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sostitutiva?</a></li> <li class="sal-leaf-indice-item"><a href="#616703" title="Quando ricorrere alla TOS?">Quando ricorrere alla TOS?</a></li> <li class="sal-leaf-indice-item"><a href="#616704" title="Tipi di TOS">Tipi di TOS</a></li> <li class="sal-leaf-indice-item"><a href="#616705" title="TOS e ormoni femminili">TOS e ormoni femminili</a></li> <li class="sal-leaf-indice-item"><a href="#616706" title="TOS e ormoni maschili">TOS e ormoni maschili</a></li> <li class="sal-leaf-indice-item"><a href="#616707" title="TOS e patologie tiroidee">TOS e patologie tiroidee</a></li> <li class="sal-leaf-indice-item"><a href="#616708" title="TOS e ormone della crescita">TOS e ormone della crescita</a></li> </ol> <div class="sal-list-separator"></div> </div> <div id="toc-hook"> <section class="sal-widget-section sal-mBottom5x"> <a id="616702"></a> <h2 class="sal-mBottom2x sal-widget-title sal-section-heading toc-content-title"> Cos'è la terapia ormonale sostitutiva? </h2> <p>La terapia ormonale sostitutiva (o <strong>TOS</strong>) è una terapia farmacologica basata sulla somministrazione di ormoni.</p> <p>Generalmente, quando si parla di terapia ormonale sostitutiva (in inglese, Hormon Replacement Therapy o HRT), si pensa immediatamente al trattamento farmacologico cui si sottopongono alcune pazienti in età <a href="/salute/menopausa.html" title="Menopausa: Significato Biologico, Sintomi, Approfondimenti">post-menopausale</a>, allo scopo di contrastare sintomi e disturbi associati all'inevitabile diminuzione della sintesi di ormoni femminili.</p> <p>In verità, il significato di terapia ormonale sostitutiva è molto più ampio, poiché questa dicitura raggruppa tutte quelle terapie farmacologiche che si basano sulla somministrazione di ormoni diversi.</p> </section> <div class="sal-adv-slot amePlaceholderBox sal-honcode sal-mBottom5x sal-hide-desktop"><div class="sal-adv-gpt" id="adv-gpt-box-mobile-container1"></div></div> <section class="sal-widget-section sal-mBottom5x"> <a id="616703"></a> <h2 class="sal-mBottom2x sal-widget-title sal-section-heading toc-content-title"> Quando ricorrere alla TOS? </h2> <p>Il ricorso alla terapia ormonale sostitutiva si rende necessario quando un paziente, per un qualsiasi motivo - patologico o fisiologico - si trova in una condizione in cui determinati ormoni non vengono prodotti nelle giuste quantità, comportando l'insorgenza di disturbi e malattie.</p> <p>In verità, il ricorso alla terapia ormonale sostitutiva non sempre è necessario o indispensabile per il paziente, a meno che la mancanza degli ormoni non infici negativamente sulla qualità della vita dello stesso paziente e/o non costituisca un reale pericolo per la sua salute.</p> <p>Ad ogni modo, fra le patologie e i disturbi che possono richiedere la somministrazione di una terapia ormonale sostitutiva, ricordiamo:</p> <ul> <li>Patologie in cui si assiste ad una ridotta sintesi di <a href="/fisiologia/ormoni.html" title="Ormoni">ormoni sessuali</a> maschili o femminili;</li> <li>Sintomi post-menopausali e prevenzione di patologie che possono manifestarsi in seguito al calo della <a href="/fisiologia/sistema-endocrino.html" title="Sistema endocrino">produzione degli ormoni</a> sessuali femminili (ad esempio, l'<a href="/osteoporosi.htm" title="Osteoporosi">osteoporosi</a>);</li> <li>Disturbi e malattie che diminuiscono la <a href="/fisiologia/tiroide.html" title="Tiroide">funzionalità della tiroide</a> in maniera permanente (come avviene, ad esempio, nell'<a href="/salute/ipotiroidismo.html" title="Ipotiroidismo">ipotiroidismo</a> di Hashimoto), o in maniera temporanea;</li> <li>Rimozione chirurgica - parziale o totale - della toroide (<a href="/salute-benessere/tiroidectomia.html" title="Tiroidectomia">tiroidectomia</a>) a causa di tumori (<a href="/salute/tumore-tiroide.html" title="Tumore della tiroide">tumore della tiroide</a>) o altre malattie.</li> <li>Malattie caratterizzate da un'insufficiente o mancata produzione di ormone della crescita.</li> </ul> <p>Infine, la terapia ormonale sostitutiva può essere effettuata anche in caso di cambio di sesso, allo scopo di somministrare al paziente gli ormoni associati al sesso con cui esso si identifica (<a href="/fisiologia/ormoni/testosterone.html" title="Testosterone: cosa fa, cosa provoca la carenza e come aumentarlo">testosterone</a> per le donne che desiderano diventare uomini ed <a href="/fisiologia/ormoni/estrogeni.html" title="Estrogeni: cosa sono, funzioni e perché sono importanti">estrogeni</a> per gli uomini che desiderano diventare donne).</p> </section> <section class="sal-widget-section sal-mBottom5x"> <a id="616704"></a> <h2 class="sal-mBottom2x sal-widget-title sal-section-heading toc-content-title"> Tipi di TOS </h2> <p>Alla luce di quanto finora detto, perciò, si può affermare che esistono diversi tipi di terapia ormonale sostitutiva che possiamo così riassumere:</p> <ul> <li><strong>Terapia ormonale sostitutiva estrogenica e progestinica</strong> (ovvero a base di ormoni sessuali femminili); appartiene a questo gruppo anche la terapia ormonale sostitutiva post-menopausale;</li> <li><strong>Terapia ormonale sostitutiva androgenica</strong> (ossia, a base di ormoni sessuali maschili);</li> <li><strong>Terapia ormonale sostitutiva a base di <a href="/fisiologia/ormoni/ormoni-tiroidei.html" title="Ormoni Tiroidei: Funzioni e Ruolo Biologico, Triiodotironina (T3) e Tiroxina (T4)">ormoni tiroidei</a></strong>;</li> <li><strong>Terapia ormonale sostitutiva a base di ormone della crescita</strong>.</li> </ul> <p>Di seguito, tali tipologie di terapia ormonale sostitutiva verranno brevemente descritte.</p> </section> <div id="advertorialTarget1" class="advt-output"></div> <section class="sal-widget-section sal-mBottom5x"> <a id="616705"></a> <h2 class="sal-mBottom2x sal-widget-title sal-section-heading toc-content-title"> TOS e ormoni femminili </h2> <h3 class="sal-section-subheading sal-mBottom2x">Terapia ormonale sostitutiva estrogenica e progestinica</h3> <p>La terapia ormonale sostitutiva a base di ormoni femminili (estrogeni e progestinici) viene effettuata in caso di ridotta sintesi di questi stessi ormoni, per prevenire o contrastare sintomi e disturbi che si possono manifestare a causa di una simile carenza.