GAngguan haid.ppt

8/17/2019 GAngguan haid.ppt

1/19


2/19

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.$


3/19

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

%

"'(


4/19


5/19


6/19


7/19


8/19


9/19


10/19


11/19


12/19


13/19

%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


14/19

%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


15/19

%1

ELE5*+E! LH

S+,MUL*+E

O5*#6

*)!#O(E)

P#O!

!,S+U#B

FOL,7ULO(E)ES,S


16/19

Oligo 8 *novulation

Hyperandrogen

E 99

Periphery$

LH 99

OM,!egradation 99

EarlyMaturation

o: Oocyte

Ovulation

Prolonged

*ging$

Oocyte;uality ↓↓

Fertiliti


17/19

Mengapa padaIbu hamil tidak haid


18/19

# ! 6 $ # ! 6 $ # D' 4 6 8 10 12 14 Weeks

Menses Ovulation Implantation Menses

Progesterone

LH HCG

FSH

"&IG" $ )*E#"RE


19/19

"&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(

GAngguan haid.ppt

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