3.SIKLUS MENSTRUASI

SIKLUS MENSTRUASIYONAS HADISUBROTO

PENDAHULUAN

Menstruasi merupakan hasil kerjasama yang sangat rapi dan baku dari poros H-H-O (Hipotalamus-Hipofisis-Ovarium)

Triono Soendoro 12503

Hipotalamus

Foliculogenesis &

Oogenesis

E & P

FSH & LH

Steroidogenesis

GnRH

Pulsatile Secretion

In

“Critical Range”

Hipofisis

Ovarium

MenstruationSingle

ovulation

Ultra Short FB

(Down Reg.)

Short F.B

Long F.B

Triono Soendoro 12503

10

9

8

7

6

5

4

3

2

1

FSH

LH

Estradiol

FSH-Gran. Cell Prolif.-Arom. Androg – E2-FSH & E2 R/FSH in Gran. Cell-Stim. Inhibin. Act. ProdLH (Theca Cell)- Synth. Androg

LH surge-Menghambat Oosit Maturation Inhibitor(OMI)-Synth. Prostaglandin (PG)-Elevated P + : -Plasminogen Plasmin -FSH—Surge FSH Surge : - Proteolytic enzym activity - FSH + E2 R/ LH in gran cells

P

FSH & LH

LH Maintain - Corpus luteum -Vascul.-Steroidogenesis

Progesterone

17-OHP Ng/ml.Physiology of Ovulation (Menstruation)

2 4 6 8 10 12 14 16 18 20 22 24 26 28

Teori Dua Sel

Fase Proliferasi

Estrogen meningkat feedback negatif FSH menurun Teori threshold-window Folikel dominan

Estrogen terus meningkat >200 pg/ml selama 50 jam LH surge 36-48 jam kemudian terjadi Ovulasi

Dominasi estrogen endometrium pada fase proliferasi

FSH: Teori Threshold-Window

window

recruitment

threshold

selection dominance

FS

H le

vel

Fo

llicl

e si

ze

luteo-follicular transition

Triono Soendoro 12503

10

9

8

7

6

5

4

3

2

1

FSH

LH

Estradiol

LH

FSH

Estradiol

17-OH-Progesterone

Pogesterone

FSH-Gran. Cell Prolif.-Arom. Androg – E2-FSH & E2 R/FSH in Gran. Cell-Stim. Inhibin. Act. ProdLH (Theca Cell)- Synth. Androg

LH surge-Menghambat Oosit Maturation Inhibitor(OMI)-Synth. Prostaglandin (PG)-Elevated P + : -Plasminogen Plasmin -FSH—Surge FSH Surge : - Proteolytic enzym activity - FSH + E2 R/ LH in gran cells

P

FSH & LH

LH Maintain - Corpus luteum -Vascul.-Steroidogenesis

Progesterone

17-OHP Ng/ml.Physiology of Ovulation (Menstruation)

2 4 6 8 10 12 14 16 18 20 22 24 26 28

Fase Sekresi

Pasca Ovulasi Corpus Luteum menghasilkan Progesteron

Dominasi Progesteron endometrium pada fase sekresi

Triono Soendoro 12503

10

9

8

7

6

5

4

3

2

1

FSH

LH

Estradiol

LH

FSH

Estradiol

17-OH-Progesterone

Pogesterone

LH Progestrerone

FSH

Estradiol

LH

17-OH-Progesterone

FSH-Gran. Cell Prolif.-Arom. Androg – E2-FSH & E2 R/FSH in Gran. Cell-Stim. Inhibin. Act. ProdLH (Theca Cell)- Synth. Androg

LH surge-Menghambat Oosit Maturation Inhibitor(OMI)-Synth. Prostaglandin (PG)-Elevated P + : -Plasminogen Plasmin -FSH—Surge FSH Surge : - Proteolytic enzym activity - FSH + E2 R/ LH in gran cells

P

FSH & LH

LH Maintain - Corpus luteum -Vascul.-Steroidogenesis

Progesterone

17-OHP Ng/ml.Physiology of Ovulation (Menstruation)

2 4 6 8 10 12 14 16 18 20 22 24 26 28

OV

Fase Mentruasi

Apabila tidak ada kehamilan Corpus Luteum akan atresia Estrogen dan Progesteron menurun

Estrogen dan Progesteron menurun berakibat : endometrium pada fase menstruasi

feed back positif FSH dan LH (mulai siklus menstruasi yang baru)

TERIMA KASIH