</p> <p>Fra le principali indicazioni della terapia ormonale sostitutiva con ormoni femminili, ricordiamo:</p> <ul> <li><strong><a href="/salute-benessere/ipogonadismo.html" title="Ipogonadismo">Ipogonadismo</a> femminile</strong> (condizione associata ad una riduzione dell'attività ovarica) e altre malattie che causano una ridotta produzione di ormoni femminili;</li> <li><strong>Sintomi post-menopausali</strong> e <strong><a href="/alimentazione/prevenzione-osteoporosi.html" title="Come Prevenire l'Osteoporosi?">prevenzione dell'osteoporosi</a></strong> in menopausa;</li> <li><strong>Cambio di sesso</strong>.</li> </ul> <p>Aldilà del quadro sintomatologico delle patologie e dei disturbi sopra citati (ipogonadismo, malattie che causano una diminuita produzione di ormoni femminili e <a href="/salute/menopausa-sintomi.html" title="Sintomi della Menopausa">sintomi della menopausa</a>), la mancanza o la ridotta sintesi di ormoni femminili in una donna può causare: assenza di <a href="/salute/mestruazioni.html" title="Mestruazioni">mestruazioni</a>, <a href="/caduta_capelli.htm" title="Caduta dei Capelli">perdita di capelli</a>, ridotto sviluppo del <a href="/salute/seno.html" title="Seno: Com’è Fatto e Funzioni delle Mammelle">seno</a>, <a href="/Sintomi/Calo-del-desiderio-sessuale" title="Calo del desiderio sessuale">diminuzione della libido</a>, <a href="/salute/vampate-menopausa.html" title="Vampate di Calore in Menopausa">vampate</a> di calore e <a href="/benessere/galattorrea.html" title="Galattorrea">galattorrea</a>.</p> <p>La terapia ormonale sostitutiva a base di ormoni femminili può prevedere la <a href="/farmacologia/vie-di-somministrazione-1.html" title="Vie di somministrazione di un farmaco">somministrazione di farmaci</a> estrogenici, progestinici o una combinazione di queste due tipologie di principi attivi.</p> <p>La somministrazione dei suddetti principi attivi può avvenire sostanzialmente per <a href="/farmacologia/somministrazione-orale-3.html" title="Via di somministrazione orale, per os">via orale</a> (compresse), per via transcutanea o per via <a href="/fisiologia/vagina.html" title="Vagina">vaginale</a> (<a href="/dispositivi-medici/prodotti-per-il-sollievo-dei-piedi-dai-cerotti-per-calli-ai-separa-dita-ecco-i-migliori.html" title="Prodotti per il sollievo dei piedi: dai cerotti ai separa dita">cerotti</a> transdermici, gel, <a href="/benessere/creme-vaginali.html" title="Creme Vaginali: Cosa sono, A Cosa Servono, Come si Usano">creme vaginali</a>, ecc.).</p> <p>La scelta di intraprendere una terapia ormonale sostitutiva a base di uno o più dei suddetti ormoni femminili spetta al medico e dipende sostanzialmente dal tipo di disturbo, patologia o sintomo che si vuole trattare.</p> <h3 class="sal-section-subheading sal-mBottom2x">Terapia ormonale sostitutiva post-menopausale</h3> <p>La terapia ormonale sostitutiva post-menopausale è, con molta probabilità, la forma di TOS maggiormente conosciuta. Questo tipo di trattamento viene effettuato al fine di sopperire alla ridotta sintesi di ormoni femminili che si manifesta nel periodo seguente la menopausa.</p> <p>Più nel dettaglio, la terapia ormonale sostitutiva viene effettuata in fase post-menopausale per contrastare l'insorgenza delle <strong>vampate di calore </strong>che possono influenzare negativamente la qualità della vita della paziente. Allo stesso tempo, la TOS in menopausa può essere sfruttata per <strong>prevenire l'insorgenza di osteoporosi</strong> in pazienti idonee e ad elevato rischio di sviluppare questa malattia.</p> <p>La terapia ormonale sostitutiva post-menopausale può essere effettuata somministrando un solo <a href="/farmacognosia/3farmacognosia-salute1.html" title="Principio attivo e fitocomplesso">principio attivo</a> di natura estrogenica, oppure utilizzando in associazione un principio attivo di natura estrogenica ed uno di natura progestinica. Fra i principi attivi che si possono impiegare in quest'ambito, ricordiamo l'<a href="/fisiologia/ormoni/estradiolo.html" title="Estradiolo">estradiolo</a> (estrogeno) e il <a href="/benessere/noretisterone.html" title="Noretisterone">noretisterone</a> (progestinico).</p> <p>A questo proposito, ricordiamo che la terapia ormonale sostitutiva a base di estrogeni e progestinici può essere:</p> <ul> <li><strong>Combinata</strong>: quando i principi attivi di natura estrogenica e progestinica vengono somministrati quotidianamente insieme;</li> <li><strong>Sequenziale</strong>: quando i principi attivi estrogenici vengono somministrati nei primi giorni del ciclo di terapia ed i principi attivi progestinici vengono somministrati gli ultimi 10-12 giorni del ciclo terapeutico.</li> </ul> <h3 class="sal-section-subheading sal-mBottom2x">Effetti collaterali della TOS a base di ormoni sessuali femminili</h3> <p>Gli effetti collaterali indotti dalla terapia ormonale sostitutiva a base di ormoni femminili possono essere molteplici, fra questi ne ricordiamo alcuni fra i più comuni:</p> <ul> <li><a href="/salute-benessere/mal-di-testa.html" title="Mal di Testa: Cause, Sintomi e Classificazione">Mal di testa</a>;</li> <li><a href="/farmacologia/cura-dolore-63.html" title="Dolore: da cosa dipende il dolore?">Dolore</a> e/o tensione del seno;</li> <li><a href="/candida.html" title="Candida">Candidiasi</a> vaginale;</li> <li><a href="/Sintomi/Nervosismo" title="Nervosismo">Nervosismo</a> e agitazione;</li> <li><a href="/salute/sintomi-depressione.html" title="Depressione: cos'è, sintomi, cause. Come curarla?">Depressione</a>;</li> <li>Malessere generalizzato;</li> <li>Debolezza;</li> <li>Aumento del <a href="/bellezza/peso-ideale.html" title="Peso ideale">peso corporeo</a>.</li> </ul> <div class="sal-widget-text-editorial sal-outer sal-mBottom2x"> <h3>Nota Bene</h3> <p>La terapia ormonale sostitutiva a base di soli estrogeni può aumentare il rischio d'insorgenza di <a href="/salute/tumore-endometrio.html"><strong>tumore dell'endometrio</strong></a>; mentre la terapia ormonale sostitutiva a base di estrogeni e progestinici può aumentare il rischio d'insorgenza di <strong><a href="/salute/tumore-seno.html" title="Tumore al Seno: Sintomi, Cura e Sopravvivenza">tumore al seno</a></strong>.