{"id":5743,"date":"2025-09-14T05:32:48","date_gmt":"2025-09-14T05:32:48","guid":{"rendered":"https:\/\/polikistikover.net\/yeni\/?page_id=5743"},"modified":"2026-01-15T00:13:54","modified_gmt":"2026-01-15T00:13:54","slug":"polikistik-over-sendromunda-sivilce-ve-tedavisi","status":"publish","type":"page","link":"https:\/\/polikistikover.net\/yeni\/polikistik-over-sendromunda-sivilce-ve-tedavisi\/","title":{"rendered":"Polikistik Over Sendromu\u2019nda Sivilce ve Tedavisi"},"content":{"rendered":"<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-full is-resized\"><img loading=\"lazy\" decoding=\"async\" width=\"195\" height=\"220\" src=\"https:\/\/polikistikover.net\/yeni\/wp-content\/uploads\/2025\/09\/image-1.png\" alt=\"\" class=\"wp-image-5754\" style=\"width:353px;height:auto\"\/><\/figure>\n<\/div>\n\n\n<p class=\"has-text-align-center wp-embed-aspect-16-9 wp-has-aspect-ratio\"><strong><mark style=\"background-color:rgba(0, 0, 0, 0)\" class=\"has-inline-color has-dark-pink-color\">Sivilce (Akne vulgaris) deride ya\u011f bezleri ve k\u0131l k\u00f6klerinin birlikte bulundu\u011fu yap\u0131n\u0131n (pilosebaceous unit) &nbsp;iltihab\u0131d\u0131r&nbsp;(277,278,279,280,281,282,291).<\/mark><\/strong><\/p>\n\n\n\n<p class=\"has-text-align-center wp-embed-aspect-16-9 wp-has-aspect-ratio\">&nbsp;<strong><mark style=\"background-color:rgba(0, 0, 0, 0)\" class=\"has-inline-color has-dark-pink-color\">Ergenlik \u00e7a\u011f\u0131nda (adolesan d\u00f6nem)&nbsp;gen\u00e7 k\u0131zlarda erkeklik hormonlar\u0131n\u0131n \u00fcretiminin artmas\u0131na ba\u011fl\u0131 olarak 12 ya\u015f civar\u0131nda g\u00f6r\u00fclmeye ba\u015flar ve giderek \u015fiddetlenerek 15-17 ya\u015flar\u0131nda zirveye ula\u015f\u0131r(272,274). Daha sonra gerilemeye ba\u015flar ve \u00e7o\u011funlukla &nbsp;20-25 ya\u015flar\u0131ndan sonra art\u0131k bir sorun olmaktan \u00e7\u0131kar.&nbsp;Fakat, &nbsp;kad\u0131nlar\u0131n bir k\u0131sm\u0131nda 25 ya\u015f\u0131ndan sonra da akne \u015fikayeti 40&nbsp;l\u0131 ya\u015flara kadar g\u00f6r\u00fclebilmekte&nbsp;hatta daha k\u00fc\u00e7\u00fck bir k\u0131sm\u0131nda&nbsp;<\/mark><\/strong><mark style=\"background-color:rgba(0, 0, 0, 0)\" class=\"has-inline-color has-dark-pink-color\"><strong>menopoz sonras\u0131nda <\/strong><\/mark><strong><mark style=\"background-color:rgba(0, 0, 0, 0)\" class=\"has-inline-color has-dark-pink-color\">da devam etmektedir(273,275,276,285,286). <\/mark><\/strong><\/p>\n\n\n\n<p class=\"has-text-align-left wp-embed-aspect-16-9 wp-has-aspect-ratio\"><strong><mark style=\"background-color:#fd5802\" class=\"has-inline-color\">1-<\/mark><\/strong> Kad\u0131nlarda 20 li ya\u015flardan sonra g\u00f6r\u00fclen sivilcelerin b\u00fcy\u00fck \u00e7o\u011funlu\u011fu ergenlik d\u00f6neminde ba\u015flayan sivilcelerin devam\u0131 \u015feklindedir (Persistent acne).<\/p>\n\n\n\n<p class=\"has-text-align-left wp-embed-aspect-16-9 wp-has-aspect-ratio\"><strong><mark style=\"background-color:#fe5a05\" class=\"has-inline-color\"> 2-<\/mark><\/strong> 20 li ya\u015flardan sonra g\u00f6r\u00fclen sivilcelerin bir k\u0131sm\u0131 ise ergenlik d\u00f6nemi sivilcelerinin devam\u0131 olmay\u0131p ilk defa ortaya \u00e7\u0131kmaktad\u0131r (Late-onset acne)&nbsp;(273,287,288,289,290,292,293,294).<\/p>\n\n\n\n<p class=\"wp-embed-aspect-16-9 wp-has-aspect-ratio\">Sivilce g\u00f6r\u00fclen kad\u0131nlar\u0131n b\u00fcy\u00fck bir k\u0131sm\u0131nda erkeklik hormonlar\u0131 (testosteron, dihidrotestosteron) ve erkeklik hormonlar\u0131na d\u00f6n\u00fc\u015fen hammaddeler (DHEAS, androstenedione) kan dola\u015f\u0131m\u0131nda fazla miktarlarda&nbsp;(hiperandrogenemia) bulunmaktad\u0131r &nbsp;(276,295,296,297,298,299,300,301,302,303,304,307). <\/p>\n\n\n\n<p class=\"has-text-align-center wp-embed-aspect-16-9 wp-has-aspect-ratio\"><strong><mark style=\"background-color:rgba(0, 0, 0, 0)\" class=\"has-inline-color has-dark-pink-color\">8-9 ya\u015flar\u0131ndan \u00f6nce ba\u015flayan veya 20 li ya\u015flardan sonra ergenlik d\u00f6nemi sivilcelerinin devam\u0131 olan ya da ilk defa 20 li ya\u015flardan sonra ortaya \u00e7\u0131kan, a\u011f\u0131z \u00e7evresi, \u00e7ene, al\u0131n, ense, s\u0131rt ve g\u00f6\u011f\u00fcs \u00fcst\u00fc b\u00f6lgelerinde, iltihapl\u0131, tedaviye diren\u00e7li, adet kanamas\u0131 \u00f6ncesi d\u00f6nemde \u015fiddetlenen,&nbsp;t\u00fcylenme&nbsp;art\u0131\u015f\u0131,&nbsp;adet d\u00fczensizli\u011fi&nbsp;ve&nbsp;sa\u00e7 d\u00f6k\u00fclmesinin&nbsp;de e\u015flik etti\u011fi sivilceler \u00e7o\u011funlukla polikistik over sendromu olan kad\u0131nlarda g\u00f6r\u00fclmektedir(147,275,305,306,308).