1. Prof. dr. Djaswadi Dasuki, MPH, Ph.D
Menarche and spermache
MENARCHE AND
SPERMACHE
Block 7, August 30, 2005 Week 5 International Programme

2. Objective GOI : To understand physiology of menarche and spermache
SOI : To understand micro environment of menarche and spermache
To understand macro environment of menarche and spermache
To understand inhibiting factor related to menarche and spermache
To understand the relationship of menarche and live cycle health problem

3. Prof. dr. Djaswadi Dasuki, MPH, Ph.D
Menarche and spermache
Ovarian Physiology
Oocyte Maturation
Follicle Development
The Effect of LH on Theca Cells
The Effect of FSH on Granulosa Cells
Follicular Microenvironment
Inhibin
Follicle-Regulatory Protein
Prostaglandins
Melatonin
Steroids, Gonadotropins, and Prolactin
Block 7, August 30, 2005 Week 5 International Programme

4. Definition
Menarche : mēn/month + archē/beginning; the establishment or beginning of the menstrual function.
Menses : Mensis/month; the monthly flow of blood from the genital tract of women

5. Spermache. :. Sperma/seed ‘testicular secretion’. arche/beginning
Spermache : Sperma/seed ‘testicular secretion’ arche/beginning. The establishment or beginning of the testicular secretion/ejaculate.
Ejaculate : to expel suddenly, especially semen.
Ejaculation : ejaculation a sudden act of expulsion, as of the semen.

6. Sperm : Sperma/seed; the semen or testicular secretion.
Semen : The thick, whitish secretion of the reproductive organs in the male; spermatozoa in their nutriant plasma, secrections from the prostate, seminal vesicles, and various other glands, epithelial cells and minor constituents.

7. Menstruation. :. The cyclic physiologic uterine
Menstruation : The cyclic physiologic uterine bleeding which normally recurs, usually at approximately four-week intervals, in the absence of pregnancy during the reproductive period of the female of the human and a few other species of primates.

8. The menstrual cycle has an average duration of 28 days with a range of days. It consists of proliferative and secretory phases that correspond with the follicular and luteal phases of the ovarian cycle.

9. Delayed menarche
If menstruation has not started by 16 years of age in the presence of otherwise normal sexual development it is considered delayed and required investigation.

10. Causes of delayed menarche
Vaginal atresia
Defective cycle initiation
Androgen insensitivity syndrome

11. Table Types of amenorrhea
Description
Primary
No spontaneous menses by age 16 yrs
Secondary
Cessation of spontaneous menses for  4 mo
Central
Low basal gonadotropin levels, low blood estradiol concentrations (<50 pg/ml)
Peripheral
High basal gonadotropin levels, low estradiol levels (<25 pg/ml)

12. Prof. dr. Djaswadi Dasuki, MPH, Ph.D
Menarche and spermache
EVALUATION OF AMENORRHEA
Amenorrhea
Prior menstrual history Wight change Cyclical pain
Autoimmune disorders
Stress
Excessive exercise
Eating disorders
Physical examination
Rule out pregnancy
Prolactin level
Exclude
Normal
Asthenic habitus
Genetic syndrome,
Genital anomaly,
Outflow obstruction
galactorrhea
Elevated
Administer
progesterone
Evaluate for pituitary adenoma and hypothyroidism
Withdrawal
bleeding
Anovulation
LH, FSH
Primary
amenorrhea
Measure TSH
Secondary
Chromosome karyotype
Eclude Kalmann’s
Normal or low
Menopause
Hypothalamic
Block 7, August 30, 2005 Week 5 International Programme

13. Puberty is a time of profound physical and psychological development linking childhood to adulthood. The most obvious change is the appearance of the secondary sex characteristics. These begin to appear at a mean age of years, but there is great individual variation.

14. The adult ovary is organized on a pattern comparable to the testis with stromal tissue containing the primordial follicles (homologous to tubules) and also glandular tissue, the so-called interstitial glands (homologous to the Leydig cells).

15. The stages of puberty Five morphological changes are seen;
Breast growth
Pubic hair growth
Axillary hair growth
Growth spurt
menstruation

16. Delayed puberty
This mean failure of the development of secondary sex characteristics by 14 years of age.

17. Abnormalities of puberty
The onset of puberty varies within a wide age range, and is dependent on the integrity of the HPO axis. Abnormalities of puberty include:
Delayed puberty
Delayed menarche
Precocious puberty
Pseudo-precocious puberty

18. Reproductive Physiology of the Male
Pituitary-Testicular axis of Spermatogenic Regulation
Structure and Function of Leydig Cells
Androgen Biosynthesis
Testosterone Transport and Metabolism
Pituitary-Leydig Cell Axis: Hormonal Control
Pituitary-Seminiferous Tubule Axis
Sertoli Cells and FSH
Inhibin
Paracrine Regulation of Spermatogenesis
Histology of Spermatogenesis
Spermatocytogenesis
Meiosis
Spermiogenesis
Sperm Maturation in the Epididymis
Sperm Capacitation and Acrosome Reaction
Normal Semen Analysis

19. The testis has two major products: the spermatozoa that transmit the male’s genes to the embryo; and the androgens required for completion of masculinization. The synthesis of androgens and spermatozoa occurs in two separate compartments within the testis.
Spermatozoa develop within the tubules while androgens are synthesized between the tubules.

20. Table Disorders that produce primary testicular failure
Congenital
Acquired
Kinefleter’s syndrome (47.XXY and variants)
Orchitis
(mumps, pyogenic, traumatic)
Cryptorchidism
Malignancy
(germ cell leukemia, lymphoma)
Congenital anorchia
(vanishing testis syndrome)
Torsion
Varicocele
Noonan’s syndrome
Spinal cord injury
Myston’s muscular dystrophy
Systemic illness
(liver disease, renal failure)
Sickle cell disease
Drugs
X-irradiation
Aging

21. THANK YOU