</p> <p>La relazione fra <a href="/salute/terapia-ormonale-sostitutiva-cancro.html">terapia ormonale sostitutiva e cancro</a> è ancora oggi un argomento largamente dibattuto. Per maggiori informazioni, si consiglia la lettura dell'articolo dedicato.</p> </div> </section> <section class="sal-widget-section sal-mBottom5x"> <a id="616706"></a> <h2 class="sal-mBottom2x sal-widget-title sal-section-heading toc-content-title"> TOS e ormoni maschili </h2> <h3 class="sal-section-subheading sal-mBottom2x">Terapia ormonale sostitutiva androgenica</h3> <p>La terapia ormonale sostitutiva a base di <a href="/fisiologia/androgeni.html" title="Androgeni">ormoni maschili</a> viene effettuata soprattutto in caso di <strong><a href="/salute-benessere/ipogonadismo-maschile.html" title="Ipogonadismo Maschile">ipogonadismo maschile</a></strong>, per prevenire o contrastare l'<strong><a href="/salute/andropausa.html" title="Andropausa">andropausa</a></strong>, per ristabilire il normale livello di androgeni negli uomini che hanno <strong>perso la normale funzionalità <a href="/fisiologia/testicoli.html" title="Testicoli: come sono fatti e come funzionano">testicolare</a></strong> (ad esempio, a causa di malattie come il <a href="/salute-benessere/tumore-dei-testicoli.html" title="Tumore ai Testicoli">tumore dei testicoli</a>) e in caso di <strong>cambio di sesso</strong>.</p> <p>Così come gli ormoni sessuali femminili sono di fondamentale importanza nelle donne; gli androgeni svolgono funzioni molto importanti nell'organismo maschile.</p> <p>A questo proposito, fra i sintomi che possono manifestarsi in caso di carenza di androgeni nell'uomo, ricordiamo: debolezza, <a href="/salute/disfunzione-erettile.html" title="Disfunzione Erettile">disfunzione erettile</a>, <a href="/Sintomi/Atrofia_muscolare" title="Atrofia muscolare">atrofia muscolare</a>, <a href="/salute/ansia.html" title="Ansia: Cos'è, Cause, Sintomi e Disturbi Ansiosi">ansia</a>, depressione, riduzione della <a href="/fisiologia/massa-ossea.html" title="Massa ossea, picco di massa ossea">densità ossea</a> e aumento della <a href="/massa-grassa.html" title="Massa Grassa: Cos’è e Come Calcolare il Grasso Corporeo?">massa grassa</a>.</p> <p>I principi attivi maggiormente impiegati nell'ambito della terapia ormonale sostitutiva androgenica sono il <strong>testosterone</strong> e i suoi derivati. La somministrazione di tali principi attivi può avvenire per via orale, per <a href="/farmacologia/vie-di-somministrazione-parenterali-6.html" title="Vie di somministrazione parenterali">via parenterale</a> o <a href="/farmacologia/via-transcutanea-11.html" title="Via di somministrazione transcutanea">per via transdermica</a> (<a href="/integratori/capsula.html" title="Capsule">capsule</a>, soluzione iniettabile per <a href="/farmacologia/somministrazione-intramuscolare-7.html" title="Via di somministrazione intramuscolare">via intramuscolare</a>, gel e <a href="https://www.my-personaltrainer.it/benessere/cerotti-antinfiammatori.html">cerotti transdermici</a>).</p> <h3 class="sal-section-subheading sal-mBottom2x">Effetti collaterali della TOS a base di ormoni sessuali maschili</h3> <p>Fra i principali effetti collaterali che si possono manifestare in caso di terapia ormonale sostitutiva a base di androgeni, ricordiamo:</p> <ul> <li>Alterazione dell'<a href="/salute/emocromo.html" title="Emocromo">emocromo</a>;</li> <li>Alterazioni dell'umore;</li> <li><a href="/ginecomastia.htm" title="Ginecomastia">Ginecomastia</a>;</li> <li><a href="/ipertensione/ipertensione.html" title="Ipertensione o Pressione Alta: cause, sintomi e come abbassarla">Ipertensione</a>;</li> <li><a href="/salute/iperplasia-prostatica-benigna.html" title="Iperplasia Prostatica Benigna">Iperplasia prostatica benigna</a>.</li> </ul> <p>Infine, è doveroso ricordare che con la terapia ormonale sostitutiva a base di testosterone o suoi derivati può aumentare il rischio d'insorgenza di<strong> <a href="/salute-benessere/tumore-alla-prostata.html" title="Tumore alla Prostata: Cause, Fattori di Rischio e Sintomi">tumore alla prostata</a></strong>. Per tale ragione, è necessario effettuare regolari controlli ed analisi, in particolare, quando la TOS viene effettuata per contrastare l'andropausa.</p> </section> <section class="sal-widget-section sal-mBottom5x"> <a id="616707"></a> <h2 class="sal-mBottom2x sal-widget-title sal-section-heading toc-content-title"> TOS e patologie tiroidee </h2> <h3 class="sal-section-subheading sal-mBottom2x">Terapia ormonale sostitutiva con ormoni tiroidei</h3> <p>Il ricorso alla terapia ormonale sostitutiva con ormoni tiroidei si rende necessario in caso di <strong>ridotta o cessata funzionalità della tiroide</strong>.</p> <p>Gli ormoni prodotti dalla tiroide, infatti, sono coinvolti in numerose funzioni biologiche fondamentali per l'organismo, quali, ad esempio, lo sviluppo cerebrale e <a href="/fisiologia/muscolo-scheletrico.html" title="Il muscolo scheletrico">scheletrico</a> nel <a href="/salute/sviluppo-feto.html" title="Sviluppo dell'Embrione e del Feto">feto</a>, l'<a href="/salute/crescita-bambino.html" title="Crescita del Bambino">accrescimento corporeo</a> nei bambini, la regolazione del <a href="/fisiologia/metabolismo-glucidi.html" title="Metabolismo dei glucidi">metabolismo glucidico</a> e della <a href="/biologia/la-sintesi-proteica.html" title="In che cosa consiste la sintesi proteica?">sintesi proteica</a> e la regolazione dei processi di <a href="/acidigrassi.htm" title="Beta ossidazione e biosintesi degli acidi grassi">lipolisi</a> e di <a href="/fisiologia/lipogenesi.html" title="Lipogenesi, sintesi degli acidi grassi">lipogenesi</a>.