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"Badan Koordinasi Keluarga Berencana Nasional (BKKBN) telah mensosialisasikan metode kontrasepsi LAM (Lactation Amenorrhea Method) untuk memenuhi kebutuhan kontrasepsi yang efektif dan aman pasca persalinan. Hasil data SDKI 2007 menunjukkan bahwa di beberapa daerah memiliki median amenorrhea laktasi lebih lama namun median pemberian ASI eksklusif cukup pendek.Penelitian ini bertujuan untuk mengetahui pengaruh pemberian ASI eksklusif terhadap amenorrhea laktasi di Indonesia setelah dikontrol oleh faktor ibu dan faktor keluarga. Penelitian ini menggunakan data sekunder SDKI 2007. Populasi dalam penelitian ini adalah ibu yang memiliki bayi usia 0 ? 6 bulan. Jumlah sampel yang ada untuk analisis adalah 2104 bayi. Analisis dilakukan dengan metode life-table, uji logrank dan regresi cox.Hasil penelitian menunjukkan bahwa ibu yang memberikan ASI eksklusif memiliki masa amenorrhea lebih lama. Efektivitas LAM pada dua bulan pertama adalah 85,59% dan pada bulan keenam adalah 45,80%. Pada enam bulan pertama pasca persalinan, ibu yang tidak memberikan ASI eksklusif 1,3 (95%CI: 1,1 ? 1,7) kali lebih cepat untuk mengalami menstruasi kembali dibandingkan ibu yang memberikan ASI eksklusif, setelah dikontrol dengan frekuensi pemberian ASI, penggunaan kontrasepsi dan paritas ibu. Oleh karena itu, BKKBN perlu meningkatkan promosi metode kontrasepsi lain disamping metode LAM serta mengefektifkan LAM pada dua bulan pertama pasca persalinan.

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Bureau of National Family Planning (BKKBN) has determined contraception method LAM (Lactation Amenorrhea Method) to fulfill the needs of an effective and safety postpartum contraception. Data result from DHS 2007 shown there was inconsistency between median lactation ammenorhea with median of exclusive breastfeeding in several region.This research has goal to know the influence of exclusive breastfeeding against lactation amenorrhea in Indonesia after controlled by maternal factors and household factors using secondary data DHS 2007. Population is mothers who have infants within range of ages 0 - 6 months. The analysis using 2104 infants as a sample, while the analysis were life-table, logrank test and cox regression.Result shows that mother who gives exclusive breastfeeding having longer amenorrhea. LAM effectiveness within first 2 months are 85,59% and 45,80% at the sixth month. Within a sixth month of postpartum, mothers who have not give exclusive breast feeding were 1,3 times faster to have menstruation compared with mothers who give exclusive breastfeeding (95%CI: 1,1 - 1,7) controlled by breastfeeding frequency, contraception usage and mothers parity. Therefore, BKKBN needs to increase the promotion of other contraception method instead of LAM. The highest effectiveness of LAM is at the first two months postpartum. It is recomended to undertaken an extended study (mother?s cohort study) to measure exclusive brestfeeding accurately."

