Kareseban: Béda antarrépisi
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== Sari ==
Nu bener-bener ngalaman siklus kareseban mah ukur manusa jeung [[kera gedé]], [[mamalia]] [[bali (anatomi)|plaséntal]] lianna mah lolobana ukur ngalaman [[éstrus]]. Siklus kareseban diatur ku sistim [[hormon]] [[baranahan|réproduksi]] nu diperlukeun pikeun [[baranahan]], sacara umum lumangsung bulanan ti saprak [[pubertas]] nepi ka [[ménopause]].
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Dina awal siklus kareseban, wanoja nu geus sawawa sacara séksual ngaleupaskeun hiji [[ovum]] (atawa, kadang-kadang, dua, nu bisa ngahasilkeun [[kembar]] [[zigot|dizigotik]] atawa non-idéntik) nalika [[ovulasi]]. Sanggeus ovulasi, lapisan éndométrium [[rahim]] robah pikeun nyiapkeun kamungkinan [[implantasi]] ovum nu geus dibuahan pikeun ngamimitian [[reuneuh|kakandungan]]. Mun teu aya fértilisasi sarta teu reuneuh, rahim ngaleupaskeun lapisan éndométrium pikeun nyiapkeun siklus salajengna. Prosés ngaleupaskeun lapisan éndométrium ieu nu disebut '''kareseban''', kaluarna éndométrium jeung [[getih]] ngaliwatan [[heunceut]]. Najan sacara umum dianggap getih, kandunganana mah béda ti [[getih véna]].
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Common usage refers to menstruation and menses as a '''period'''. This bleeding serves as a sign that a woman has not become [[pregnancy|pregnant]]. (However, this cannot be taken as certainty, as sometimes there is some bleeding in early pregnancy.) During the reproductive years, failure to menstruate may provide the first indication to a [[woman]] that she may have become pregnant. A woman might say that her "period is late" when an expected menstruation has not started and she might have become pregnant.
Menstruation forms a normal part of a natural cyclic process occurring in healthy women between [[puberty]] and the end of the reproductive years. The onset of menstruation, known as ''[[menarche]]'', occurs at an average age of 12, but can occur any time between the ages of 8 and 16.{{ref|age}} However, the condition [[precocious puberty]] has caused menstruation to occur in girls as young as 8 months old. The last period, [[menopause]], usually occurs between the ages of 45 and 55. Deviations from this pattern deserve medical attention. [[Amenorrhea]] refers to a prolonged absence of menses during the reproductive years of a woman for reasons other than pregnancy. For example, women with very low [[body fat]], such as [[athlete]]s, may cease to menstruate. The presence of menstruation does not prove that ovulation took place; women who do not ovulate may have menstrual cycles. Those [[anovulatory cycle]]s tend to take place less regularly and show greater variation in cycle length. In addition, the absence of menstruation also does not prove that ovulation did not take place, because hormone disruptions in
non-pregnant women can suppress bleeding on occasion.-->
==
Siklus kareseban téh rupa-rupa panjang waktuna, ogé dina unggal sato. Wanoja mah rata-rata siklus karesebanana salila 28 poé, nu kabagi kana opat fase: kareseban, fase folikulér, ovulasi, jeung fase lutéal.
===Fase folikulér===
<!--Through the influence of a rise in [[Follicle stimulating hormone]] (FSH), five to seven tertiary-stage ovarian follicles are recruited for entry into the menstrual cycle. These follicles, that have been growing for the better part of a year in a process known as [[folliculogenesis]], compete with each other for dominance. In a signal cascade kicked off by [[luteinizing hormone]] (LH), the follicles secrete [[estradiol]], a steroid that acts to inhibit pituitary secretion of FSH. With diminished FSH supply comes a slowing in growth that eventually leads to follicle death, known as ''atresia''. The largest follicle secretes [[inhibin]] that serves as a finishing blow to less competent follicles by further suppressing FSH. This ''dominant follicle'' continues growing, forms a bulge near the surface of the ovary, and soon becomes competent to ovulate.▼
The follicles also secrete [[estrogen]]s (of which estradiol is a member). Estrogens initiate the formation of a new layer of endometrium in the uterus, histologically identified as the proliferative endometrium. If fertilised, the [[embryo]] will implant itself within this hospitable flesh.-->▼
===
<!--[[image:ovulation.jpg|thumb|This ovary is about to release an egg.]]▼
▲Through the influence of a rise in [[Follicle stimulating hormone]] (FSH), five to seven tertiary-stage ovarian follicles are recruited for entry into the menstrual cycle. These follicles, that have been growing for the better part of a year in a process known as [[folliculogenesis]], compete with each other for dominance. In a signal cascade kicked off by [[luteinizing hormone]] (LH), the follicles secrete [[estradiol]], a steroid that acts to inhibit pituitary secretion of FSH. With diminished FSH supply comes a slowing in growth that eventually leads to follicle death, known as ''atresia''. The largest follicle secretes [[inhibin]] that serves as a finishing blow to less competent follicles by further suppressing FSH. This ''dominant follicle'' continues growing, forms a bulge near the surface of the ovary, and soon becomes competent to ovulate.