<\/mark><\/strong><\/p>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-full is-resized\"><img loading=\"lazy\" decoding=\"async\" width=\"768\" height=\"576\" src=\"https:\/\/polikistikover.net\/yeni\/wp-content\/uploads\/2026\/01\/image.png\" alt=\"\" class=\"wp-image-13365\" style=\"aspect-ratio:1.3333785470131843;width:640px;height:auto\" srcset=\"https:\/\/polikistikover.net\/yeni\/wp-content\/uploads\/2026\/01\/image.png 768w, https:\/\/polikistikover.net\/yeni\/wp-content\/uploads\/2026\/01\/image-300x225.png 300w\" sizes=\"auto, (max-width: 768px) 100vw, 768px\" \/><\/figure>\n<\/div>\n\n\n<p class=\"has-text-align-left wp-embed-aspect-16-9 wp-has-aspect-ratio\"><br><strong><mark style=\"background-color:#fdf204\" class=\"has-inline-color\">1-<\/mark><\/strong>Ciltte bulunan ya\u011f bezi h\u00fccrelerinde (sebocytes) ya\u011fl\u0131 bir madde (sebum) \u00fcretilmektedir(277).<\/p>\n\n\n\n<p class=\"wp-embed-aspect-16-9 wp-has-aspect-ratio\"> <strong><mark style=\"background-color:#fed905\" class=\"has-inline-color\">2-<\/mark><\/strong>Erkeklik hormonlar\u0131 (testosteron, dihidrotestosteron) ya\u011fl\u0131 maddeyi \u00fcreten h\u00fccrelerin (sebocytes) say\u0131s\u0131n\u0131 ve ya\u011fl\u0131 madde (sebum) \u00fcretimini artt\u0131rmaktad\u0131r (Seborrhea) (277,278,279,309,310). <\/p>\n\n\n\n<p class=\"wp-embed-aspect-16-9 wp-has-aspect-ratio\"><strong><mark style=\"background-color:#fff404\" class=\"has-inline-color\">3-<\/mark><\/strong>Cilt \u00fczerinde yerle\u015fmi\u015f olan (Colonization) baz\u0131 bakteriler (Propionibacterium acnes) erkeklik hormonlar\u0131n\u0131n miktar\u0131n\u0131 artt\u0131rd\u0131\u011f\u0131 bu ya\u011fl\u0131 madde (sebum) ile beslenerek \u00e7o\u011falmaktad\u0131r(278,279). <\/p>\n\n\n\n<p class=\"wp-embed-aspect-16-9 wp-has-aspect-ratio\"><strong><mark style=\"background-color:#faef04\" class=\"has-inline-color\">4-<\/mark><\/strong>\u00c7o\u011falan bakterilerin \u00fcretti\u011fi baz\u0131 maddelerin (free fatty acids) ya\u011f bezlerinde ve k\u0131l k\u00f6klerinde olu\u015fturdu\u011fu iltihabi reaksiyon sivilceye (akne) neden olmaktad\u0131r(280,281).<\/p>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-full is-resized\"><img loading=\"lazy\" decoding=\"async\" width=\"768\" height=\"576\" src=\"https:\/\/polikistikover.net\/yeni\/wp-content\/uploads\/2026\/01\/image-2.png\" alt=\"\" class=\"wp-image-13368\" style=\"aspect-ratio:1.3333785470131843;width:610px;height:auto\" srcset=\"https:\/\/polikistikover.net\/yeni\/wp-content\/uploads\/2026\/01\/image-2.png 768w, https:\/\/polikistikover.net\/yeni\/wp-content\/uploads\/2026\/01\/image-2-300x225.png 300w\" sizes=\"auto, (max-width: 768px) 100vw, 768px\" \/><\/figure>\n<\/div>\n\n\n<p class=\"has-text-align-center wp-embed-aspect-16-9 wp-has-aspect-ratio\"><strong><mark style=\"background-color:rgba(0, 0, 0, 0)\" class=\"has-inline-color has-dark-pink-color\">Erkeklik hormonlar\u0131n\u0131n (testosteron, dihidrotestosteron) b\u00fcy\u00fck bir k\u0131sm\u0131 b\u00f6brek \u00fcst\u00fc bezinde (Adrenal Gland) \u00fcretilen DHEA (Dehydroepiandrosterone) ve Androstenedione hormonlar\u0131n\u0131 hammadde olarak kullanarak k\u0131l k\u00f6kleri ve ya\u011f bezlerinin bulundu\u011fu deri gibi ayn\u0131 zamanda erkeklik hormonlar\u0131n\u0131n (testosteron, dihidrotestosteron) hedefi olan organlarda&nbsp;\u00fcretilirken ancak k\u00fc\u00e7\u00fck bir k\u0131sm\u0131 yumurtal\u0131k ve b\u00f6brek \u00fcst\u00fc bezinde \u00fcretilmektedir&nbsp;(Intracrinology)119,120,311,312).<\/mark><\/strong><\/p>\n\n\n\n<p class=\"has-text-align-center wp-embed-aspect-16-9 wp-has-aspect-ratio\"><strong><mark style=\"background-color:rgba(0, 0, 0, 0)\" class=\"has-inline-color has-dark-pink-color\">Kan dola\u015f\u0131m\u0131nda bulunan testosteron miktar\u0131 sadece yumurtal\u0131k ve b\u00f6brek \u00fcst\u00fc bezinden do\u011frudan sal\u0131nan miktar\u0131 g\u00f6stermektedir.<\/mark><\/strong><\/p>\n\n\n\n<p class=\"has-text-align-center wp-embed-aspect-16-9 wp-has-aspect-ratio\"><strong><mark style=\"background-color:rgba(0, 0, 0, 0)\" class=\"has-inline-color has-dark-pink-color\">Kad\u0131nlarda testosteron hormonunun b\u00fcy\u00fck k\u0131sm\u0131&nbsp;\u00fcretildi\u011fi deri, ya\u011f dokusu, meme gibi organlarda kalmaktad\u0131r. Ancak k\u00fc\u00e7\u00fck bir miktar (%10) testosteron kan dola\u015f\u0131m\u0131na girmektedir(121).