"[ABSTRAKLatar Belakang: Kualitas hidup dan fertilitas merupakan isu yang ingin ditangani pada kasus amenorhea primer, dan kedua masalah ini menjadi alasan utama pasien mencari pengobatan. Penundaan diagnosis dan tatalaksana dapat mempengaruhi masa depan jangka panjang pasien. Walaupun prevalensi amenorhea primer sangat jarang (<0.1%), belum didapatkan data di senter pelayanan rawat jalan poliklinik Endokrinologi-Reproduksi RSCM. Tujuan: Meneliti karakteristik pasien amenorhea primer yang ditemui di poliklinik endokrinologi RSCM selama tahun 2014. Metode: Telaah retrospektif rekam medik dengan desain studi deskriptif kategorik terhadap pasien amenore primer yang berobat jalan di poliklinik imunoendokrinologi-reproduksi RSCM selama tahun 2014. Hasil dan simpulan: Terdapat 57 subyek penelitian. Selama 1 tahun terdapat 74% kasus baru dan 26% kasus lama, mayoritas kasus rujukan (79%) dengan karakteristik: Usia pada awal kontrol 22 ± 5.9 tahun. Keluhan utama yang tersering ditemukan adalah belum menstruasi (91.2%). Keluhan penyerta lain berupa gangguan pertumbuhan seks sekunder (8.7%). Sebanyak 93% tidak memiliki riwayat operasi dan obatan. Setengah populasi (50%) pasien tidak pernah mengalami perdarahan haid. Indeks massa tubuh pasien sebesar 20.77±3.5 kg/m2. Sebanyak 22.8% pasien amenore primer berperawakan kecil, serta 56.14% pasien amenore primer tidak memiliki pertumbuhan seks sekunder. Sebanyak 98.3% pasien tanpa hirsutisme, pembesaran tiroid, galaktore atau massa inguinal. Sebanyak 68.5 % dengan genitalia eksterna normal. Sebanyak 56.2% pasien dengan hipoplasi uterus, dan 49.1% dengan hipoplasi ovarium. Amenore primer hipergonadotropin-hipogonadisme adalah profil lab yang tersering ditemukan (33.33%). Dari gambaran kariotipe tersering 38% adalah 46XX. Etiologi dasar pada yang tersering adalah disgenesis gonad (36.8%), diikuti kelainan pembentukan duktus muller (28.07%) dan kelainan sentral (15.79%). Tatalaksana yang dilakukan terhadap kasus amenore primer berupa, induksi haid 42.1% dengan terapi hormonal. Pasien yang mendapat terapi hormonal, 24.56% mengalami perdarahan sela; Pada 28% mengalami perubahan klasifikasi Tanner. Operasi penyesuaian jender dilakukan pada 5 kasus (11%).

