AMENORRHEA

Dr.H. Zain Alkaff, SpOG, KFER

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

Menstruasi, syarat:
1. anatomis
2. endometrium
3. axis hypotalamus
4. hormon : - FSH E2
- LH progesteron

Phisiologi:
1. hamil, HSG
2. menarche 2-12-24 bulan
3. menopause
Pathologi:
1. 14 tahun: sexual sec (-)
2. 16 tahun: sexual sec (+)
3. secundair amenorrhea

I.

EUGONADOTROPIC

1.

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

2. Acquired
A. - Asherman
- TBC
B. Androgen
- adrenal
- ovarium

II.

HYPERGONADOTROPIC
1. Chromosome Abnormal
2. Chromosome Normal:
a. Gonadal agenesis
b. Ovarian Insensitivity
c. Androgen Sensitivity

III. HYPOGONADOTROPIC
1.
2.
3.
4.
5.

KALMANNS
Emotional
Nutrisi
Obat-obatan
Kelainan Hipophise

EVALUASI
1. History
a. Umur
b. Emosi
c. Sexual
2. Phisic
a. Menarche mundur
b. - masculinisasi
- Thyroid
3. Laboratoris
a. Primair amenorrhea
b. Secundair amenorrhea

Secundair Amenorrhea
1.
2.
3.
4.
5.
6.

HCG
Progesteron Challenge
Potensi endometrium
Prolactin
Testosteron & DHEA SO4
Thyroid

Primair Amenorrhea
1. Gonadotropin
2. Pyelogram
3. Laparoscopi

Therapy
A. Eugonadotropic
1. congenital
2. Asherman
B. Hypogonadotropic
1. progestin
4. Bromocryptin
2. CC
5. operasi
3. Thyroid & adrenal
C. Hypergonadotropic
1. HRT
2. Sequential HT: .secondary sec
3. Surgical