</p> <p>Una ridotta produzione - e, nei casi più severi, la totale mancanza - degli ormoni tiroidei, può causare una serie di sintomi e complicazioni anche gravi, quali: <a href="/dieta/dieta-ingrassare.html" title="Dieta per ingrassare: come gestirla e cosa mangiare">aumento del peso corporeo</a>, <a href="/bellezza/pelle-secca.html" title="Pelle Secca">cute secca</a> e <a href="/salute/tiroide-capelli.html" title="Tiroide e capelli">capelli fragili</a>, <a href="/benessere/spossatezza.html" title="Stanchezza e Spossatezza: Cosa Sono, Cause, Rimedi">stanchezza</a> e <a href="/salute/debolezza-muscolare.html" title="Debolezza Muscolare: Cause e Rimedi">debolezza muscolare</a>, <a href="/allenamento/frequenza-cardiaca/frequenza-cardiaca.html" title="Frequenza Cardiaca">frequenza cardiaca</a> bassa, <a href="/salute/gozzo-tiroideo.html" title="Gozzo">gozzo</a>, infertilità e <a href="/salute/mixedema.html" title="Mixedema">mixedema</a>.</p> <p>Fra gli ormoni che si possono impiegare nella terapia ormonale sostitutiva per sopperire alla carenza dei suddetti ormoni, ricordiamo la <strong><a href="/farmaci/eutirox.html" title="EUTIROX ® Levotiroxina">levotiroxina sodica</a></strong> e la <strong><a href="/farmaci/titre.html" title="TITRE ® Liotironina sodica">liotironina sodica</a></strong>. L'assunzione di questi principi attivi va a compensare, rispettivamente, la mancanza di tiroxina (o <a href="/salute/T4-tiroxina.html" title="Tiroxina nel Sangue - T4 Totale, T4 Libero">T4</a>) e di <a href="/fisiologia/ormoni/ormoni-tiroidei2.html" title="Azioni degli ormoni tiroidei: tiroxina e triiodotironina">triiodotironina</a> (<a href="/salute/T3-triiodotironina.html" title="Triiodotironina nel Sangue - T3 Totale, T3 Libero">T3</a>). La terapia ormonale sostitutiva può essere effettuata sia utilizzando i sopra citati principi attivi in monoterapia, sia utilizzandoli in associazione.</p> <p>La scelta di intraprendere un determinato tipo di terapia ormonale sostitutiva con ormoni tiroidei piuttosto di un altro (monoterapia con <a href="/benessere/levotiroxina.html" title="Levotiroxina: Cos'è, A Cosa Serve, Effetti Collaterali">levotiroxina</a> sodica, monoterapia con liotironina sodica o terapia in associazione) spetta al <a href="/salute/discipline-mediche-endocrinologo.html" title="Endocrinologo, Gastroenterologo, Ortopedico e Pediatra">medico endocrinologo</a> e dipende da svariati fattori, come il tipo di malattia che affligge il paziente e la sua gravità.</p> <p>Ad ogni modo, la terapia ormonale sostitutiva con ormoni tiroidei viene somministrata per via orale (compresse, soluzione orale, capsule molli e gocce orali).</p> <h3 class="sal-section-subheading sal-mBottom2x">Effetti collaterali della TOS a base di ormoni tiroidei</h3> <p>Nonostante la terapia ormonale sostitutiva venga effettuata allo scopo di ripristinare i normali livelli di ormoni tiroidei, essa può dare origine a diversi effetti collaterali, come del resto qualsiasi altro tipo di trattamento farmacologico.</p> <p>Fra gli effetti indesiderati che potrebbero manifestarsi durante la terapia ormonale sostitutiva con ormoni tiroidei, ricordiamo:</p> <ul> <li>Mal di testa;</li> <li>Agitazione e <a href="/salute/insonnia.html" title="Insonnia: cos'è, sintomi, cause e cure">insonnia</a>;</li> <li><a href="/salute-benessere/vertigini.html" title="Vertigini">Vertigini</a>;</li> <li><a href="/cardiopalmo.html" title="Cardiopalmo (Palpitazioni): Significato Clinico, Cause e Cosa Fare">Palpitazioni</a> e <a href="/salute/tachicardia.html" title="Tachicardia">tachicardia</a>;</li> <li>Alterazioni del <a href="/salute/ciclo-mestruale.html" title="Ciclo Mestruale">ciclo mestruale</a>;</li> <li><a href="/salute/iperidrosi.html" title="Iperidrosi">Iperidrosi</a>;</li> <li><a href="/Sintomi/Perdita-di-peso" title="Perdita di peso">Perdita di peso</a>.</li> </ul> </section> <section class="sal-widget-section sal-mBottom5x"> <a id="616708"></a> <h2 class="sal-mBottom2x sal-widget-title sal-section-heading toc-content-title"> TOS e ormone della crescita </h2> <h3 class="sal-section-subheading sal-mBottom2x">Terapia ormonale sostitutiva a base di ormone della crescita</h3> <p>Un'altra tipologia di terapia ormonale sostitutiva è quella basata sulla somministrazione di ormone della crescita. Tale ormone è importante tanto nei bambini quanto negli adulti; difatti, una sua carenza può causare un ridotto accrescimento strutturale nei primi e <a href="/Sintomi/Difficoltagrave-di-concentrazione" title="Difficoltà di concentrazione">difficoltà di concentrazione</a>, diminuzione dell'<a href="/nutrizione/calorie-cibi.html" title="Calorie dei cibi">energia</a>, debolezza, disturbi cardiovascolari, insulino-<a href="/allenamento/resistenza.html" title="Resistenza fisica nello sport: quali tipi e come classificarla">resistenza</a> ecc nei secondi.</p> <p>La terapia ormonale sostitutiva a base di ormone della crescita viene somministrata per via parenterale ed è indicata in tutte quelle patologie caratterizzate da una <strong>insufficiente produzione</strong> o da una <strong>mancanza totale</strong> del suddetto ormone.</p> <p>Fra i principali effetti indesiderati associati a questo tipo di terapia ormonale sostitutiva ricordiamo: <a href="/salute/ritenzione-idrica.html" title="Ritenzione Idrica">ritenzione idrica</a>, <a href="/Sintomi/Edema" title="Edema">edema</a>, <a href="/salute/dolore-muscolare-mialgia.html" title="Dolore Muscolare (Mialgia)">mialgia</a>, <a href="/salute/artralgia.html" title="Artralgia">artralgia</a>, <a href="/Sintomi/Parestesia" title="Parestesia">parestesia</a>, <a href="/salute/cefalea.html" title="Cefalea: Perché si Manifesta? 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if ( typeof(myp_vertical) != 'undefined' && myp_vertical.key !