<\/mark><\/strong><\/p>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-full is-resized\"><img loading=\"lazy\" decoding=\"async\" width=\"768\" height=\"576\" src=\"https:\/\/polikistikover.net\/yeni\/wp-content\/uploads\/2026\/01\/image-3.png\" alt=\"\" class=\"wp-image-13372\" style=\"aspect-ratio:1.3333785470131843;width:693px;height:auto\" srcset=\"https:\/\/polikistikover.net\/yeni\/wp-content\/uploads\/2026\/01\/image-3.png 768w, https:\/\/polikistikover.net\/yeni\/wp-content\/uploads\/2026\/01\/image-3-300x225.png 300w\" sizes=\"auto, (max-width: 768px) 100vw, 768px\" \/><\/figure>\n<\/div>\n\n\n<p><\/p>\n\n\n\n<p class=\"has-text-align-center wp-embed-aspect-16-9 wp-has-aspect-ratio\"><strong><mark style=\"background-color:rgba(0, 0, 0, 0)\" class=\"has-inline-color has-dark-pink-color\">Kan dola\u015f\u0131m\u0131na girmeyen testosteron hormonunun b\u00fcy\u00fck \u00e7o\u011funlu\u011fu ise 5-&nbsp;\u03b1 reduktaz (reductase) enzimi taraf\u0131ndan testosteron hormonundan 10 kat daha g\u00fc\u00e7l\u00fc bir etkiye sahip olan dihidrotestosteron (dhydrotestosterone) hormonuna d\u00f6n\u00fc\u015fmektedir&nbsp;(119,122,123,124,125).<\/mark><\/strong><\/p>\n\n\n\n<p class=\"wp-embed-aspect-16-9 wp-has-aspect-ratio\"><strong><mark style=\"background-color:#f7fd04\" class=\"has-inline-color\">1- <\/mark><\/strong>Dihidrotestosteron hormonunun etkili olabilmesi i\u00e7in ilk olarak erkeklik hormonu al\u0131c\u0131s\u0131na (androgen receptor) tutunmas\u0131 gerekmektedir(309,310,315).<\/p>\n\n\n\n<p class=\"wp-embed-aspect-16-9 wp-has-aspect-ratio\"><strong><mark style=\"background-color:#faef01\" class=\"has-inline-color\">2-<\/mark><\/strong> Erkeklik hormonu al\u0131c\u0131lar\u0131 deride en \u00e7ok ya\u011f bezlerinde (sebaceous glands), k\u0131l k\u00f6klerinde (dermal papilla) ve ter bezlerinde bulunmaktad\u0131r(129,130,131).<\/p>\n\n\n\n<p class=\"wp-embed-aspect-16-9 wp-has-aspect-ratio\"><strong><mark style=\"background-color:#fbd704\" class=\"has-inline-color\">3-<\/mark><\/strong> Polikistik over sendromu olan kad\u0131nlar\u0131n bir k\u0131sm\u0131nda erkeklik hormonu al\u0131c\u0131s\u0131 (androgen receptor) \u00fcretimini sa\u011flayan genin (Androgen receptor gene) belirli b\u00f6lgelerinde (polymorphism of glutamine repeats in exon 1) genetik farkl\u0131l\u0131klar (variant)&nbsp;vard\u0131r(324,325). Bu genetik de\u011fi\u015fiklikler erkeklik hormonu al\u0131c\u0131lar\u0131n\u0131n etkinli\u011fini (transcritional activity) artt\u0131rarak sivilce olu\u015fumuna neden olmaktad\u0131r(324,325).<\/p>\n\n\n\n<p class=\"wp-embed-aspect-16-9 wp-has-aspect-ratio\"><strong><mark style=\"background-color:#fad605\" class=\"has-inline-color\">4-<\/mark><\/strong> 5-&nbsp;\u03b1 reduktaz (reductase) enziminin 2 formu (isozyme) vard\u0131r(313,314).&nbsp;5-&nbsp;\u03b1 reduktaz (reductase) tip 1 en \u00e7ok deri h\u00fccresinde (epidermis), k\u0131l k\u00f6klerinde, ya\u011f (sebaceous) bezlerinde ve ter bezlerinde bulunmaktad\u0131r(124,313,314).<\/p>\n\n\n\n<p class=\"wp-embed-aspect-16-9 wp-has-aspect-ratio\"><strong><mark style=\"background-color:#f6f305\" class=\"has-inline-color\">5-<\/mark><\/strong> Ya\u011f bezlerinin say\u0131s\u0131n\u0131 ve ya\u011fl\u0131 madde (sebum) \u00fcretimini artt\u0131rarak&nbsp;(proliferasyon) sivilce olu\u015fumuna neden olan dihidrotestosteron hormonunu \u00fcreten 5-&nbsp;\u03b1 reduktaz (reductase) enzimi sivilce \u00e7\u0131kma e\u011filimi olan y\u00fcz gibi b\u00f6lgelerde&nbsp;sivilce \u00e7\u0131kma e\u011filimi olmayan b\u00f6lgelere g\u00f6re \u00e7ok daha etkin&nbsp;(aktif) \u00e7al\u0131\u015fmaktad\u0131r(315). Bu nedenle sivilce \u00e7\u0131kma e\u011filimi olan b\u00f6lgelerde dihidrotestosteron daha fazla miktarda \u00fcretilmektedir(315).<\/p>\n\n\n\n<p class=\"wp-embed-aspect-16-9 wp-has-aspect-ratio\"> <strong><mark style=\"background-color:#fbdf04\" class=\"has-inline-color\">6-<\/mark><\/strong> 5-&nbsp;\u03b1 reduktaz (reductase) enziminin etkinli\u011finde (activity) b\u00fcy\u00fck oranda anneden k\u0131z\u0131na genetik&nbsp;ge\u00e7i\u015f bulunmaktad\u0131r(315).&nbsp;Polikistik over sendromu olan kad\u0131nlar\u0131n bir k\u0131sm\u0131nda&nbsp;&nbsp;5-&nbsp;\u03b1 reduktaz (reductase) tip 1 enziminin \u00fcretimini sa\u011flayan SRD5A1 geninin belirli b\u00f6lgelerinde genetik farkl\u0131l\u0131klar (variant)&nbsp;vard\u0131r. Bu genetik de\u011fi\u015fiklikler&nbsp;5-&nbsp;\u03b1 reduktaz (reductase) tip 1 enziminin etkinli\u011fini (activity) artt\u0131rarak sivilce olu\u015fumuna&nbsp;etki etmektedir(321,322,323).<\/p>\n\n\n\n<p class=\"wp-embed-aspect-16-9 wp-has-aspect-ratio\"><strong><mark style=\"background-color:#ffd205\" class=\"has-inline-color\">7-<\/mark><\/strong> Dihidrotestosteron hormonunun da testosteron hormonu gibi b\u00fcy\u00fck \u00e7o\u011funlu\u011fu (%90) kan dola\u015f\u0131m\u0131na girmemektedir. Kan dola\u015f\u0131m\u0131na girmeyen dihidrotestosteron hormonu \u00fcretildi\u011fi deri h\u00fccresinde bulunan ya\u011f bezleri ve k\u0131l k\u00f6klerinde sivilce olu\u015fumuna&nbsp;neden olmaktad\u0131r&nbsp;(123,317).