When the follicle has matured, it secretes enough estradiol to trigger the acute release of [[luteinizing hormone]] (LH). In the average cycle this LH surge starts around cycle day 12 and may last 48 hours. The release of LH matures the egg and weakens the wall of the follicle in the ovary. This process leads to [[ovulation]]: the release of the now mature [[ovum]], the largest cell of the body (with a diameter of about [[1 E-4 m|0.5 mm]]). Which of the two ovaries — left or right — ovulates appears essentially random; no known left/right co-ordination exists. The [[Fallopian tube]] needs to capture the egg and provide the site for [[fertilisation]]. A characteristic clear and stringy [[mucus]] exhibiting [[spinnbarkeit]] develops at the [[cervix]], ready to accept [[sperm]] from [[intercourse]]. In some women, ovulation features a characteristic pain called ''[[Mittelschmerz]]'' (German term meaning 'middle pain') which lasts for several hours. The sudden change in hormones at the time of ovulation also causes light mid-cycle bleeding for some women. Many women perceive the vaginal and cervical mucus changes at ovulation, particularly if they are monitoring themselves for [[Fertility awareness|signs of fertility]]. An unfertilised egg will eventually disintegrate or dissolve in the uterus. Scientific investigations{{ref|threshold}} have indicated that the [[olfactory]] acuity or the sense of [[olfaction|smell]] is greatest during ovulation in women.-->▼
===Fase lutéal===
▲The follicles also secrete [[estrogen]]s (of which estradiol is a member). Estrogens initiate the formation of a new layer of endometrium in the uterus, histologically identified as the proliferative endometrium. If fertilised, the [[embryo]] will implant itself within this hospitable flesh.
<!--The corpus luteum is the solid body formed in the ovaries after the egg has been released from the fallopian tube which continues to grow and divide for a while. After ovulation, the residual follicle transforms into the [[corpus luteum]] under the support of the pituitary hormones. This corpus luteum will produce [[progesterone]] in addition to estrogens for approximately the next 2 weeks. Progesterone plays a vital role in converting the proliferative endometrium into a secretory lining receptive for [[implantation]] and supportive of the early [[pregnancy]]. It raises the body temperature by half- to one degree Fahrenheit (one-quarter to one-half degree Celsius), thus women who record their temperature on a daily basis will notice that they have entered the luteal phase. If fertilisation of an egg has occurred, it will travel as an early [[embryo]] through the tube to the uterine cavity and implant itself 6 to 12 days after ovulation. Shortly after implantation, the growing embryo will signal its existence to the maternal system. One very early signal consists of [[human chorionic gonadotropin]] ([[hCG]]), a hormone that [[pregnancy test]]s can measure. This signal has an important role in maintaining the corpus luteum and enabling it to continue to produce progesterone. In the absence of a pregnancy and without hCG, the corpus luteum demises and inhibin and progesterone levels fall. This will set the stage for the next cycle. Progesterone withdrawal leads to menstrual shedding (''progesterone withdrawal bleeding''), and falling inhibin levels allow FSH levels to rise to raise a new crop of follicles.▼
==Gejala kareseban==
▲[[image:ovulation.jpg|thumb|This ovary is about to release an egg.]]