== 'mypt') { placeholder_txt = myp_vertical.search_ph; } var SALheaderOptions = { topstrip: true, search: { visible: true, placeholder: placeholder_txt, submitCallback: "doSubmit" }, social: [ { name: "Facebook", className: "sal-header-facebook", url: "https://www.facebook.com/My-personaltrainerit-169273149780864/" }, { name: "YouTube", className: "sal-header-youtube", url: "https://www.youtube.com/channel/UCtKXnFU2lu0pOdipAnQyBzg" }, { name: "Instagram", className: "sal-header-instagram", url: "https://www.instagram.com/myptrainer/" } ] }; if ( typeof(myp_vertical) != 'undefined' && myp_vertical.key === 'beauty') { // beauty ha solo IG come social SALheaderOptions.social = [{ name: "Instagram", className: "sal-header-instagram", url: "https://www.instagram.com/myptbeauty/" }]; } if (typeof(myp_vertical) != 'undefined' && myp_vertical.key === 'mypet') { // mypet ha solo IG come social SALheaderOptions.social = [{ name: "Instagram", className: "sal-header-instagram", url: "https://www.instagram.com/mypersonalpet/" }]; } </script> <script async src="/js/min/salheader.min.js?cb=d4ffe5742aad9de15ecbc4232a55ff8ac72607e5"></script> <script> mmLoader({ src: "/js/min/common.min.js?cb=d4ffe5742aad9de15ecbc4232a55ff8ac72607e5", defer: true }); </script> <script> mmLoader({ src: "https://dafne.sirio.stbm.it/utility-fe/prod/web-components/ame-mh.min.js", defer: true }); </script> <script type="module"> import { onINP, } from 'https://unpkg.com/web-vitals@3/dist/web-vitals.attribution.js?module'; function sendToGoogleAnalytics(_ref) { console.log('INP',_ref) var name = _ref.name, value = _ref.value, id = _ref.id, attribution = _ref.attribution; // Destructure the attribution object: var eventEntry = attribution.eventEntry, eventTarget = attribution.eventTarget, eventType = attribution.eventType, loadState = attribution.loadState; // Get timings from the event timing entry: var startTime = eventEntry.startTime, processingStart = eventEntry.processingStart, processingEnd = eventEntry.processingEnd, duration = eventEntry.duration, interactionId = eventEntry.interactionId; var eventParams = { event_category: 'INP_V1', // The page's INP value: metric_inp_value: value, // A unique ID for the page session, which is useful // for computing totals when you group by the ID. metric_id: id, // The event target (a CSS selector string pointing // to the element responsible for the interaction): metric_inp_event_target: eventTarget, // The type of event that triggered the interaction: metric_inp_event_type: eventType, // Whether the page was loaded when the interaction // took place. Useful for identifying startup versus // post-load interactions: metric_inp_load_state: loadState, // The time (in milliseconds) after page load when // the interaction took place: metric_inp_start_time: startTime, // When processing of the event callbacks in the // interaction started to run: metric_inp_processing_start: processingStart, // When processing of the event callbacks in the // interaction finished: metric_inp_processing_end: processingEnd, // The total duration of the interaction. Note: this // value is rounded to 8 milliseconds of granularity: metric_inp_duration: duration, // The interaction ID assigned to the interaction by // the Event Timing API. This could be useful in cases // where you might want to aggregate related events: metric_inp_interaction_id: interactionId, non_interaction: true }; let now = new Date(); if(now.getHours() == 15 || now.getHours() == 16 || now.getHours() == 9 || now.getHours() == 22 || now.getHours() == 6 ) { // Send to Google Analytics gtag('event', 'INP_V1', eventParams); } } // Pass the reporting function to the web-vitals INP reporter: onINP(sendToGoogleAnalytics); </script> <script src="/js/min/advertorial.min.js?cb=d4ffe5742aad9de15ecbc4232a55ff8ac72607e5" async></script> <script> var jsCounter = false; var sectionCounter = 7; var showInread = false; var isAdvertorial = true; var showAdsense = false; function MM_jumpMenu(targ,selObj,restore){ eval(targ+".location='"+selObj.options[selObj.selectedIndex].value+"'"); if (restore) selObj.selectedIndex=0; } mmLoader({ src: "/js/min/foglia.min.js?cb=d4ffe5742aad9de15ecbc4232a55ff8ac72607e5", async: true }); </script> <script> </script> <script> // PERMUTIVE CONSENT CONFIG var permutiveEnabled = false; // GET CONSENT TOKEN (euconsent-v2) let token = (document.cookie.match(/(?:iub)?euconsent-v2=([^;]*)/) || [])[1]; const noadvurls = [ "https://www.my-personaltrainer.it/codici-sconto-efarma-marzo-2025.html" ] if (noadvurls.some(el => window.location.href.includes(el))) { document.body.classList.add("sal-adv-hidden") } function setupPermutive() { __tcfapi('getTCData', 2, (tcData, success) => { if (success && tcData) { if(tcData.purpose.consents["1"] && tcData.purpose.consents["3"] && tcData.purpose.consents["5"] && tcData.purpose.consents["7"] && tcData.purpose.consents["9"] && tcData.vendor.consents["361"]) { permutiveEnabled = true; window._exaudiMediaset = window._exaudiMediaset || []; window._exaudiMediaset.push(["S",["_cm","PERMUTIVE"]]); } if(!token) { token = tcData.tcString; } } }); } postTcfReady(setupPermutive); let adMantxLoaded = false; function startAdvChain2022() { let startTime = performance.now(); const startAdmantx = function () { /* ADMANTX CONF */ let admantxOptions = `{"tag": "mypersonaltrainer.it","key": "4c1d28029914072d7b96a278ef7ef6fd25809a20638848ee8590da4a3cf07bc4","method": "descriptor","filter": "default","decorator": "template.mypersonal","type": "URL","mode": "async","body": "${escape(document.location.href)}"}`; let decodedAdmantx = 'https://euasync01.admantx.com/admantx/service?request='+admantxOptions; let urlAdmantx = encodeURI(decodedAdmantx); return mmLoader({ src: urlAdmantx, async: true },"advChain"); } const startNeodata = function () { /* NEODATA CONF */ let urlNeodata = `https://c.neodatagroup.com/mediaset.js`; if(permutiveEnabled) { return mmLoader({ src: urlNeodata, async: true },"advChain"); } return false; } const promises = [startAdmantx(),startNeodata()]; Promise.allSettled(promises). then((results) => { console.log('[startAdvChain2022] neodata e admantx elaborati', performance.now() - startTime); console.log('[startAdvChain2022]',results) //Permutive listen event adMantxLoaded = true; var adMantxReady = new Event("adMantxReady"); window.dispatchEvent(adMantxReady); console.log('[Permutive]' + adMantxLoaded); mmLoader({ src: "//adv.mediamond.it/hpsponsor/mypersonaltrainer/header_cls.v3.js", async: true },"advChain").then(()=> window.dispatchEvent(new Event("introCanStart"))); }).then(e => { console.log('[startAdvChain2022] mm caricato', performance.now() - startTime); const advChainEvent = new Event('advChainLoaded'); window.dispatchEvent(advChainEvent); }) } if (!noadvurls.some(el => window.location.href.includes(el))) { postTcfReady(startAdvChain2022) } function startPermutive() { console.log("[permutive] start permutive"); if(permutiveEnabled) { // SETUP CONSENT ON PERMUTIVE permutive.consent({ "opt_in": true, "token": token }); console.log(`[permutive] setup consent with token`, token); // SETUP PERMUTIVE USER IDENTITIES let identities = [ {"id": getGaClientId(), "tag": "ame_publisher_id", "priority": 1} // AME PUBLISHER ID ]; permutive.identify(identities); console.log(`[permutive] setup user identities`, identities); // ADDON PERMUTIVE adMantxLoaded ? addonPermutive() : window.addEventListener('adMantxReady', () => addonPermutive()); } } function postPermutiveIdGeneratorReady() { if(typeof permutiveIdGeneratorReady !