<\/p>\n\n\n\n<p class=\"wp-embed-aspect-16-9 wp-has-aspect-ratio\">&nbsp;<strong><mark style=\"background-color:#fdf207\" class=\"has-inline-color\">8-<\/mark><\/strong> Deride (cilt) \u00fcretilen&nbsp;dihidrotestosteron (DHT) hormonunun b\u00fcy\u00fck \u00e7o\u011funlu\u011fu deri h\u00fccresini testosteron hormonundan korumak amac\u0131yla&nbsp;UGT- enzimi ile herhangi bir hormon etkisi olmayan \u00fcr\u00fcnler&nbsp;(metabolit) olan 3&nbsp;\u03b1- androstanediol glucuronide (3\u03b1 diol G) ve androsterone Glucuronide (ADT-G) d\u00f6n\u00fc\u015ferek deri h\u00fccresinden kan dola\u015f\u0131m\u0131na girmektedir(317,318,319,320). Kan dola\u015f\u0131m\u0131na kat\u0131lan 3&nbsp;\u03b1- androstanediol glucuronide (3\u03b1 diol G) ve androsterone Glucuronide (ADT-G) idrar yolu ile v\u00fccuttan at\u0131lmaktad\u0131r(317,318,319,320).<\/p>\n\n\n\n<p class=\"wp-embed-aspect-16-9 wp-has-aspect-ratio\"><em><strong>Erkeklik hormonlar\u0131 (androgens) testosteron ve DHT (dihidrotestosteron) (dihydrotestosterone), erkeklik hormonlar\u0131n\u0131n hammaddesi DHEA (dehidroepiandrosteron)(dehydrotestosterone) ve erkeklik hormonlar\u0131n\u0131n y\u0131k\u0131m \u00fcr\u00fcnlerinin ADT-G (androsterone glucuronide) ve 3 \u03b1-diol-G ( 3 \u03b1-androstanediol glucuronide) kan dola\u015f\u0131m\u0131nda ve h\u00fccre i\u00e7inde (deri k\u0131l k\u00f6kleri ve ya\u011f bezleri) bulunan miktarlar\u0131n\u0131n da\u011f\u0131l\u0131m\u0131. Testosteron ve Dihidrotestosteron hormonlar\u0131n\u0131 g\u00f6steren mavi ve sar\u0131 dikd\u00f6rtgenlerin y\u00fckseklikleri bu maddelerin miktarlar\u0131 ile orant\u0131l\u0131d\u0131r.<\/strong><\/em><\/p>\n\n\n\n<p class=\"has-text-align-center wp-embed-aspect-16-9 wp-has-aspect-ratio\"><br><strong><mark style=\"background-color:rgba(0, 0, 0, 0)\" class=\"has-inline-color has-dark-pink-color\">Sivilce \u015fikayeti olmas\u0131na ra\u011fmen polikistik over sendromu olan kad\u0131nlar\u0131n bir k\u0131sm\u0131nda kan dola\u015f\u0131m\u0131nda erkeklik hormonlar\u0131 (testosteron ve dihidrotestosteron) normal seviyelerde bulunmaktad\u0131r. <\/mark><\/strong><\/p>\n\n\n\n<p class=\"has-text-align-center wp-embed-aspect-16-9 wp-has-aspect-ratio\"><strong><mark style=\"background-color:rgba(0, 0, 0, 0)\" class=\"has-inline-color has-dark-pink-color\">Ayn\u0131 zamanda kan dola\u015f\u0131m\u0131nda bulunan erkeklik hormonlar\u0131n\u0131n miktarlar\u0131 sivilcenin \u015fiddetiyle paralel olarak da de\u011fi\u015fmemektedir<\/mark><\/strong>;<\/p>\n\n\n\n<p class=\"wp-embed-aspect-16-9 wp-has-aspect-ratio\"><strong><mark style=\"background-color:#fa0202\" class=\"has-inline-color\">1-<\/mark><mark style=\"background-color:rgba(0, 0, 0, 0)\" class=\"has-inline-color has-dark-pink-color\">Bunun bir nedeni erkeklik&nbsp;hormonlar\u0131n\u0131n b\u00fcy\u00fck bir k\u0131sm\u0131n\u0131n kan dola\u015f\u0131m\u0131na girmeden ciltte ya\u011f bezi h\u00fccrelerinde \u00fcretilmesidir. <\/mark><\/strong><\/p>\n\n\n\n<p class=\"wp-embed-aspect-16-9 wp-has-aspect-ratio\"><strong><mark style=\"background-color:#fd0202\" class=\"has-inline-color\">2-<\/mark><mark style=\"background-color:rgba(0, 0, 0, 0)\" class=\"has-inline-color has-dark-pink-color\">Di\u011fer bir nedeni de bu kad\u0131nlar\u0131n bir k\u0131sm\u0131nda dihidrotestosteron hormonunu \u00fcreten 5-&nbsp;\u03b1 reduktaz (reductase) enziminin etkinli\u011finin (activity) artm\u0131\u015f olmas\u0131d\u0131r.&nbsp;Polikistik over sendromu\u2019nda erkeklik hormonlar\u0131n\u0131n miktar\u0131ndaki art\u0131\u015f\u0131 ve sivilce \u015fikayetini&nbsp;de\u011ferlendirirken yukar\u0131da anlatt\u0131\u011f\u0131m buz da\u011f\u0131n\u0131n g\u00f6r\u00fcnmeyen k\u0131sm\u0131n\u0131n da olabilece\u011fini unutmamal\u0131y\u0131z.<\/mark><\/strong><\/p>\n\n\n\n<p class=\"has-text-align-center wp-embed-aspect-16-9 wp-has-aspect-ratio\"><strong>TEDAV\u0130;<\/strong><\/p>\n\n\n\n<p class=\"has-text-align-center wp-embed-aspect-16-9 wp-has-aspect-ratio\"><mark style=\"background-color:rgba(0, 0, 0, 0)\" class=\"has-inline-color has-dark-color\"><strong>A vitamini&nbsp;(Retinoik asit)&nbsp;benzeri&nbsp;maddeler&nbsp;i\u00e7eren ila\u00e7lar<\/strong>;<\/mark><\/p>\n\n\n\n<p class=\"has-text-align-left wp-embed-aspect-16-9 wp-has-aspect-ratio\"><strong><mark style=\"background-color:#fb7204\" class=\"has-inline-color\">1-<\/mark><mark style=\"background-color:rgba(0, 0, 0, 0)\" class=\"has-inline-color has-dark-pink-color\"><a href=\"http:\/\/polycysticovary.net\/Duyuru\/oral-contraceptives-and-polycystic-ovary-syndrome\">&nbsp;<\/a><\/mark><\/strong><mark style=\"background-color:rgba(0, 0, 0, 0)\" class=\"has-inline-color has-dark-color\">Polikistik over sendromu olan kad\u0131nlarda altta yatan sorunu&nbsp;tedavi etmemektedir(329,330,331,332,333).