gangguan haid.ppt
TRANSCRIPT
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Hypothalamus
GnRHGnRH
Pulsatile SecretionPulsatile Secretion
InIn
““Critical Range”Critical Range”
Pituitary FSH & LH
Ovary
Steroidogenesis
E & P
Menstruation
Foliculogenesis&
oogenesis
Single
Ovulation
Long F.B Short F.BUltra Short FB!o"n #eg.$
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FSH
LH
Estradiol
Progesterone
%'OH Progesterone
EstradiolFSH
LH
E r/PE r/P
PHYSIOLOGY OF OVULATION / M(n#H
(O)*!O+#OP,)
ES+#O(E)
&
P#O(ES+E#O)
E)!OME+#,UM
2 4 6 8 10 12 14 16 18 20 22 24 26 28
Estradiol
FSHLH
Progesterone
%'OH Progesterone
Progesterone1!"HP
#g$%&
%-
/
0
1
2
3
4
%
"'(
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%3
KADARKADAR PROLAKTINPROLAKTINKLINISKLINIS
PROLAKTINPROLAKTIN
NORMALNORMALMAKIN TINGGIMAKIN TINGGI
OVULASIOVULASINORMALNORMAL DFLDFL ANOVULASIANOVULASI AMENOREAMENORE
* PX GALAKTORE & KADAR PROLAKTIN PENTING* PX GALAKTORE & KADAR PROLAKTIN PENTING
PADA PENAPISAN ANOVULASIPADA PENAPISAN ANOVULASI
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%2
PATHOPHYSIOLOGY OF PCOs
(HYPOTHESIS)
I.RI.R69 %69 %OVARY ADRENALOVARY ADRENAL
6!%6!%
PCOPCOOLIGO OLIGO
AN OVUL.AN OVUL.
CENTRALCENTRAL
( LH ) ""%( LH ) ""%
HYPERHYPER
ANDROGEN *ANDROGEN *
* Due to H – P – O Axis, not the other etiologies
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%1
ELE5*+E! LH
S+,MUL*+E
O5*#6
*)!#O(E)
P#O!
!,S+U#B
FOL,7ULO(E)ES,S
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Oligo 8 *novulation
Hyperandrogen
E 99
Periphery$
LH 99
OM,!egradation 99
EarlyMaturation
o: Oocyte
Ovulation
Prolonged
*ging$
Oocyte;uality ↓↓
Fertiliti
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Mengapa padaIbu hamil tidak haid
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# ! 6 $ # ! 6 $ # D' 4 6 8 10 12 14 Weeks
Menses Ovulation Implantation Menses
Progesterone
LH HCG
FSH
"&IG" $ )*E#"RE
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"&IG" $ )*E#"RE"&IG" $ )*E#"RE
+SH , PR&+SH , PR&
PR"GES+ +ES+PR"GES+ +ES+
#" PREG#)#C-.#" PREG#)#C-.
C"#G( )#"*)&I.C"#G( )#"*)&I.
HIRS/+IS*.HIRS/+IS*. && G)&)C+"REG)&)C+"RE
2! )-S2! )-S
&EEI#G 3&EEI#G 3 &EEI#G !&EEI#G !
)#"5/&)+I"#)#"5/&)+I"#
E 3 P SE/E#+I)&E 3 P SE/E#+I)&
&EEI#G 3&EEI#G 3 &EEI#G !&EEI#G !
/+ERI#E F)C(/+ERI#E F)C(
2 7EES2 7EES
G"#)"+HR"PI# E9)*(G"#)"+HR"PI# E9)*(
&"7&"7 #"R*)"R*)& HIGHHIGH
2 7EES2 7EES
#" &EE(#" &EE(
"5)RI)#"5)RI)#
F)I&/REF)I&/RE
PH"+" CE&&) $PH"+" CE&&) $ GnRH $ CC +ES+GnRH $ CC +ES+
)#"R*( !)#"R*( ! )#"R*( 3)#"R*( 3
H-P"+H)&)*/SH-P"+H)&)*/S PI+/I+)R-PI+/I+)R-
"5( -SFS("5( -SFS(