▲When the follicle has matured, it secretes enough estradiol to trigger the acute release of [[luteinizing hormone]] (LH). In the average cycle this LH surge starts around cycle day 12 and may last 48 hours. The release of LH matures the egg and weakens the wall of the follicle in the ovary. This process leads to [[ovulation]]: the release of the now mature [[ovum]], the largest cell of the body (with a diameter of about [[1 E-4 m|0.5 mm]]). Which of the two ovaries — left or right — ovulates appears essentially random; no known left/right co-ordination exists. The [[Fallopian tube]] needs to capture the egg and provide the site for [[fertilisation]]. A characteristic clear and stringy [[mucus]] exhibiting [[spinnbarkeit]] develops at the [[cervix]], ready to accept [[sperm]] from [[intercourse]]. In some women, ovulation features a characteristic pain called ''[[Mittelschmerz]]'' (German term meaning 'middle pain') which lasts for several hours. The sudden change in hormones at the time of ovulation also causes light mid-cycle bleeding for some women. Many women perceive the vaginal and cervical mucus changes at ovulation, particularly if they are monitoring themselves for [[Fertility awareness|signs of fertility]]. An unfertilised egg will eventually disintegrate or dissolve in the uterus. Scientific investigations{{ref|threshold}} have indicated that the [[olfactory]] acuity or the sense of [[olfaction|smell]] is greatest during ovulation in women.
▲The corpus luteum is the solid body formed in the ovaries after the egg has been released from the fallopian tube which continues to grow and divide for a while. After ovulation, the residual follicle transforms into the [[corpus luteum]] under the support of the pituitary hormones. This corpus luteum will produce [[progesterone]] in addition to estrogens for approximately the next 2 weeks. Progesterone plays a vital role in converting the proliferative endometrium into a secretory lining receptive for [[implantation]] and supportive of the early [[pregnancy]]. It raises the body temperature by half- to one degree Fahrenheit (one-quarter to one-half degree Celsius), thus women who record their temperature on a daily basis will notice that they have entered the luteal phase. If fertilisation of an egg has occurred, it will travel as an early [[embryo]] through the tube to the uterine cavity and implant itself 6 to 12 days after ovulation. Shortly after implantation, the growing embryo will signal its existence to the maternal system. One very early signal consists of [[human chorionic gonadotropin]] ([[hCG]]), a hormone that [[pregnancy test]]s can measure. This signal has an important role in maintaining the corpus luteum and enabling it to continue to produce progesterone. In the absence of a pregnancy and without hCG, the corpus luteum demises and inhibin and progesterone levels fall. This will set the stage for the next cycle. Progesterone withdrawal leads to menstrual shedding (''progesterone withdrawal bleeding''), and falling inhibin levels allow FSH levels to rise to raise a new crop of follicles.
In many women, various unpleasant symptoms caused by the involved hormones and by [[cramp]]ing of the uterus can precede or accompany menstruation. More severe symptoms may include significant menstrual pain ([[dysmenorrhea]]), abdominal pain, [[migraine]] headaches, [[depression (mood)|depression]] and irritability. Some women encounter [[premenstrual stress syndrome]] (PMS or premenstrual syndrome), a cyclic clinical entity. Other women are said to suffer from what some doctors call [[post-menstrual syndrome]] where similar symptoms manifest themseleves. This is rare and is usually not as severe or as long as pre-menstrual syndrome. Breast discomfort caused by [[premenstrual water retention]] is very common. The list of symptoms experienced varies from person to person. Furthermore, within an individual, the severity of the symptoms may vary from cycle to cycle. Pharmaceutical and herbal companies provide [[#Menstrual products|products]] designed to lessen or relieve some or all of these symptoms.
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== The anovulatory menstrual cycle==
Not all menstruations result from an ovulatory menstrual cycle ([[Anovulatory cycle]] - literally 'an-' absence of 'ovulation'). In some women, follicular development may start but not complete, nevertheless estrogens will form and will stimulate the uterine lining. Sooner or later the uterus will shed this lining. As no ovulation and no progesterone involvement occurs, doctors call this type of bleeding an ''estrogen breakthrough bleeding'', and cannot always predict its duration or frequency. Anovulatory bleeding commonly occurs prior to [[menopause]] (premenopause) or in women with [[polycystic ovary syndrome]]. Infrequent or irregular ovulation is called ''oligoovulation''.-->
==Abnormalitas siklus==
{{main|Kalainan kareseban}}
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===Frequency===
The "normal menstrual cycle" occurs every 28 days ± 7 days.
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