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ENDOKRINOLOGI

REPRODUKSI

Bayu Kurniawan, dr.


Topik Pembelajaran

• Dasar Endokrinologi Reproduksi


Wanita

• Dasar Endokrinologi Reproduksi Pria


Dasar
Endokrinologi
Reproduksi
Wanita
Tujuan Pembelajaran

Mahasiswa mampu memahami &


menjelaskan :
 Fenotip wanita
 Sistem endokrin & reproduksi
 Konsep Menstruasi
THE FEMALE -
PHENOTYPE
W hat makes a woman ?
1. Chromosomal composition of female is XX

2. Gonads that are functionally and str uctur ally


ovaries

3. Female sex hor mone production

4. Appropriate inter nal and exter nal genitalia

5. Self - Acceptance of female role


Endocrine System

• Communication system
– Allows for cells in distant parts of body to
communicate
– Communication generally slower in onset,
but longer in duration, compared to nervous
system communication
• Consists of all the organs that secrete
hormones (endocrine organs)
Hor mones
 Chemical Messengers
 Produced by an endocrine gland
 Released into and carried via bloodstream
to target tissues
 Target tissues = tissues bearing receptors that
can bind and physiologically respond to the
chemical messenger in question
 Amount of chemical messenger produced and
released intocirculation is generally very small
SEX HORMONES - FEMALE
Hormones responsible for development and maintenance
of female phenotype:

Peptides
1. Gonadotrophin-releasing hormone (GnRH) (decapeptide)
LH Releasing Factor, FSH Releasing Factor

2. Luteinising hormones (LH)

3. Follicle stimulating hormone (FSH)

4. Inhibin (Protein hormone)

5. Activin (Protein hormone)


Steroids
6. estrogens, progesterons & androgens
TRADITIONAL ENDOCRINE SYSTEM
stimulus
hormone
Hormone producing cell
A B nucleus
second
Ca 2+
messengers
hormone

capillary
general blood circulation

Target Cell

Feedback loop second messengers


nucleus
cellular effects
Norman, A.W.; Litwack, G. (1997) Hormones
2nd Ed. Academic Press biological response
Reproductive System
• Survival of the organism
– Other systems of the body work together to
maintain homeostasis and promote survival of
the organism under varying environmental
conditions
• Survival of the species
– Reproductive system is designed to package
and transmit genetic information from
generation to generation, therefore promotes
survival of the species over time
Major Functions of Male and
Female Repr oductive
Systems
 Production of gametes
 Male gametes = sperm
 Spermatogenesis = production of mature sperm
 Female gametes = eggs (ova)
 Oogenesis = production of mature eggs
 Steroidogenesis
 Production of steroid hormones
 estrogens, progesterons, androgens
PEPTIDE/ PROTEIN HORMONES INVOLVED IN
FEMALE DEVELOPMENT AND REPRODUCTION

Hormone Site of Principal target tissue Biological function


Production

GnRH Hypothalmus Adenohypophysis Stimulation of release of


FSH and LH

FSH Adenohypo- Ovarian Granulosa Growth ovarian follicle


physis and thecal cells Stimulation estrogen
production

LH Adenohypo- Corpus luteum Stimulate progesterone


physis production

Inhibin Follicle granulosa Hypothalmus- Participate in feedback


cell pituitary inhibition of FSH secretion

Activin Follicle granulosa Hypothalmus Increase secretion of FSH


Female Reproductive
System (1)
• Fase Intrauterine
• Fase Bayi
• Fase Anak
• Fase Pra-pubertas
• Fase Reproduksi
• Fase Klimakterium
• Fase Senium
Female Reproductive
System
• Poros Hormon Reproduksi
(2)
- Susunan Sentral
- Pineal
- Hipotalamus
- Hipofise
- Susunan Perifer
- Ovarium
- Endometrium
• Organ Endokrin Ekstra Gonad
- Timus
- Tiroid
- Adrenal
- Pankreas
PINEAL (1)