== 'undefined') { startPermutive(); } else { window.addEventListener('permutiveIdGeneratorReady', function () { startPermutive(); }); } } function addonPermutive() { let label = !(ADX_label.includes(ADX_lemmas)) ? `${ADX_label},${ADX_lemmas},${ADX_people},${ADX_categories},${ADX_places},${ADX_companies}` : ADX_label; let semantic_label = label.split(','); console.log('[Permutive label]' + semantic_label); const hour = new Date().getHours(); let time_of_day = (hour < 12 ? 'Morning' : hour < 17 ? 'Afternoon' : hour < 22 ? 'Evening' : 'Night'); const d = new Date(); const weekday = ["Domenica","Lunedì","Martedì","Mercoledì","Giovedì","Venerdì","Sabato"]; let day_of_week = weekday[d.getDay()]; let platform = document.documentElement.clientWidth < 480 ? 'mypersonaltrainer-web-mobile' : 'mypersonaltrainer-web-desktop'; /*Tutte le condizioni utili al popolamento dell'oggetto addonData sono contenute nel file pageDetailsDetect*/ let addonData = { "page":{ semantic_label, // ["list", "of", "strings"] "brand": "My Personal Trainer", // "text" time_of_day, // "text" "page": { "section": "benessere", "type": "Foglia" // "text" }, "publisher": "Mondadori", // "text" day_of_week, "published_at": "2025-01-14T11:47:00+01:00", "meta_keywords":["Farmaci","Terapia-ormonale-sostitutiva","Estrogeni","Androgeni","Ormoni-tiroidei","Ormone-della-crescita-gh"], "article": { "authors": "Dott.ssa Ilaria Randi", // "text" "title": "Terapia ormonale sostitutiva (TOS): cos'è, tipi, effetti collaterali" // "text" }, platform, "site_name": "mypersonaltrainer", // "text" "classifications_watson": { "categories": "$alchemy_taxonomy", "keywords": "$alchemy_keywords" } } } permutive.addon('web', addonData); console.log(`[permutive] addon web`, addonData); } postTcfReady(postPermutiveIdGeneratorReady); function injectAudioSentinel() { return new Promise((resolve, reject)=>{ const videoSentinel = window.top.document.createElement('video'); videoSentinel.src = "/video-sentinel/sentinel.mp4" videoSentinel.controls = true; videoSentinel.muted = false; videoSentinel.playsInline = true; videoSentinel.volume = 0.001; videoSentinel.setAttribute("style", "position:fixed;bottom:-200px;z-index:-1;"); window.top.document.body.appendChild(videoSentinel); console.log('[Check AudioOn] Video sentinella caricato'); resolve(checkSentinelResponse(videoSentinel)); }); } function checkSentinelResponse(elem){ return new Promise((resolve, reject) => { let interrogateSentinel = elem.play(); if (interrogateSentinel !== undefined){ interrogateSentinel.then(function () { resolve(audioModeOnSentinel = true); console.log('[Check AudioOn] AudioOn permesso!', 'Valore audioModeOnSentinel:',audioModeOnSentinel); }).catch(function (error) { resolve(); // Non modifico audioModeOnSentinel. È false di default console.log('[Check AudioOn]', error) }) } }) } function setCookie(cname, cvalue, exhours, domain='') { // IMPORTANTE - inserire il dato "exhours" in ore indica la scadenza del cookie const d = new Date(); d.setTime(d.getTime() + (exhours * 3600000)); let expires = "expires="+ d.toUTCString(); document.cookie = cname + "=" + cvalue + ";" + expires + ";domain="+domain + ";path=/"; } function getCookie(cname) { let name = cname + "="; let decodedCookie = decodeURIComponent(document.cookie); let ca = decodedCookie.split(';'); for(let i = 0; i <ca.length; i++) { let c = ca[i]; while (c.charAt(0) === ' ') { c = c.substring(1); } if (c.indexOf(name) === 0) { return c.substring(name.length, c.length); } } return ""; } /*Tutte le condizioni utili al popolamento dell'oggetto addonData sono contenute nel file pageDetailsDetect*/  /* Setta una variabile per inibire la pushdown su HP, hp di categorie e in presenza di altri video */ let showPushDown = true; let audioModeOnSentinel = false; let checkUserConnection = true; if(navigator.connection !== undefined && navigator.connection.downlink < 2) { showPushDown = false; checkUserConnection = false; console.log('[Push-diretta] Push inibita per connessione troppo lenta, downlink a',navigator.connection.downlink); } //Il parametro "website" è differente per desk, mob. android, mob. ios let website = 'mppv'; if (/(iPad|iPhone|iPod)/g.test(navigator.userAgent)) { website = "mppm-ios"; } else if (navigator.userAgent.toLowerCase().indexOf("android") !== -1){ website = "mppm-android"; } let isMobile = window.innerWidth < 1000; //Il parametro "webpushdownTargetElement" indica all'interno di quale ID erogare la push e/o dove riposizionarla (desk/mob) in caso di chiusura let targetElementId = 'flyfirst-mobile-placement'; if(!isMobile) targetElementId = 'flyfirst-placement'; let pushFrequencyCap = { mobile: 24, //Impostare il valore in ORE desktop: null, //Impostare null se non utilizzato } let checkCap = isMobile ? getCookie('pushDownCapMobile') : getCookie('pushDownCapDesktop'); console.log(`%c[Push-diretta] Il valore di pushFrequencyCap ${isMobile ? 