka kokukhula komntwana wakho uma kuwusizo

Lungiselela umntwana wakho i-aphoyintimenti ngokuchaza ukuthi udokotela udinga ukuhlola ukuthuthuka kwakhe. Mqinisekise ukuthi lokhu kuyinto evamile futhi akukho lutho olufanele luhlabe ikhanda.

Ngesikhathi sokuvakasha, ungangabazi ukubuza imibuzo mayelana nokuxilongwa, izinketho zokwelapha, imiphumela emibi, kanye nombono wesikhathi eside. Ukuqonda isimo somntwana wakho kusiza ukuba unikeze ukusekela okungcono ekhaya.

Iyini into ebalulekile mayelana nokuvuthwa kwezitho zobulili ngaphambi kwexesha?

Ukuvuthwa kwezitho zobulili ngaphambi kwexesha kungase kuzwakale kukukhathaza uma uqala ukubona izimpawu, kodwa kubalulekile ukukhumbula ukuthi abantwana abaningi abalesi simo benza kahle kakhulu ngokunakekelwa okufanele nokusekelwa.

Ukunqunywa ngokushesha nokwelashwa uma kudingeka kungasiza ekuvikeleni ukuphakama komuntu omdala womntwana wakho nokusekela inhlala-kahle yabo yomzwelo. Imikhakha eminingi ayidingi ukwelashwa kwezokwelapha, futhi lezo ezidingayo zivame ukuphendula kahle emithi ekhona.

Umntwana wakho usengumuntu omangalisayo njengoba ehlale enjalo, kuphela ukuthuthuka komzimba ngaphambi kwexesha. Ngothando lwakho, ukusekela, kanye nokukhathalelwa kwezokwelapha okufanele uma kudingeka, bangase baqonde le ndlela ngempumelelo futhi baqhubeke bephila impilo evamile, enempilo.

Imibuzo evamile ebuzwa mayelana nokuvuthwa kwezitho zobulili ngaphambi kwexesha

Ingabe umntwana wami uzoba mfushane njengomuntu omdala ngenxa yokuvuthwa kwezitho zobulili ngaphambi kwexesha?

Ngaphandle kokwelashwa, abantwana abane-precocious puberty bangase baphele ngokuba mfushane kunokuthuthuka kwabo kwe-genetic ngoba ama-growth plates abo avala ngokushesha. Noma kunjalo, ngokwelashwa okufanele usebenzisa i-GnRH agonists, abantwana abaningi bangase bafinyelele ukuphakama kwabo komuntu omdala okulindelekile. Udokotela wakho uzolandelela ukuthuthuka ngokucophelela futhi alungise ukwelashwa uma kudingeka.

Ukwelashwa kokuvuthwa kwezitho zobulili ngaphambi kwexesha kuhlala isikhathi esingakanani?

Isikhathi sokwelashwa sihlukahluka kuye ngesimo somntwana wakho, kodwa ngokuvamile sihlala iminyaka engu-2-4. Abantwana abaningi baqala ukwelashwa cishe eminyakeni engu-6-8 futhi baqhubeka kuze kube yilapho befika eminyakeni efanele yokubuyela ekuvuthweni kwezitho zobulili, ngokuvamile cishe eminyakeni engu-10-11 emadodeni neminyaka engu-11-12 emadodaneni. Udokotela wakho uzonquma isikhathi esifanele esekwe ekuthuthukeni komntwana wakho.

Ingabe kukhona imiphumela emibi yemithi yokuvuthwa kwezitho zobulili ngaphambi kwexesha?

Imithi ye-GnRH agonist ngokuvamile iyanakekelwa kahle ngemiphumela emibi emincane. Abanye abantwana bangase babe nezinkinga zesikhashana zendawo yokunjoloba, ukushisa, noma ukushintsha komoya lapho beqala ukwelashwa. Lokhu ngokuvamile kuyaqeda njengoba umzimba uziqhelanisa nemithi. Udokotela wakho uzolandelela noma yimiphi imiphumela emibi futhi alungise ukwelashwa uma kudingeka.

Ingabe ukuvuthwa kwezitho zobulili ngaphambi kwexesha kungavinjelwa?

Imikhakha eminingi yokuvuthwa kwezitho zobulili ngaphambi kwexesha ayikwazi ukunqatshelwa ngoba ivela ekuhlukahlukenini kwemvelo ekuthuthukeni noma izici ze-genetic. Noma kunjalo, ukugcina isisindo esinempilo ngokudla okuhle nokuzivocavoca njalo kungasiza ekuqedeni ingozi. Ukuqeda ukuvezwa kwama-hormone angaphandle nokuqinisekisa ukunakekelwa kwezokwelapha okufanele kungase kube usizo.

Ingabe umntwana wami uzobe ekwazi ukuba nabantwana ngokujwayelekile esikhathini esizayo?

Yebo, ukuvuthwa kwezitho zobulili ngaphambi kwexesha ngokuvamile akukuthinti ukukhulelwa kwesikhathi esizayo. Abantwana abathinteka ekuvuthweni kwezitho zobulili ngaphambi kwexesha ngokuvamile bathuthukisa umsebenzi wokuzala ovamile futhi bangaba nabantwana uma bekhetha njengabantu abadala. Imithi yokwelapha ibuyisela futhi ayibangeli imiphumela ehlala njalo ekuzalaneni. Impilo yokuzala yomntwana wakho kufanele iqhubeke ngokujwayelekile uma ukwelashwa sekuqedile.