<\/mark><\/p>\n\n\n\n<p class=\"has-text-align-left wp-embed-aspect-16-9 wp-has-aspect-ratio\"><strong><mark style=\"background-color:#fe6407\" class=\"has-inline-color has-dark-color\">2-<\/mark><mark style=\"background-color:rgba(0, 0, 0, 0)\" class=\"has-inline-color has-dark-pink-color\"> <\/mark><\/strong><mark style=\"background-color:rgba(0, 0, 0, 0)\" class=\"has-inline-color has-dark-color\">Depresyon ve intihar giri\u015fimi gibi hayati tehlikesi olan yan etkilere sahip olmas\u0131na&nbsp;ra\u011fmen polikistik over sendromu\u2019nda&nbsp;sivilce tedavisi amac\u0131yla&nbsp;halen yayg\u0131n olarak kullan\u0131lmaktad\u0131r(334). <\/mark><\/p>\n\n\n\n<p class=\"has-text-align-center wp-embed-aspect-16-9 wp-has-aspect-ratio\"><strong><mark style=\"background-color:rgba(0, 0, 0, 0)\" class=\"has-inline-color has-dark-pink-color\">Polikistik over sendromu olan kad\u0131nlarda A vitamini benzeri ila\u00e7larla&nbsp;yap\u0131lan tedavi sivilce \u015fikayetinde ge\u00e7ici bir iyile\u015fme sa\u011flamakla birlikte, bu ki\u015filerde sivilce \u015fikayeti \u00e7o\u011funlukla bir s\u00fcre sonra tekrarlamaktad\u0131r(329,330,331,332,333). Bu durum&nbsp;hamilelik d\u00f6neminde ve hatta hamile kalmadan belirli bir s\u00fcre \u00f6nce kullan\u0131ld\u0131\u011f\u0131nda bebekte ciddi sorunlara (teratojen) yol a\u00e7abilen ve&nbsp;uzun y\u0131llar kullanan kad\u0131nlarda erken menopoz\u2018a&nbsp;neden olabilen bu ila\u00e7lar\u0131n&nbsp;genellikle tekrar tekrar, d\u00fczensiz bir \u015fekilde kullan\u0131lmas\u0131na neden olmaktad\u0131r(326,327,328).<\/mark><\/strong><\/p>\n\n\n\n<figure class=\"wp-block-embed is-type-rich is-provider-embed-handler wp-block-embed-embed-handler wp-embed-aspect-16-9 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\n<iframe loading=\"lazy\" title=\"#polikistikover #sivilce #sivilcetedavisi #tekrarlayansivilceler #akne #polikistikovertedavisi\" width=\"1320\" height=\"743\" src=\"https:\/\/www.youtube.com\/embed\/HAmx220gnkQ?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<\/div><\/figure>\n\n\n\n<p class=\"has-text-align-center wp-embed-aspect-16-9 wp-has-aspect-ratio\"><mark style=\"background-color:rgba(0, 0, 0, 0)\" class=\"has-inline-color has-dark-pink-color\"><strong>A vitamini (Retinoik asit) benzeri ila\u00e7lar\u0131n&nbsp;polikistik over sendromu olan kad\u0131nlarda sivilce tedavisinin kal\u0131c\u0131 olmas\u0131 i\u00e7in altta yatan hormonal sorunun tedavisi yap\u0131lmadan \u00f6nce kullan\u0131lmas\u0131 do\u011fru de\u011fildir.<\/strong><\/mark><\/p>\n\n\n\n<figure class=\"wp-block-embed is-type-rich is-provider-embed-handler wp-block-embed-embed-handler wp-embed-aspect-16-9 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\n<iframe loading=\"lazy\" title=\"#polikistikover #sivilce #sivilcetedavisi #akne #do\u011fumkontrolhaplar\u0131 #aknetekrar\u0131 #avitaminitedavisi\" width=\"1320\" height=\"743\" src=\"https:\/\/www.youtube.com\/embed\/t8Vmom0Hrik?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<\/div><\/figure>\n\n\n\n<p class=\"has-text-align-center wp-embed-aspect-16-9 wp-has-aspect-ratio\"><mark style=\"background-color:rgba(0, 0, 0, 0)\" class=\"has-inline-color has-dark-color\"><strong>Do\u011fum kontrol haplar\u0131<\/strong>;<\/mark><\/p>\n\n\n\n<p class=\"wp-embed-aspect-16-9 wp-has-aspect-ratio\">Uzun etkili ve kal\u0131c\u0131 bir tedavi etkinli\u011finin olmamas\u0131na ve bacak damarlar\u0131n\u0131n p\u0131ht\u0131 ile t\u0131kanmas\u0131 (derin ven trombozu) ve ordan kopan p\u0131ht\u0131 par\u00e7as\u0131n\u0131n da akci\u011fer damarlar\u0131n\u0131 t\u0131kamas\u0131 (pulmoner embol<strong>i<\/strong>) ve&nbsp;meme kanseri&nbsp;ihtimalini artt\u0131rmas\u0131 gibi bir k\u0131sm\u0131 hayati tehlikeye sahip olan bir \u00e7ok yan etkiye sahip olmas\u0131na ra\u011fmen do\u011fum kontrol haplar\u0131 sivilce&nbsp;tedavisinde halen yayg\u0131n olarak kullan\u0131lmaktad\u0131r(335,336,337,338,339,340,341,342).<\/p>\n\n\n\n<p class=\"has-text-align-center wp-embed-aspect-16-9 wp-has-aspect-ratio\"><mark style=\"background-color:rgba(0, 0, 0, 0)\" class=\"has-inline-color has-dark-pink-color\"><strong>Polikistik over sendromu\u2019nda sivilce tedavisinde<\/strong>&nbsp;<strong>do\u011fum kontrol hap\u0131 kullan\u0131lmas\u0131&nbsp;do\u011fru de\u011fildir.