SIKLUS MENSTRUASI

YONAS HADISUBROTO

PENDAHULUAN

Menstruasi merupakan hasil kerjasama

yang sangat rapi dan baku dari poros
H-H-O (Hipotalamus-Hipofisis-Ovarium)

Physiology of Ovulation (Menstruation

Short F.B

Hipotalamus
Long F.B
GnRH
Pulsatile Secretion
In
Critical Range

Hipofisis

Ultra Short
FB
(Down
Reg.)

FSH & LH
Ovarium

Steroidogenesis

Foliculogenesis
&
Oogenesis

E&P
Menstruation

Triono Soendoro 12503

Single
ovulation

Progesterone

Physiology of
Ovulation
(Menstruation)

17-OHP Ng/ml.
10
9
8
7
FSH

6
5
4

LH

3
2
1

Estradiol

4
24 26

6
28

10

12

14

LH surge
SH
-Menghambat Oosit Maturation Inhibitor(OMI)
Gran. Cell Prolif.
-Synth. Prostaglandin (PG)
Arom. Androg E2
FSH & E2 R/FSH in Gran. Cell-Elevated P + : -Plasminogen Plasmin
Stim. Inhibin. Act. Prod
-FSHSurge
H (Theca Cell)
FSH Surge : - Proteolytic enzym activity
Triono Soendoro 12503
Synth. Androg
- FSH + E2 R/ LH in gran cells

16

18

20

22

P
FSH & LH
LH Maintain - Corpus luteum
-Vascul.
-Steroidogenesis

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 3648 jam kemudian terjadi Ovulasi
Dominasi estrogen endometrium
pada fase proliferasi

FSH level

FSH: Teori ThresholdWindow

threshold

window

selection dominance

Follicle size

recruitment

luteo-follicular transition

Progesterone
17-OHP Ng/ml.
10

Physiology of
Ovulation
(Menstruation)

LH

9
8
7
FSH

FSH
5
4
LH

3
2

Estradiol

1
Estradiol

17-OH-Progesterone

Pogesterone

4
24 26

6
28

10

12

14

LH surge
SH
-Menghambat Oosit Maturation Inhibitor(OMI)
Gran. Cell Prolif.
-Synth. Prostaglandin (PG)
Arom. Androg E2
FSH & E2 R/FSH in Gran. Cell-Elevated P + : -Plasminogen Plasmin
Stim. Inhibin. Act. Prod
-FSHSurge
H (Theca Cell)
FSH Surge : - Proteolytic enzym activity
Triono Soendoro 12503
Synth. Androg
- FSH + E2 R/ LH in gran cells

16

18

20

22

P
FSH & LH
LH Maintain - Corpus luteum
-Vascul.
-Steroidogenesis

Fase Sekresi

Pasca Ovulasi Corpus Luteum

menghasilkan Progesteron
Dominasi Progesteron endometrium
pada fase sekresi

Progesterone
17-OHP Ng/ml.
10

Physiology of
Ovulation
(Menstruation)

LH

LH

Progestrerone

8
7

FSH

FSH

Estradiol

FSH
5
4

LH
LH

3
2

Estradiol

1
Estradiol

17-OH-Progesterone

17-OH-Progesterone

Pogesterone

4
24 26

6
28

10

OV
12
14

LH surge
SH
-Menghambat Oosit Maturation Inhibitor(OMI)
Gran. Cell Prolif.
-Synth. Prostaglandin (PG)
Arom. Androg E2
FSH & E2 R/FSH in Gran. Cell-Elevated P + : -Plasminogen Plasmin
Stim. Inhibin. Act. Prod
-FSHSurge
H (Theca Cell)
FSH Surge : - Proteolytic enzym activity
Triono Soendoro 12503
Synth. Androg
- FSH + E2 R/ LH in gran cells

16

18

20

22

P
FSH & LH
LH Maintain - Corpus luteum
-Vascul.
-Steroidogenesis

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