AMENORRHEADr.H. Zain Alkaff, SpOG, KFER

Amenorrhea (6 bulan):1. Eug g: symtom : a. anatomic b. genetic c. phisiologic d. emotional2. hyper gonadotropic3. hypo gonadotropic

Menstruasi, syarat:1. anatomis2. endometrium3. axis hypotalamus4. hormon : - FSH E2 - LH progesteron

Phisiologi:1. hamil, HSG2. menarche 2-12-24 bulan3. menopause

Pathologi:1. 14 tahun: sexual sec (-)2. 16 tahun: sexual sec (+)3. secundair amenorrhea

EUGONADOTROPIC

Congenital:A. Rokitansky-Kuster Hauser - kegagalan fusi - vaginal agenesis - ovarium normal - kelainan renB. Hymen imperforota (septum transverse vaginam) - sakit - endometiosis - infertil

AcquiredA. - Asherman - TBCB. Androgen - adrenal - ovarium

HYPERGONADOTROPIC

1. Chromosome Abnormal2. Chromosome Normal:a. Gonadal agenesisb. Ovarian Insensitivityc. Androgen Sensitivity

HYPOGONADOTROPIC

1. KALMANNS2. Emotional3. Nutrisi4. Obat-obatan5. Kelainan Hipophise

EVALUASIHistorya. Umurb. Emosic. SexualPhisica. Menarche mundurb. - masculinisasi - ThyroidLaboratorisa. Primair amenorrheab. Secundair amenorrhea

Secundair AmenorrheaHCGProgesteron ChallengePotensi endometriumProlactinTestosteron & DHEA SO4Thyroid

Primair AmenorrheaGonadotropinPyelogramLaparoscopi

TherapyEugonadotropic1. congenital2. AshermanHypogonadotropic1. progestin4. Bromocryptin2. CC5. operasi3. Thyroid & adrenalHypergonadotropic1. HRT2. Sequential HT: .secondary sec3. Surgical