•Kelenjar kecil di posterior


hipotalamus
•Embriologis berasal dari
diensefalon posterior
•Organ sisa ?
PINEAL (2)
• Sintesis
 Melatonin (>> aktif)
 5-Metoksi-Triptofol
 Arginin Vasotosin
• Sekresi
 Belum seluruhnya diketahui
 Irama Sirkadian, Pulsatil
(Melatonin)
PINEAL (3)
 Fungsi
 Belum seluruhnya diketahui
 Dipengaruhi cahaya & hormon
 Terdapat reseptor hormon steroid seks &
prolaktin
 Berpengaruh terhadap :
- Poros hipotalamus-hipofise-gonad
- Reproduksi
- Siklus Seksual & Siklus haid
- Seks Sekunder
- Genitalia Interna
- Ovulasi
Hypothalamic-Pituitary Axis
 Hypothalamus
• Region of brain (diencephalon)
• Lies below third ventricle at base of
brain
• Important regulator of endocrine
action
 Pituitary Gland (hypophysis)
• Endocrine gland connected to
hypothalamus by infundibulum
(stalk containing nerves and small
blood vessels)
Hypothalamus (1)
• Contains neuroendocrine cells that
release neurohormones which
1. enter the portal vessels and are
transported to anterior pituitary
2. regulate anterior pituitary hormone
production
• Contains neuroendocrine cells whose
– cell bodies lie within hypothalamus
• Hypothalamus = site of hormone production
– axons travel through hypothalamic-
pituitary stalk and terminate in posterior
pituitary
• Posterior pituitary = site of hormone storage
and release
Hypothalamus (2)

Hypothalamus Hormones

 Hypothalamic Releasing Hormones


 Hypothalamic Inhibitory Hormones
Hypothalamic Releasing
Hormones
• Produced in and released from
hypothalamus
• Enter portal blood vessels and are
transported to ANTERIOR PITUITARY
• Stimulate discrete cell types within
anterior pituitary to secrete additional
hormone(s)
Hypothalamic Releasing
Hormones
• Corticotropin Releasing Hormone
(CRH)
– Acts on corticotrophs
– Stimulates AP production of
adrenocorticotropic hormone (ACTH)
• Thyrotropin Releasing Hormone (TRH)
– Acts on thyrotrophs
– Stimulates AP production of Thyroid
Stimulating Hormone (TSH)
Hypothalamic Releasing
Hormones
• Gonadotropin Releasing Hormone
(GnRH)
– Previously known as Luteinizing
Hormone Releasing Hormone (LHRH)
– Acts on lactotrophs to stimulate AP
production of Follicle-Stimulating
Hormone (FSH) and Luteinizing
Hormone (LH)
Hypothalamic Releasing
& Inhibitory Hormones
• Growth Hormone Releasing Hormone
(GHRH = somatotropin)
– Acts on somatotrophs
– Stimulates AP production of Growth
Hormone (GH)
• Growth Hormone Inhibitory Hormone
(GIH = somatostatin)
– Acts on somatotrophs
– Inhibits AP production of Growth
Hormone
Pituitary Gland
In humans has two lobes = distinct glands
• Anterior (toward front of head) lobe =
adenohypophysis
• Posterior (toward back of head) lobe =
neurohypophysis
Lobes connected to hypothalamus by
different means
• Anterior lobe connected by (portal) blood
vessels
• Posterior lobe connected by nerves (axons)
Anterior Pituitary (AP)
 Endocrine(hormone-secreting) gland
containing several different cells types
 Lactotrophs; secrete prolactin
 Gonadotrophs; secrete LH and FSH
 Somatotrophs; secrete Growth hormone
 Thyrotrophs; secrete Thyroid stimulating hormone
 Corticotrophs; secrete Adrenocorticotropic
Hormone
 Connected to hypothalamus by portal blood
vessels
Prolaktin
 Fungsi
o Merangsang galaktopoeisis
(mempertahankan laktasi &
laktogenesis untuk
membentuk air susu)
o Memicu mammogenesis
FSH & LH
 Fungsi
- Pematangan folikel
- Ovulasi
- Pembentukan korpus luteum
- Sintesis steroid seks
Posterior Pituitary
 Outgrowth of the hypothalamus;
composed of neural tissue
 Specific neuroendocrine cells in
hypothalamus have axons that project
through the stalk and into the posterior
pituitary
 Secretes two important hormones
 Oxytocin (OXY)
 Antidiuretic hormone (ADH)
 Fungsi Oxytocin
 Persalinan : kontraksi uterus
 Pengeluaran air susu dgn kontraksi
mioepitel payudara

 Fungsi ADH
 Mengendalikan osmolalitas & volume
plasma
Ovarium
 Fungsi Utama
1. Fungsi Proliferatif
Sumber ovum selama fase reproduksi
2. Fungsi Sekretorik
Pembentukan & pengeluaran hormon
steroid seks (estrogen, progesteron &
androgen)
Estrogen (1)
• Hormon steroid dgn 10 atom C, dibentuk
dari 17-ketosteroid androstendion
• Estrogen alamiah : estradiol (E2), estron
(E1), estriol (E3) E2:E1:E3 = 10:5:1
• Disintesis di ovarium, adrenal, plasenta,
testis, jaringan lemak, SSP
Estrogen (2)
• Khasiat Umum
- Merangsang sintesis DNA melalui
RNA
- Membentuk messenger RNA