'Mobile' : 'Desktop'} risulta settato a: ${isMobile ? pushFrequencyCap.mobile : pushFrequencyCap.desktop }`,'background-color: #55FFFF;padding:5px;color:black;'); function initPushdown() { //Le variabili, website, targetElementId, showPushDown e mobile sono inizializzate in pushdown-common-var.inc.tpl //PushConfObj è l'oggetto che contiene tutti i parametri con i quali andremo a inizializzare la PUSH const pushConfObj = { adServer:"freewheel", amazonTam: { enabled:true, pubID:'5123', sellerData:{ asi:'adkaora.com', sid:'1111', hp:1 } }, advFallbacks:true, closeFlyingAfter:7000, flyMode:"fade", targetElementId, audioModeOn: audioModeOnSentinel,////////////////////SUI VIDEO DI CONTENUTO L'iniziolizzazione passa da PAMELA:PHP C controlla li.... type:"flyfirst", website, eventListener: (ptpEvent) => { if (ptpEvent === 'preroll_started'){ if (isMobile && typeof pushFrequencyCap.mobile == "number" && (typeof checkCap == null || checkCap === '')) { console.log("%c[Push-diretta] Il preroll è stato erogato setto il cookie pushDownCapMobile.", 'background-color: #FFFF55;padding:5px;color:black;'); setCookie('pushDownCapMobile','enabled', pushFrequencyCap.mobile); } if (!isMobile && typeof pushFrequencyCap.desktop == "number" && (typeof checkCap == null || checkCap === '')) { console.log("%c[Push-diretta] Il preroll è stato erogato setto il cookie pushDownCapDesktop.", 'background-color: #FFFF55;padding:5px;color:black;'); setCookie('pushDownCapDesktop','enabled', pushFrequencyCap.desktop); } } } }; //Facciamo partire la chiamata a PTP per il caricamento di tutte le risorse del player (function (a,l,t,e,r) { a[e] = a[e] || function(s) { (a[e].run = a[e].run || []).push(s)}; let g,z = l.getElementsByTagName(t)[0]; if (l.getElementById(e)){return;} g = l.createElement(t); g.id = e; g.src = r; g.async = 1; z.parentNode.insertBefore(g,z); }(window, document, 'script', 'AVPushLoader', "https://ptp.stbm.it/pushdown/loader/av/pushdown-loader.js")); console.log("[Push-diretta] Parametri di Configurazione:", pushConfObj); //Avviamo la Pushdown! AVPushLoader(pushConfObj); console.log("%c[Push-diretta] Push inizializzata.", 'background-color: #55FF55;padding:5px;color:black;'); } /***************************************** FINE configurazioni push*/ /* * injectAudioSentinel crea un video fuori dalla viewport. * Prova a farlo partire con audio bassissimo. * Se si ottiene una promise l'audio on è consentito e la VAR "audioModeOnSentinel" viene impostata a true. * Se la variabile audioModeOnSentinel è true usiamo le api del player per impostare un volume al preroll. * Se la variabile audioModeOnSentinel è true PTP passa nella chiamata le nuove tag che ci ha fornito mediamond. */ function pushChainStarter(){ let audioFrequencyCap = 12; let audioCheckCap = getCookie('audioCap'); injectAudioSentinel().then(function () { if (showPushDown && !inSpecial &&(typeof checkCap == null || checkCap === '') && checkUserConnection === true) { const startPushDelay = () => { setTimeout(()=>{ initPushdown(); console.log(`%c[Push-diretta] Controllo showPushDown: ${showPushDown}. Controllo inSpecial: ${inSpecial}. | siamo su ${isMobile ? 'Mobile' : 'Desktop'} e il cookie pushFrequencyCap NON è ancora stato salvato nel browser. Controllo connessione: ${checkUserConnection}. Possiamo erogare!`, 'background-color: #55FF55;padding:5px;color:black;'); },15000) } postTcfReady(startPushDelay); } else { console.log(`%c[Push-diretta] Controllo showPushDown: ${showPushDown}. Controllo inSpecial: ${inSpecial}. Valore cookie: ${checkCap || 'Disabled'}. Controllo connessione: ${checkUserConnection}. Non possiamo erogare!`,'background-color: #FF5555;padding:5px;color:black;'); } }).then(function () { if (audioModeOnSentinel){ window.addEventListener("preroll_started", function() { console.log('[Check AudioOn] preroll_started'); setTimeout(function () { if (!isMobile && AVPushRunningInstances[0].opt.mode !== 'content' && (typeof audioCheckCap == null || audioCheckCap === '')){ AVPushRunningInstances[0].api.setVolume(0.05); ///////////////////////////Solo per le pushdown desktop impostiamo un CAP per l'audio_on di 12 ore setCookie('audioCap','enabled', audioFrequencyCap); console.log('[Check AudioOn] Setto il cap audio'); } else if (!isMobile && AVPushRunningInstances[0].opt.mode !== 'content' && audioCheckCap === 'enabled'){ console.log('[Check AudioOn] Cap audio rilevato non imposto audio'); } else { AVPushRunningInstances[0].api.setVolume(0.05); console.log('[Check AudioOn] Siamo su mobile o è in esecuzione un video content. Imposto audio on'); } },200) }); } }) } postTcfReady(pushChainStarter); //Label video del giorno stuckAVPush = (id) => { window.addEventListener('pushClose', ev => { window.removeEventListener('pushClose', stuckAVPush); if (!document.querySelector('.sal-video-giorno')){ let flyfirstPlacement = document.getElementById(id); flyfirstPlacement.insertAdjacentHTML('beforebegin', `<div class="sal-video-giorno">Video del giorno</div>`); } }); } window.innerWidth >= 1000 ? stuckAVPush('flyfirst-placement') : stuckAVPush('flyfirst-mobile-placement'); (function () { /***************************************** Gestiamo internamente la chiamata alla intro*/ let introFrequencyCap = !inSpecial ? 6 : null; console.log(`%c[Load Intro] introFrequencyCap : ${introFrequencyCap}.`,'background-color: #55FF55;padding:5px;color:black;'); let checkCap = getCookie('introCap'); function startIntro(){ window.googletag = window.googletag || {}; googletag.cmd = googletag.cmd || []; googletag.cmd.push(function() { if (typeof checkCap == null || checkCap === '' || inSpecial){ console.log(`%c[Load Intro] Cookie non settato procedo con la intro.`,'background-color: #55FF55;padding:5px;color:black;'); if (typeof initIntro === "function"){ console.log(`%c[Load Intro] Intro Chiamata.`,'background-color: #55FF55;padding:5px;color:black;'); initIntro(); } else{ console.log(`%c[Load Intro] La funzione initIntro non risulta dichiarata. Probabile race contidion con file mediamond.`,'background-color: #FF5555;padding:5px;color:black;'); } googletag.pubads().addEventListener('slotRenderEnded', function (event) { let slotId = event.slot.getSlotElementId(); // La size della intro [1,1] if ((slotId === 'adv-gpt-outofpage' && !event.isEmpty) && (event.size[0] === 1 && event.size[1] === 1) && typeof introFrequencyCap === "number"){ setCookie('introCap','enabled', introFrequencyCap, ".my-personaltrainer.it"); console.log(`%c[Load Intro] Intro erogata. Setto il cookie.`,'background-color: #FFFF55;padding:5px;color:black;'); } }); } else { console.log(`%c[Load Intro] Il cookie introCap risulta settato. Non possiamo erogare la intro.