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ABSTRACTBackground : Quality of life and fertility are the two main issues to be handled in cases of primary amenorhea, as they become the main reasons for patients to seek medical care. Delay in diagnosis and treatment may affect the patient in the long term. Prevalence of primary amenorrhea is very rare (<0.1%) and there is minimal data on our reproductive endocrinology clinic at RSCM. Aim: To study the characteristics of primary amenorrhea patients at the reproductive endocrinology outpatient clinic during 2014. Methods: retrospective medical record review with cathegorical descriptive study to patients at reproductive-imunoendocrinology outpatient clinic during 2014. Results and conclusion: There were 57 study subjects. During 1 year there wer e74% new cases and 26% old cases with majority of referred casess(79%) with characteristics as such. Age at first control was 22 ± 5.9 years old. The most frequent chief complaint were no menstruation (91.2%). Other frequent complaint were disorder of secondary sex characteristics (8.7%). As much as 93% did not have history of surgery nor medication. Half of the cases (50%) never had menstruation. Body mass index mean was 20.77±3.5 kg/m2. As much as 22.8% patients were short-statured with 56.14% with no signs of secondary sex characteristics growth. Mostly (99.3%) patients had no hirsutism, thyroid enlargement nor inguinal. Normal external genitalia was found at 68.5% cases. 56.2% patient had uterus hipoplasia, and 49.1% with hipoplasia of the ovaries. Most often laboratory profile found was hypergonadotropin-hypogonadism (33.3%). Most frequent karyotpe were 46XX (38%). Most frequent etiology of primary amenorrhe in this study is gonadal dygenesis (36.8%) and mullerian dysgenesis/agenesis, and central disorders (15.79%). Most frequent etiology found was gonadal dysgenesis (36.8%), mullerian dysgenesis (28.07%) and central disorder (15.79%). Hormonal therapy was the most frequent treatment (42.1%). on patient with hormones, 24.6% had breakthrough bleeding, 28% had Tanner stage changes, and 11% had gender change. ;Background : Quality of life and fertility are the two main issues to be handled in cases of primary amenorhea, as they become the main reasons for patients to seek medical care. Delay in diagnosis and treatment may affect the patient in the long term. Prevalence of primary amenorrhea is very rare (<0.1%) and there is minimal data on our reproductive endocrinology clinic at RSCM. Aim: To study the characteristics of primary amenorrhea patients at the reproductive endocrinology outpatient clinic during 2014. Methods: retrospective medical record review with cathegorical descriptive study to patients at reproductive-imunoendocrinology outpatient clinic during 2014. Results and conclusion: There were 57 study subjects. During 1 year there wer e74% new cases and 26% old cases with majority of referred casess(79%) with characteristics as such. Age at first control was 22 ± 5.9 years old. The most frequent chief complaint were no menstruation (91.2%). Other frequent complaint were disorder of secondary sex characteristics (8.7%). As much as 93% did not have history of surgery nor medication. Half of the cases (50%) never had menstruation. Body mass index mean was 20.77±3.5 kg/m2. As much as 22.8% patients were short-statured with 56.14% with no signs of secondary sex characteristics growth. Mostly (99.3%) patients had no hirsutism, thyroid enlargement nor inguinal. Normal external genitalia was found at 68.5% cases. 56.2% patient had uterus hipoplasia, and 49.1% with hipoplasia of the ovaries. Most often laboratory profile found was hypergonadotropin-hypogonadism (33.3%). Most frequent karyotpe were 46XX (38%). Most frequent etiology of primary amenorrhe in this study is gonadal dygenesis (36.8%) and mullerian dysgenesis/agenesis, and central disorders (15.79%). Most frequent etiology found was gonadal dysgenesis (36.8%), mullerian dysgenesis (28.07%) and central disorder (15.79%). Hormonal therapy was the most frequent treatment (42.1%). on patient with hormones, 24.6% had breakthrough bleeding, 28% had Tanner stage changes, and 11% had gender change. , Background : Quality of life and fertility are the two main issues to be handled in cases of primary amenorhea, as they become the main reasons for patients to seek medical care. Delay in diagnosis and treatment may affect the patient in the long term. Prevalence of primary amenorrhea is very rare (<0.1%) and there is minimal data on our reproductive endocrinology clinic at RSCM. Aim: To study the characteristics of primary amenorrhea patients at the reproductive endocrinology outpatient clinic during 2014. Methods: retrospective medical record review with cathegorical descriptive study to patients at reproductive-imunoendocrinology outpatient clinic during 2014. Results and conclusion: There were 57 study subjects. During 1 year there wer e74% new cases and 26% old cases with majority of referred casess(79%) with characteristics as such. Age at first control was 22 ± 5.9 years old. The most frequent chief complaint were no menstruation (91.2%). Other frequent complaint were disorder of secondary sex characteristics (8.7%). As much as 93% did not have history of surgery nor medication. Half of the cases (50%) never had menstruation. Body mass index mean was 20.77±3.5 kg/m2. As much as 22.8% patients were short-statured with 56.14% with no signs of secondary sex characteristics growth. Mostly (99.3%) patients had no hirsutism, thyroid enlargement nor inguinal. Normal external genitalia was found at 68.5% cases. 56.2% patient had uterus hipoplasia, and 49.1% with hipoplasia of the ovaries. Most often laboratory profile found was hypergonadotropin-hypogonadism (33.3%). Most frequent karyotpe were 46XX (38%). Most frequent etiology of primary amenorrhe in this study is gonadal dygenesis (36.8%) and mullerian dysgenesis/agenesis, and central disorders (15.79%). Most frequent etiology found was gonadal dysgenesis (36.8%), mullerian dysgenesis (28.07%) and central disorder (15.79%). Hormonal therapy was the most frequent treatment (42.1%). on patient with hormones, 24.6% had breakthrough bleeding, 28% had Tanner stage changes, and 11% had gender change. ]"

"ABSTRAKAmenore postpartum adalah periode akhir kehamilan perempuan sampai waktu iamulai menstruasi kembali. Ini adalah periode ketidaksuburan sementara. Periodeamenore postpartum merupakan peristiwa penting bagi reproduksi dalam rentanghidup perempuan. Tujuan penelitian ini adalah mengetahui hubungan statusmenyusui ibu dengan amenore postpartum. Menggunakan data sekunder SDKI2012 dengan desain studi crossectional, dengan jumlah sampel sebesar 1171responden. Pada analisis multivariat dengan regresi Cox pada status menyusui ibuyang berinteraksi dengan penggunaan kontrasepsi non hormonal terhadapamenore postpartum didapatkan nilai PR 2,18 (95% CI: 1,22-3,89). Inimenunjukkan pentingnya ibu untuk terus menyusui dan menggunakan kontrasepsinon hormonal setelah melahirkan sebagai salah satu upaya untuk menjaga jarakkelahiran yang baik pada periode postpartum.