<\/strong><\/mark><\/p>\n\n\n\n<p class=\"has-text-align-center wp-embed-aspect-16-9 wp-has-aspect-ratio\"><strong>Tedavi Y\u00f6ntemleri;<\/strong><\/p>\n\n\n\n<p class=\"has-text-align-center wp-embed-aspect-16-9 wp-has-aspect-ratio\"><strong><mark style=\"background-color:rgba(0, 0, 0, 0)\" class=\"has-inline-color has-dark-pink-color\">Polikistik over sendromu\u2019nda&nbsp;sivilce&nbsp;tedavisinde en g\u00fc\u00e7l\u00fc erkeklik hormonu olan&nbsp;dihidrotestosteron hormonuna d\u00f6n\u00fc\u015fen erkeklik hormonlar\u0131n\u0131n (testosteron, androstenedione, DHEAS) etkinli\u011finin ve miktar\u0131n\u0131n azalt\u0131lmas\u0131,&nbsp;dihidrotestosteron&nbsp;hormonuna d\u00f6n\u00fc\u015f\u00fcm\u00fcn azalt\u0131lmas\u0131 ve&nbsp;Sex Hormon Binding Globulin&nbsp;miktar\u0131n\u0131n artt\u0131r\u0131lmas\u0131 sonucunda kan dola\u015f\u0131m\u0131nda serbest bulunan erkeklik hormonlar\u0131n\u0131n etkin&nbsp;formlar\u0131n\u0131n (serbest testosteron) miktar\u0131n\u0131n azalt\u0131lmas\u0131&nbsp;tedavinin temel amac\u0131d\u0131r.<\/mark><\/strong><\/p>\n\n\n\n<p class=\"wp-embed-aspect-16-9 wp-has-aspect-ratio\"><strong><mark style=\"background-color:#fe0101\" class=\"has-inline-color\">1-<\/mark><\/strong>\u0130ns\u00fclin direnci&nbsp;olan kad\u0131nlarda ins\u00fclin duyarl\u0131l\u0131\u011f\u0131n\u0131n ila\u00e7 tedavisi ile artt\u0131r\u0131lmas\u0131na ba\u011fl\u0131 olarak kan dola\u015f\u0131m\u0131nda bulunan ins\u00fclin miktar\u0131n\u0131n azalmas\u0131 yumurtal\u0131kta fazla miktarda \u00fcretilen erkeklik hormonlar\u0131n\u0131 (androstenedione, testosteron) azaltmaktad\u0131r(343,344). \u0130ns\u00fclin direncinin azalmas\u0131 ayn\u0131 zamanda karaci\u011ferde \u00fcretilen SHBG miktar\u0131n\u0131 artt\u0131rmakta ve erkeklik hormonlar\u0131n\u0131n serbest dola\u015fan etkin formlar\u0131n\u0131n (serbest testosteron ) miktar\u0131n\u0131n azalmas\u0131na neden olmaktad\u0131r(343,344).<\/p>\n\n\n\n<p class=\"wp-embed-aspect-16-9 wp-has-aspect-ratio\"><strong><mark style=\"background-color:#fa0101\" class=\"has-inline-color\">2-<\/mark><\/strong>Kan dola\u015f\u0131m\u0131nda bulunan erkeklik hormonlar\u0131n\u0131n bir k\u0131sm\u0131 ciltte ya\u011f bezlerinde&nbsp;al\u0131c\u0131lara (androgen receptor)&nbsp;tutunarak sivilce olu\u015fumuna&nbsp;neden olmaktad\u0131r. Erkeklik hormonlar\u0131n\u0131n&nbsp;ya\u011f bezlerindeki al\u0131c\u0131lara tutunmas\u0131n\u0131n engellenmesi (androgen receptor antagonist) di\u011fer&nbsp;bir tedavi se\u00e7ene\u011fidir(345,346,347,348).&nbsp;Bu ama\u00e7la&nbsp;kullan\u0131lan ila\u00e7lar\u0131n (androgen receptor antagonist) do\u011fum kontrol haplar\u0131 gibi hayati tehlikeye sahip yan etkileri (&nbsp;bacak damarlar\u0131n\u0131n p\u0131ht\u0131 ile t\u0131kanmas\u0131&nbsp;ve ordan kopan p\u0131ht\u0131 par\u00e7as\u0131n\u0131n da akci\u011fer damarlar\u0131n\u0131 t\u0131kamas\u0131 ve meme kanseri) yoktur(353,354,355).<\/p>\n\n\n\n<p class=\"wp-embed-aspect-16-9 wp-has-aspect-ratio\"><strong><mark style=\"background-color:#ff0404\" class=\"has-inline-color\">3-<\/mark><\/strong>Al\u0131c\u0131lara (receptor) tutunarak deri h\u00fccresine giren testosteron ile deri h\u00fccresinde \u00fcretilen testosteron hormonunun b\u00fcy\u00fck \u00e7o\u011funlu\u011fu 5-&nbsp;\u03b1 reduktaz (reductase) enzimi taraf\u0131ndan ya\u011f bezlerinde sivilce olu\u015fumuna&nbsp;neden olan dihidrotestosteron (dhydrotestosterone) hormonuna d\u00f6n\u00fc\u015fmektedir(122,123,124,315).&nbsp;5-&nbsp;\u03b1 reduktaz (reductase)enziminin bu etkisinin engellenmesi ( 5-&nbsp;\u03b1 &nbsp;reductase inhibitor) de bir tedavi se\u00e7ene\u011fidir(122,123,124,315,349).&nbsp;Bu ama\u00e7la&nbsp;kullan\u0131lan ila\u00e7lar\u0131n ( 5-&nbsp;\u03b1 reductase inhibitor) do\u011fum kontrol haplar\u0131 gibi hayati tehlikeye sahip yan etkileri (&nbsp;bacak damarlar\u0131n\u0131n p\u0131ht\u0131 ile t\u0131kanmas\u0131&nbsp;ve ordan kopan p\u0131ht\u0131 par\u00e7as\u0131n\u0131n da akci\u011fer damarlar\u0131n\u0131 t\u0131kamas\u0131 ve meme kanseri) yoktur(356).<\/p>\n\n\n\n<p class=\"wp-embed-aspect-16-9 wp-has-aspect-ratio\"><strong><mark style=\"background-color:#fb0808\" class=\"has-inline-color\">4-<\/mark><\/strong>Polikistik over ameliyat\u0131&nbsp;yumurtal\u0131klarda \u00fcretilen erkeklik hormonlar\u0131n\u0131n (testosteron, dihidrotestosteron) miktar\u0131n\u0131 azaltarak etki g\u00f6steren bir tedavi se\u00e7ene\u011fidir(350,351,352). Polikistik over sendromu\u2019nda yumurtal\u0131klarda \u00fcretilen erkeklik hormonlar\u0131n\u0131n (testosteron gibi) b\u00fcy\u00fck bir k\u0131sm\u0131 yumurtal\u0131klar\u0131n d\u0131\u015f k\u0131sm\u0131nda (korteks) \u00fcretilmektedir(87,149). Polikistik over sendromu tedavisi i\u00e7in yap\u0131lan ameliyatla (laparoskopik ovarian drilling) g\u00f6bek deli\u011finin alt\u0131ndan 0.5 cm lik bir a\u00e7\u0131kl\u0131ktan kamera yard\u0131m\u0131 ile tespit edilen yumurtal\u0131klar\u0131n d\u0131\u015f k\u0131sm\u0131na (korteks) elektrik ak\u0131m\u0131 (elektrokoter) veya lazer ile 4 mm \u00e7ap\u0131nda ve 8 mm derinli\u011finde 5-10 adet k\u00fc\u00e7\u00fck delik a\u00e7\u0131larak erkeklik hormonlar\u0131n\u0131n \u00fcretimi ve etkinli\u011fi azalt\u0131l\u0131r(87,149,357).