`,'background-color: #FF5555;padding:5px;color:black;'); } }); } window.addEventListener('introCanStart', function () { postTcfReady(startIntro); }); })();/***************************************** FINE configurazioni intro*/ (function(){ let iframeVideo = document.querySelector('.sal-container-video-nova'); if(iframeVideo != null) { console.log('[pushNoConsent] bloccata per presenza video in pagina'); return false; } let trackAnalytics = false; function startPushNoConsent() { window.initStartPushNoConsent = 1; console.log('[pushNoConsent] track init'); if (typeof gtag === "function" && trackAnalytics == true) { gtag("event", 'pushNoConsentV1', { event_category: 'pushNoConsentV1', event_action: 'init', event_label: document.location.href, non_interaction: true }); } var GlobalPusTimerStart = new Date().getTime(); console.log('[push] Pamela pushdown diretta initPushFlyfirst fopv flyfirst '); var ptpAdserver = 'freewheel'; let obj = { website, type: "flyfirst", flyMode: "fade", closeFlyingAfter: 7000, adServer: ptpAdserver, targetElementId, eventListener: (eventName, eventData) => { const eventBlocking = [ "adblocker_detected", "preroll_not_served", "autoplay_denied", "triggered_fallback", "preroll_error" ]; if(eventName === 'preroll_started'){ console.log('[pushNoConsent]', 'track preroll started'); if (typeof gtag === "function" && trackAnalytics == true) { gtag("event", 'pushNoConsentV1', { event_category: 'pushNoConsentV1', event_action: 'preroll_started', event_label: document.location.href, non_interaction: true }); } } // [ NPA ] event listeners per interstital ADK (adv fill se non c'è preroll) // if (eventBlocking.includes(eventName)) { // if (typeof AdKaora.loadInterstitial === 'function' && !adkPageSlots.displayed.adk_interstitial) { // console.debug('[ NPA ] init interstitial ADK causa preroll non erogato'); // AdKaora.loadInterstitial("adk_death-div"); // } // } } }; (function (a, l, t, e, r) { a[e] = a[e] || function (s) { (a[e].run = a[e].run || []).push(s) }; let g, z = l.getElementsByTagName(t)[0]; if (l.getElementById(e)) { return; } g = l.createElement(t); g.id = e; g.src = r; g.async = 1; z.parentNode.insertBefore(g, z); }(window, document, 'script', 'AVPushLoader', "https://ptp.stbm.it/pushdown/loader/av/pushdown-loader.js")); console.log('[pushNoConsent]', obj); AVPushLoader(obj); } // interstitial NPA se preroll non presente // let startInterstitialNoConsent = () => { // // [ NPA ] event listeners per interstital ADK (adv fill se non c'è preroll) // const eventBlocking = [ // "adblocker_detected", // "preroll_not_served", // "autoplay_denied", // "triggered_fallback", // "preroll_error" // ]; // eventBlocking.forEach(function(e) { // window.addEventListener(e, function() { // if (typeof AdKaora.loadInterstitial === 'function' && !adkPageSlots.displayed.adk_interstitial) { // console.debug('[ NPA ] init interstitial ADK causa preroll non erogato'); // AdKaora.loadInterstitial("adk_death-div"); // } // }); // }) // } const ADVNoConsentFlow = () => { // let NPAtarget = window.innerWidth < 1000 ? 'adv-gpt-box-mobile-container1' : 'adv-gpt-box-container1'; // if (document.getElementById(NPAtarget)){ // document.getElementById(NPAtarget).parentNode.setAttribute('id','box300NPA'); // } setTimeout(function() { mmLoader({ src: "https://cdn.adkaora.space/mondadori/generic/prod/adk-init.js", async: true, // type: 'module' }, "ADVNoConsentFlow") // .then(element => { // document.addEventListener("PWTBidComplete", function(e) { // console.debug('PWTBid completed.') // // check slot vuoti: // let emptyNPASlots = {}; // if(ifrmAdvMh.offsetHeight === 0){ // Object.assign(emptyNPASlots, { 'masthead': divslotnameStrip }); // } else { // AmeMh.strip_animation(); // } // if(ifrmAdvBox.offsetHeight === 0){ // Object.assign(emptyNPASlots, { 'box300': divslotnameBox }); // } // document.dispatchEvent(new CustomEvent("EmptyNPASlot", { // detail: emptyNPASlots // })); // }); // }, "ADVNoConsentFlow") // .then( element => mmLoader({ // src: "https://adv.mediamond.it/librerie/js-no-consent/ame/adv_no_consent.js", // async: true // }, "ADVNoConsentFlow")) .then(element => { setTimeout(function() {startPushNoConsent() },15000); // startInterstitialNoConsent(); }, "ADVNoConsentFlow"); },500); } if (!noadvurls.some(el => window.location.href.includes(el))) { postConsentRejected(ADVNoConsentFlow) } // debug only: // document.addEventListener("EmptyNPASlot", function(e) { // console.debug('[NPA] EmptyNPASlot event:', e.detail); // }); })(); let adsensePush = () => { let adsense_slots = document.querySelectorAll(".adsbygoogle"); if(adsense_slots.length > 0) { for (var i = 0; i < adsense_slots.length; i++) { (adsbygoogle = window.adsbygoogle || []).push({}); } } } function startAdsense() { setTimeout(() => { mmLoader({ src: "https://pagead2.googlesyndication.com/pagead/js/adsbygoogle.js", async: true },"adsenseChain").then(element => { adsensePush(); initAdsenseDone = true; }); },3000) } if (!noadvurls.some(el => window.location.href.includes(el))) { postTcfReady(startAdsense) } </script>  <script async src="https://dafne.sirio.stbm.it/utility-fe/prod/general/network.common.v3.js" importance="high"></script>  <script> const push_notification_api_data = { 'ajax_url': 'https://np.altervista.org/', 'account': 'myp-website', 'platform': 'myp-website' }; </script> <script type="text/javascript"> setTimeout(function() { mmLoader({ src: "https://www.gstatic.com/firebasejs/10.9.0/firebase-app-compat.js", async: true }, "pushNotificationChain") .then(element => mmLoader({ src: "https://www.gstatic.com/firebasejs/10.9.0/firebase-messaging-compat.js", async: true }, "pushNotificationChain")) .then(element => mmLoader({ src: "/js/firebase-messaging.js?cb=d4ffe5742aad9de15ecbc4232a55ff8ac72607e5", async: true }, "pushNotificationChain")) }, 5000); </script> <script> document.addEventListener("DOMContentLoaded", () => { let is_mobi = /Mobi|Android/i.test(navigator.userAgent); let is_paid = /utm_source=campLBSSAB/.test(location.search); document.querySelectorAll("a").forEach(a => { if (a.href.search('tag=pluginmyp-21') === -1) return; let link = a.href; if (link.search('ascsubtag') == -1) { link += "&ascsubtag="+(document.body.dataset.id||'unknown')+"-widget-"+(is_mobi ? 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