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ABSTRACTPostpartum amernorrhea is the end period of pregnancy women until she startedthe menstruating again. This is just temporary infertility period. Postpartumamenorrhea period is an important event of women’s reproductive life span. Theobjective of this study was to determine the relationship of maternal lactatingstatus with postpartum amenorrhea. Using IDHS 2012 secondary data’s withcrossectional design study, with 1171 respondents. In multivariate analysis withCox regression maternal lactating status which is interacting with non-hormonalcontraception use against postpartum amenorrhea showed the PR is 2,18 (95% CI:1,22-3,89). It’s showed how importance the mothers must continuingbreastfeeding and using a non-hormonal contraception after delivering as a way tomade a good spacing in the postpartum period."

"Lupus Eritematosus Sistemik LES merupakan penyakit autoimun kronik yang ditandai dengan adanya autoantibodi yang menyerang antigen sendiri. Kasus LES setiap tahunnya mengalami peningkatan. LES pada anak berkontribusi sebesar 15-20 dari keseluruhan penderita. Penyakit ini dapat menyerang berbagai sistem organ. Komplikasi endokrinopati berupa gangguan pubertas yang cukup sering terjadi pada anak. Hingga saat ini belum ada penelitian mengenai gangguan pubertas pada anak LES di Indonesia. Penelitian ini bertujuan untuk mengetahui prevalensi dan faktor-faktor yang berhubungan dengan terjadinya amenore pada anak LES. Penelitian dilakukan menggunakan desain potong lintang pada pasien anak perempuan usia 11-18 tahun di Poliklinik Alergi dan Imunologi dan Poliklinik Endokrinologi Rumah Sakit Cipto Mangunkusumo Kiara. Terdapat 25 subjek yang diikutsertakan. Hasil penelitian dilakukan analisis statistik menggunakan uji Chi-square dan uji Fisher. Prevalensi pubertas terlambat terjadi pada satu subjek 4 ; IK95 = -0,04-0,12 dan amenore terjadi pada dua belas subjek 48 ; IK95 = 0,27-0,69. Tidak terdapat hubungan yang bermakna antara amenore dengan durasi penyakit p=1,000; PR=1,05, aktivitas penyakit p=1,000; PR=0,86, durasi kortikosteroid p=0,673; PR=1,23, dan jenis terapi p=0,198; PR=0,55. Hasil penelitian tidak bermakna karena besar sampel tidak memenuhi jumlah minimal. Dari hasil tersebut, belum dapat disimpulkan bahwa tidak terdapat hubungan antara amenore terhadap durasi penyakit, aktivitas penyakit, durasi kortikosteroid, dan jenis terapi.

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Systemic Lupus Erythematosus SLE is a chronic autoimmune disease characterized by autoantibodies that attack self antigen. The case of SLE each year has increased. SLE in children contributes 15 20 of all patients. This disease can attack various organ systems. Complications of endocrinopathy in the form of pubertal disorders are quite common in children. Until now, there has been no research on pubertal disorders in children with SLE in Indonesia.

This study aims to determine the prevalence and associated factors of amenorrhea in children with SLE. This study was a cross sectional study in girls aged 11 18 years at Allergy and Immunology Polyclinic and Endocrinology Polyclinic of Cipto Mangunkusumo Kiara Hospital. There are 25 subjects included.

The result of the research was statistical analysis using Chi square test and Fisher test. The prevalence of delayed puberty occurs in one subject 4 IK95 0,04 0,12 and amenorrhea occurs in twelve subjects 48 IK95 0,27 0,69. There was no significant association between amenorrhea with disease duration p 1,000 PR 1,05, disease activity p 1,000 PR 0,86, corticosteroid duration p 0,673 PR 1,23, and type of therapy p 0,198 PR 0,55.

The results were not significant because the sample size did not meet the minimum amount. From these results, it can not be concluded yet that there is no association between delayed puberty and amenorrhea with disease duration, disease activity, corticosteroid duration, and type of therapy."