<\/p>\n\n\n\n<p class=\"wp-embed-aspect-16-9 wp-has-aspect-ratio\"><strong><mark style=\"background-color:#fb0b02\" class=\"has-inline-color\">5-<\/mark><\/strong>Polikistik over sendromunda sivilce tedavisinde kullan\u0131lan bitkiler;&nbsp;Polikistik over sendromu olan kad\u0131nlar\u0131n b\u00fcy\u00fck bir k\u0131sm\u0131 (%90) kulland\u0131klar\u0131 ila\u00e7lardan memnun olmay\u0131p, bu ila\u00e7lar\u0131n d\u0131\u015f\u0131nda ba\u015fka bir tedavi kullanmay\u0131 istemektedir. Bu kad\u0131nlar\u0131n \u00e7o\u011funlu\u011fu (%70) da bitkisel tedavi kullanmaktad\u0131r(16,17,18).<\/p>\n\n\n\n<p class=\"has-text-align-center wp-embed-aspect-16-9 wp-has-aspect-ratio\"><strong><mark style=\"background-color:rgba(0, 0, 0, 0)\" class=\"has-inline-color has-dark-pink-color\">Polikistik over sendromu tedavisinde uzun zamandan beri kullan\u0131lan \u00e7ok say\u0131da bitki vard\u0131r. Bu bitkilerin bir k\u0131sm\u0131n\u0131n etkili oldu\u011fu bilimsel \u00e7al\u0131\u015fmalar ile g\u00f6sterilmi\u015ftir.<\/mark><\/strong><\/p>\n\n\n\n<p class=\"wp-embed-aspect-16-9 wp-has-aspect-ratio\"><mark style=\"background-color:rgba(0, 0, 0, 0)\" class=\"has-inline-color has-dark-pink-color\"><strong>Bu bitkiler ki\u015fide g\u00f6r\u00fclen belirtilere, muayene bulgular\u0131na, hormon d\u00fczeylerine ve hastal\u0131k ge\u00e7mi\u015fine g\u00f6re yard\u0131mc\u0131 tedavi amac\u0131yla kullan\u0131lmaktad\u0131r. Herkese uygulanan standart bir tedavi re\u00e7etesi yoktur. Bilin\u00e7sizce ve rastgele kullan\u0131lmalar\u0131 fayda sa\u011flamak yerine tehlikeli olabilmektedir.<\/strong><\/mark><\/p>\n\n\n\n<p class=\"wp-embed-aspect-16-9 wp-has-aspect-ratio\"><strong>Polikistik over sendromu tedavisinde kullan\u0131lan bitkileri laboratuvar deneyleri, hayvan \u00e7al\u0131\u015fmalar\u0131 ve insanlarda yap\u0131lan klinik \u00e7al\u0131\u015fmalar sonucunda etki mekanizmalar\u0131na g\u00f6re 3 gruba ay\u0131rabiliriz;<\/strong><\/p>\n\n\n\n<p class=\"has-text-align-center wp-embed-aspect-16-9 wp-has-aspect-ratio\"><strong><mark style=\"background-color:#f9de05\" class=\"has-inline-color\">A-grubu<\/mark><\/strong><\/p>\n\n\n\n<p class=\"has-text-align-center wp-embed-aspect-16-9 wp-has-aspect-ratio\"><strong>&nbsp;\u0130ns\u00fclin direncine kar\u015f\u0131 duyarl\u0131l\u0131\u011f\u0131 artt\u0131rarak etki g\u00f6steren bitkiler&nbsp;(Tablo-1);<\/strong><\/p>\n\n\n\n<p class=\"wp-embed-aspect-16-9 wp-has-aspect-ratio\">&nbsp;Polikistik over sendromu\u2019nda fazla kilolu ve \u015fi\u015fman olan veya normal kilolu fakat bel \u00e7evresi kal\u0131n (erkek tipi ya\u011flanma) olan kad\u0131nlar\u0131n b\u00fcy\u00fck \u00e7o\u011funlu\u011funda ins\u00fclin direnci g\u00f6r\u00fclmektedir(61,62,63,64). \u0130ns\u00fclin direncinin ilerlemesi, k\u00f6t\u00fcye gitmesi sonucunda bozulmu\u015f glukoz (\u015feker) tolerans\u0131 ve \u015feker hastal\u0131\u011f\u0131 (Diabetes mellitus) geli\u015fmektedir.&nbsp;(65,66,67,68,69,70,71). Polikistik over sendromu olan kad\u0131nlarda genellikle ins\u00fclin direnci daha h\u0131zl\u0131 bir \u015fekilde ilerledi\u011fi, k\u00f6t\u00fcye gitti\u011fi i\u00e7in bozulmu\u015f \u015feker tolerans\u0131 ve \u015feker hastal\u0131\u011f\u0131 ergenlik (adolesan) d\u00f6neminden itibaren daha gen\u00e7 ya\u015flarda ortaya \u00e7\u0131kmaktad\u0131r(68,69,72).<\/p>\n\n\n\n<p class=\"has-text-align-center wp-embed-aspect-16-9 wp-has-aspect-ratio\"><strong>Tablo-1<\/strong><\/p>\n\n\n\n<p class=\"has-text-align-center wp-embed-aspect-16-9 wp-has-aspect-ratio\"><strong>\u0130ns\u00fclin direncine kar\u015f\u0131 duyarl\u0131l\u0131\u011f\u0131 artt\u0131rarak etki g\u00f6steren bitkiler;<\/strong><\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"576\" src=\"https:\/\/polikistikover.net\/yeni\/wp-content\/uploads\/2025\/09\/image-41-1024x576.png\" alt=\"\" class=\"wp-image-6526\" srcset=\"https:\/\/polikistikover.net\/yeni\/wp-content\/uploads\/2025\/09\/image-41-1024x576.png 1024w, https:\/\/polikistikover.net\/yeni\/wp-content\/uploads\/2025\/09\/image-41-300x169.png 300w, https:\/\/polikistikover.net\/yeni\/wp-content\/uploads\/2025\/09\/image-41-768x432.png 768w, https:\/\/polikistikover.net\/yeni\/wp-content\/uploads\/2025\/09\/image-41.png 1280w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><\/figure>\n\n\n\n<p