the neuroendocrine aspect of amen or rhea asih

8/6/2019 The Neuroendocrine Aspect of Amen or Rhea Asih

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Counselor :Counselor :H.H. UndangUndang GaniGani,, dr.,SpOGdr.,SpOG

Presented by :Presented by :

AsihAsih FadiawatiFadiawati AgustinaAgustina


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AMENORRHEAAMENORRHEA

PRIMER

SEKUNDER


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The prevalence of pathologic amenorrhea ranges

from 3 to 4 percent in reproductive-aged populations.

EPIDEMIOLOGY

ETIOLOGY

A classification of the major causes of amenorrhea in

adolescents by organ system and by estrogen status.

In clinical practice, hypothalamic amenorrhea andpolycystic ovarian syndrome (PCOS) are the most

prevalent causes of amenorrhea in adolescents..


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The most common causes of primary

amenorrhea include:

Chromosomal abnormalities

Lack of reproductive organs

Problems with the hypothalamus Pituitary disease

Structural abnormality of the vagina


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Many possible causes of secondary

amenorrhea exist:

Pregnancy

Contraceptives

Breast-feeding Stress

Medication

Illness

Hormonal imbalance

Low body weight

Excessive exercise

Thyroid disorder Premature menopause

Pituitary tumor

Uterine scarring


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THE NEUROENDOCRINE ASPECT OF

NORMAL MENSTRUAL CYCLE

Reproductive endocrinology is the study of

hormones and neuroendocrine factors that are

produced by and/or affect reproductive tissues.These tissues include the hypothalamus,

anterior pituitary gland, ovary, endometrium,

and placenta.A hormone is classically

described as a cell product that is secretes intoperipheral circulation and that exerts its effects

in distant target tissues.


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THE NEUROENDOCRINE

ASPECT OF AMENORRHEA Stressant situations, due to physical, psychologic or

metabolic stressors, are able to negatively

modulate the hypothalamus-pituitary-ovarian axis

(HPO) mainly acting through an impairment of themany neuromodulators and neuropeptides that are

produced inside the brain and in the hypothalamic

areas.


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Disorders of the Hypothalamus Hypogonadotropic Hypogonadism

Inherited Abnormalities

Acquired Hypothalamic Dysfunction


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Pathophysiology of Functional

Hypothalamic Amenorrhea


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Disorders of The Pituitary Gland Inherited Abnormalities of the Pituitary Gland

Acquired Pituitary Dysfunction

Hyperprolactinemia

Prolactinoma

Isolated Gonadotropin Deficiency

Other Causes of Hypogonadotropic

Hypogonadism : Eugonadotropic Amenorrhea


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Disorder of The Thyroid

Hypothyroidism

Hyperthryoidism

Disorder of The Adrenal

Congenital Adrenal Hyperplasia

Cushing Syndrome


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DIAGNOSIS History

Physical Examination

Other Test


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TREATMENT

Treatment of amenorrhea depends on the cause.

Primary amenorrhea often requires no treatment,

but it's always important to discover the cause of

the problem in any case. Not all conditions canbe treated, but any underlying condition that is

treatable should be treated.


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the neuroendocrine aspect of amen or rhea asih

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