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
What makes a woman ?
1. Chromosomal composition of female is XX

2. Gonads that are functionally and structurally ovaries

3. Female sex hormone production

4. Appropriate internal and external 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)
 Hormones
 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 Reproductive 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 (2)
• Poros Hormon Reproduksi
- 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)