Meningkatkan sintesa protein


Estrogen (3)
• Khasiat Khusus
- Endometrium : memicu proliferasi
endometrium, memperkuat kontraksi uterus
- Serviks : mengubah konsentrasi getah serviks
saat ovulasi
- Vagina : perubahan selaput vagina,
meningkatkan produksi getah, meningkatkan
kadar glikogen, peningkatan produksi asam
laktat, memperkecil kemungkinan infeksi
- Ovarium : memicu sintesis reseptor FSH & LH,
mengatur kecepatan keluarnya ovum,
mempersiapkan spermatozoa
Estrogen (4)
Others:
• Increase clotting factors in the blood
• Decrease rate of bone resorption
• Increase sodium and water retention
• Mood & behavior
• Spermatogenesis
• Increase HDL and decrease LDL
Progesteron (1)
 Hormon steroid dgn 21 atom C
 Dibentuk di folikel, plasenta & adrenal
 Khasiat Umum
Mempersiapkan tubuh untuk kehamilan
(syarat mutlak konsepsi & implantasi)
 Terjadi karena pengaruh estradiol, karena
estradiol mensintesis reseptor progesteron
Progesteron (2)
 Khasiat Khusus
- Endometrium : perubahan sekretorik
(fase luteal)
- Serviks : barier terhadap spermatozoa
(fase luteal)
- Miometrium : menurunkan tonus miometrium
- Suhu Basal Badan : peningkatan suhu basal
badan segera setelah
ovulasi (termogenik)
Androgens: Physiological &
Pharmacological Actions
 Necessary for development of male
fetus
 Responsible for major changes that
occur in males at puberty
 Anabolic actions
 Maintains sexual function in males
 Participates in pubertal growth
spurt & hair growth in females
Endometrium

•Fungsi
o Nidasi
o Menstruasi
o Petunjuk gangguan
fungsional & steroid seks
Organ Endokrin Ekstra Gonad

Thymus

Thyroid

Adrenal

Pankreas
THYMUS
 Berubah mengikuti usia
 Tumbuh kembang
 Puncak sesaat sebelum
pubertas
 Aktivasi Hypothalamic-
Pituitary Axis
 Terdapat reseptor estrogen &
androgen
THYMUS
•Sekresi & Fungsi
- Timosin a-1 & Timosin β-4
 Aktivasi sekresi LH-RH
Hipotalamus
 Sekresi kortikosteroid
- Didapatkan Oksitosin &
Vasopresin
 Fungsi ???
 Parakrin
THYROID
• Sekresi Hormon Thyroxin
• Gangguan sekresi : Hipertiroid –
Hipotiroid
• Hipertiroid
- Gangguan silkus haid (ringan)
• Hipotiroid
- Gangguan fertilitas
(gangguan siklus haid berat sd
anovulasi)
- Galaktorea
Hipotiroid

• T3 & T4 rendah
• TRH tinggi
• PRL tinggi
• PRL hambat FSH & LH
• Tingkatkan kadar androgen
• Hambat pematangan folikel
Adrenal
• Produksi androgen wanita : ovarium & adrenal
>>> berlebihan >>> Ggn. Reproduksi

• Intake kalori +++ >>> aktivitas adrenal


meningkat

• Androgen +++ >>> Ggn. Gonadostat


hipotalamus-hipofise >> Ggn. Hypothalamic-
Pituitary Axis >>Resistensi folikel ovarium
Pankreas
• Sekresi Insulin
• Normal: Insulin merangsang FSH – LH (Hipofise)
• Fungsi :
- meningkatnya sintesis estrogen & progesteron
- sintesis & sekresi proteoglikan &
aktivator plasminogen
- timbulnya reseptor LH & Prolaktin
• Kadar Insulin ~ Kadar androgen (androstendion &
testosteron)
• Obesitas – Anovulasi - Hirsutisme
PROSTAGLANDIN

• Ovulasi
Memicu pecahnya folikel dg mempengaruhi vaskuler & kontraksi
ovarium
• Spermatozoa
PG dari spermatozoa >> kontraksi & relaksasi uterus – tuba
• Menstruasi
Merangsang otot polos
• Dismenorea
Hiperkontraktilitas uterus (kadar progesteron rendah)