Wanita 28 Tahun dengan Hyperprolactinemia dan Hubungan terhadap Policystic Ovary Syndrome

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ABSTRACT

Polycystic Ovary Syndrome (PCOS) is a collection of symptoms characterized by 3 (three) characteristics namely, increased androgen levels (hyperandrogenism), menstrual cycle irregularities, and small cysts on one or both ovaries. PCOS is the most common hormonal disorder affecting women of childbearing age. Hyperinsulinemia and insulin resistance are often associated with PCOS and become the main pathophysiology of this disease, where insulin functions to help regulate ovarian function by functioning as a cogonadotropin that will facilitate the secretion of androgen hormones from the adrenal glands and modulate the secretion of Luteinizing Hormone (LH) pulsatilely. There are various signs and symptoms of PCOS, including enlarged ovaries with many small cysts inside, irregular menstrual cycles, low back pain, hirsutism, alopecia, acne, acanthosis nigricans, skin tags. Laboratory investigations are needed to exclude other differential diagnoses as well as to see the levels of circulating androgen hormones in the blood. These include total and free testosterone, thyroid-stimulating hormone, prolactin, 17-hydroxyprogesterone, 2-hour post-prandial oral glucose tolerance test, fasting blood glucose, and lipid profile. After bromocriptine treatment, her prolactin levels decreased. The association of PCOS and hyperprolactinemia should be taken into account in cases of PCOS.

Keywords: PCOS, Hyperandrogenism, Hyperprolactinemia, Insulin Resistance

ABSTRAK

Polycystic Ovary Syndrome (PCOS) adalah kumpulan gejala yang dicirikan dengan 3 (tiga) karakteristik yaitu, peningkatan kadar androgen (hiperandrogenisme), irregularitas siklus menstruasi, dan kista kecil pada satu atau kedua ovarium. PCOS merupakan gangguan hormonal tersering yang menyerang Wanita Usia Subur (WUS). Hiperinsulinemia dan resistensi insulin sering dihubungkan dengan PCOS dan menjadi patofisiologi utama terjadinya penyakit ini, dimana insulin berfungsi untuk membantu regulasi fungsi ovarium dengan berfungsi sebagai cogonadotropin yang akan meemfasilitasi sekresi hormon androgen dari kelenjar adrenal dan memodulasi sekresi Luteinizing Hormone (LH) secara pulsatil. Terdapat berbagai macam tanda dan gejala PCOS, diantaranya adalah, pembesaran ovarium dengan banyak kista kecil didalamnya, siklus menstruasi yang tidak teratur, nyeri pinggang, hirsutisme, alopecia, acne, akantosis nigricans, skin tags. Pemeriksaan laboratorium diperlukan untuk mengeksklusi diagnosis banding yang lain serta melihat kadar hormon androgen yang bersirkulasi dalam darah. Pemeriksaan meliputi kadar testosterone total dan testosteron bebas, kadar Thyroid-Stimulating Hormone, prolaktin, 17-Hidroksiprogesterone, tes toleransi glukosa oral 2 jam post prandial, glukosa darah puasa, serta profil lipid. Setelah pengobatan bromokriptin, kadar prolaktinnya menurun. Hubungan PCOS dan hyperprolactinemia harus diperhitungkan pada kasus PCOS.

Kata Kunci: PCOS, Hiperandrogenisme, Hyperprolactinemia, Resisten Insulin