"Latar Belakang: Amenorea primer adalah kondisi di mana seorang perempuan belum mengalami haid pada usia 14 tahun, yang disertai dengan tidak tampaknya pertumbuhan serta perkembangan tanda-tanda seks sekunder, atau kondisi di mana seorang perempuan yang belum mengalami haid pada usia 16 tahun meski telah didapatkan pertumbuhan dan perkembangan yang normal dari tanda-tanda seks sekunder. Pada penderita Amenorea primer seringkali berakibat munculnya masalah kejiwaan seperti depresi, gangguan mood, sulit tidur, dan kegelisahan. Saat ini, belum terdapat program tatalaksana yang bersifat komperhensif untuk penderita amenorea primer yang melibatkan harapan dan perasaan penderita amenorea primer. Tujuan: Penelitian ini bertujuan untuk mengeksplorasi lebih dalam pengalaman penderita amenorea primer, memahami pandangan penderita amenorea primer terhadap keadaan yang dialaminya, memahami kebutuhan penderita amenorea primer dan memahami pandangan penderita amenorea primer terhadap tatalaksana yang saat ini dilakukan sehingga pendekatan tatalaksana terhadap penderita amenorea primer dapat optimal. Metode: Penelitian ini menggunakan pendekatan fenomenologi interpretatif, dengan wawancara mendalam, observasi langsung, dan catatan lapangan terhadap penderita amenorea primer di Poliklinik Departemen Ilmu Kebidanan dan Kandungan Rumah Sakit Umum Pusat Nasional Cipto Mangunkusumo pada bulan Mei 2018-Mei 2019. Hasil: Terdapat lima partisipan, usia bervariasi dari 21-28, dengan rerata 24 tahun. Tiga partisipan (60%) terdiagnosis dengan sindroma Turner, satu partisipan (20%) dengan DSD, dan satu partisipan (20%) dengan MRKH. Penderita amenorea primer cenderung merasakan perbedaan dengan perempuan lainnya, tidak menutup diri dengan lingkungan sekitar, tidak puas dengan perkembangan organ seks sekunder, mengalami masalah dengan partner, dan harapan terhadap pengobatan yang dilakukan, yaitu; ingin mendapatkan haid, terbebas dari obat, pertumbuhan organ seks yang normal, dan keinginan memiliki keturunan. Kesimpulan: Amenorea primer cenderung memiliki dampak negatif bagi penderitanya, terutama dalam segi kepercayaan diri. Penderita amenorea primer usia reproduktif cenderung tidak memiliki masalah dalam melakukan pekerjaan sehari-hari. Dengan mengetahui pandangan dan harapan penderita amenorea primer, tentunya tenaga medis dapat melakukan penatalaksanaan dengan pendekatan yang lebih komprehensif. Dibutuhkan tambahan variasi kasus atau sampel untruk dapat memenuhi aspek transferabilitas data.

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Background: Primary amenorrhea is a condition in which a woman has not experienced menstruation at the age of 14 years, accompanied by no apparent growth and development of secondary sex signs, or a condition in which a woman has not experienced menstruation at the age of 16 despite growth and development normal from secondary sex signs. Primary amenorrhea often results in psychiatric disorders such as depression, mood disorders, insomnia, and anxiety. To date, there is no comprehensive treatment program that involves the hope and feelings of those with primary amenorrhea Objective: This study aims to explore more in the experience of primary amenorrhoea sufferers, understand the views of primary amenorrhoea sufferers on their condition, understand the needs of primary amenorrhoea sufferers and understand the views of primary amenorrhoea sufferers on the current management so that the management approach for patients with primary amenorrhea can be optimal. Methods: This study uses an interpretative phenomenology approach, with in-depth interviews, direct observation, and field notes on primary amenorrhoea sufferers at the Polyclinic of the Department of Midwifery and Gynecology at the Cipto Mangunkusumo National Center General Hospital in MAy 2018-May 2019. Results: There were five participants, ages varied from 21-28, with a mean of 24 years. Three participants (60%) were diagnosed with Turner syndrome, one participant (20%) with DSD, and one participant (20%) with MRKH. Primary amenorrhoea sufferers tend to feel the difference with other women, were not satisfied with the development of secondary sex organs, experienced problems with their partners. Their hope for the treatment included wanting to have menstruation, be free from medical therapy, develop secondary sex organs, and desire to have children. Conclusions: Primary amenorrhea tends to have a negative impact on sufferers, especially in terms of self-confidence. Primary amenorrhea sufferers of reproductive age tend not to have problems in doing daily work. By knowing the views and expectations of primary amenorrhoea sufferers, of course medical personnel can carry out management with a more comprehensive approach. Additional variations of cases or samples are needed to meet the aspects of data transferability."

"Latar belakang: Amenore primer merupakan gangguan pada siklus menstruasi wanita. 11,1% wanita remaja menunjukkan keluhan ginekologi terkait menstruasi. Prevalensi kasus amenore primer terjadi pada 0,1–2% wanita usia reproduksi.Amenore primer dapat disebabkan sex reversal female (kromosom 46XY) atausindrom Turner (45X). Abnormalitas perkembangan genitalia eksterna merupakanmanifestasi dari gangguan kromosom. Belum ada penelitian yang mengkaji hubungan antara presentasi genitalia eksterna dengan genotip kromosom seks pada pasien amenore primer di Rumah Sakit Cipto Mangunkusumo (RSCM), Jakarta.Tujuan: Mengetahui tampilan genitalia eksterna pada pasien amenore primer di RSCM, Jakarta dan hubungannya dengan kejadian ambiguitas genitalia. Metode: Penelitian ini dilakukan desain studi dengan potong lintang secara retrospektif menggunakan rekam medis pasien amenore primer DepartemenObstetri dan Ginekologi RSCM periode Januari tahun 2018-2020. Data diolahmenggunakan program Statistical Package for the Social Sciences (SPSS) versi 20.Uji hipotesis akan dilakukan menggunakan uji Chi-Square atau Fisher’s exact test.Hasil: 65 rekam medis amenore primer yang melakukan analisa genetika berhasil dikumpulkan. 90,77% (n=59) kasus amenore primer bergenitalia eksterna normal dan 9,23% (n=9) bergenitalia ambigu. Seluruh kasus genitalia ambiguberkarakteristik pembesaran klitoris dengan 1 kasus juga diamati phallus genital. Hanya 53,8% kasus yang memiliki kromosom perempuan normal, 46XX. Hubungan signifikan didapatkan antara ambiguitas genitalia eksterna danabnormalitas kromosom seks (p=0,042) Simpulan: Terdapat hubungan yang signifikan antara ambiguitas genitalia eksterna serta tidak normalnya hasil analisa kromosom seks pada pasien amenore primer di Departemen Obstetri dan Ginekologi RSCM periode Januari tahun 2018-2020.

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Background: Primary amenorrhea is a disorder of a woman's menstrual cycle. 11.1% of adolescent women showed gynecological complaints related tomenstruation. The prevalence of primary amenorrhea cases occurs in 0.1–2% of women of reproductive age. Primary amenorrhea can be caused by female sex reversal (chromosome 46XY) or Turner syndrome (45X). Abnormalities in the development of external genitalia are a manifestation of chromosomal disorders. There are no studies that have examined the relationship between external genitalia presentation and sex chromosome genotypes in primary amenorrhea patients at Cipto Mangunkusumo Hospital (RSCM), Jakarta. Goal: Finding the characteristic the appearance of external genitalia in primary amenorrhea patients at RSCM, Jakarta and its relationship with the incidence of genital ambiguity Method: This study was conducted with a retrospective cross-sectional study design using the medical records of primary amenorrhea patients from the Department of Obstetrics and Gynecology RSCM January 2018-2020. Data were processed using the Statistical Package for the Social Sciences (SPSS) program version 20. Hypothesis testing will be carried out using the Chi-Square test or Fisher's exact test. Result: 65 medical records of primary amenorrhea that performed genetic analysis were collected. 90.77% (n = 59) cases of primary amenorrhea with external genitalia were normal and 9.23% (n = 9) had ambiguous genitalia. All cases of ambiguous genitalia were characterized by clitoral enlargement with 1 case also observed for the genital phallus. Only 53.8% of cases had a normal female chromosome, 46XX. There was a significant relationship between external genital ambiguity and sex chromosome abnormalities (p = 0.042). Conclusion: There is a significant relationship between external genital ambiguity and abnormal results of sex chromosome analysis in primary amenorrhea patients in the Obstetrics and Gynecology Department of RSCM for the period January 2018-2020 (p<0,05)."