class=\"wp-embed-aspect-16-9 wp-has-aspect-ratio\"><strong><mark style=\"background-color:#fdd004\" class=\"has-inline-color\">A1\u2013<\/mark><\/strong>&nbsp;\u0130ns\u00fclin direnci nedeniyle kan dola\u015f\u0131m\u0131nda fazla miktarda bulunan ins\u00fclin hormonu polikistik over sendromu olan kad\u0131nlar\u0131n bir k\u0131sm\u0131nda hem do\u011frudan yumurtal\u0131\u011fa giderek hem de hipofiz bezinde LH (luteinizing hormon) \u00fcretimini artt\u0131rarak olgun folik\u00fcl (preovulatory) (dominant) olu\u015fumunu ve takiben yumurtlamay\u0131 (ovulation) engellemektedir(73,74). Bunun sonucunda adet kanamalar\u0131 35 g\u00fcn ile 3 ay aras\u0131nda de\u011fi\u015fen aral\u0131klarla (oligomenorrhea) veya 3 aydan daha uzun aral\u0131klarla (amenorrhea) olanlarda adet kanamalar\u0131 21 ila 35 g\u00fcnde bir (eumenorrhea) olanlara g\u00f6re ins\u00fclin direnci ve \u015feker hastal\u0131\u011f\u0131 (diabetes mellitus ) daha s\u0131k g\u00f6r\u00fclmektedir(75,76,77,78,79).<\/p>\n\n\n\n<p class=\"wp-embed-aspect-16-9 wp-has-aspect-ratio\"><strong><mark style=\"background-color:#fdda0f\" class=\"has-inline-color\">A2-<\/mark><\/strong>&nbsp;Kan dola\u015f\u0131m\u0131nda fazla miktarda bulunan \u0130ns\u00fclin hormonu do\u011frudan yumurtal\u0131\u011fa giderek yumurtal\u0131kta erkeklik hormonlar\u0131n\u0131n \u00fcretimini artt\u0131rmaktad\u0131r&nbsp;(80,81,82,83,84,85). Erkeklik hormonlar\u0131n\u0131n \u00fcretiminin artmas\u0131 (hiperandrogenism) nedeniyle bu kad\u0131nlarda t\u00fcylenme art\u0131\u015f\u0131, sivilce ve sa\u00e7 d\u00f6k\u00fclmesi g\u00f6r\u00fclmektedir.<\/p>\n\n\n\n<p class=\"wp-embed-aspect-16-9 wp-has-aspect-ratio\"><mark style=\"background-color:#fbf904\" class=\"has-inline-color\"><strong>A3-<\/strong>&nbsp;<\/mark>Kan dola\u015f\u0131m\u0131nda fazla miktarda bulunan ins\u00fclin hormonu beyinde yer alan hipofiz bezinde erkeklik hormonlar\u0131n\u0131n yumurtal\u0131kta yap\u0131lmas\u0131n\u0131 sa\u011flayan LH (luteinizing hormon) \u00fcretimini artt\u0131rmaktad\u0131r(86,87,88,89). LH (luteinizing hormon) miktar\u0131n\u0131n artmas\u0131 erkeklik hormonlar\u0131n\u0131n yap\u0131m\u0131n\u0131 artt\u0131rmaktad\u0131r (hiperandrogenism)(85,87,89,90).<\/p>\n\n\n\n<p class=\"wp-embed-aspect-16-9 wp-has-aspect-ratio\"><strong><mark style=\"background-color:#fdfa05\" class=\"has-inline-color\">A4-<\/mark><\/strong>&nbsp;Karaci\u011ferde \u00fcretilen sex hormone binding globulin (SHBG) erkeklik hormonlar\u0131na ba\u011flanarak kan dola\u015f\u0131m\u0131nda serbest bulunan etkin formlar\u0131n (serbest testosteron) miktar\u0131n\u0131 azaltmaktad\u0131r(91,92). Kan dola\u015f\u0131m\u0131nda fazla miktarda bulunan ins\u00fclin hormonu sex hormone binding globulin (SHBG) \u00fcretimini azaltmaktad\u0131r(93).<\/p>\n\n\n\n<p class=\"has-text-align-center wp-embed-aspect-16-9 wp-has-aspect-ratio\"><strong><mark style=\"background-color:#fae708\" class=\"has-inline-color\">B-grubu<\/mark><\/strong><\/p>\n\n\n\n<p class=\"has-text-align-center wp-embed-aspect-16-9 wp-has-aspect-ratio\">&nbsp;<strong>GnRH hormonu salg\u0131layan jenerat\u00f6r\u00fc (dinamo) etkileyerek LH (luteinizing hormon) miktar\u0131n\u0131 azaltan bitkiler&nbsp;(Tablo-2);<\/strong>&nbsp;<\/p>\n\n\n\n<p class=\"wp-embed-aspect-16-9 wp-has-aspect-ratio\">Beyinde hipotalamus b\u00f6lgesinde GnRH (Gonadotropin-releasing hormone) salg\u0131layan sinir h\u00fccreleri (neurons) bulunmaktad\u0131r(94,95). GnRH hormonunun belirli aral\u0131klarla art\u0131\u015flar ve azal\u0131\u015flar g\u00f6sterek salg\u0131lanmas\u0131na ba\u011fl\u0131 olarak hipofiz bezinde LH ve FSH hormonlar\u0131n \u00fcretim s\u0131kl\u0131\u011f\u0131 ve miktar\u0131 belirlenmektedir(96,97,98).<\/p>\n\n\n\n<p class=\"wp-embed-aspect-16-9 wp-has-aspect-ratio\">Polikistik over sendromu olan kad\u0131nlar\u0131n bir k\u0131sm\u0131nda erkeklik hormonlar\u0131n\u0131n (testosteron, dihidrotestosteron) fazla miktarda \u00fcretilmesi ve ins\u00fclin direncine ba\u011fl\u0131 ins\u00fclin miktar\u0131n\u0131n artmas\u0131 beyinde GnRH (Gonadotropin-releasing hormone) salg\u0131layan h\u00fccrelerden daha \u00fcst seviyelerde bulunan sinir h\u00fccrelerinde \u00fcretilen GABA ve Kisspeptin (neurotransmitters) salg\u0131lanmas\u0131n\u0131 etkileyerek GnRH hormonu salg\u0131layan jenerat\u00f6r\u00fcn (dinamo) fazla \u00e7al\u0131\u015fmas\u0131na neden olmaktad\u0131r.&nbsp;(96,99,100,101,102). GnRH hormonunun salg\u0131lanma s\u0131kl\u0131\u011f\u0131n\u0131n artmas\u0131 hipofiz bezinde \u00fcretilen LH hormonunun salg\u0131lanma s\u0131kl\u0131\u011f\u0131n\u0131n (frequency) ve kan dola\u015f\u0131m\u0131nda bulunan miktar\u0131n\u0131n artmas\u0131na neden olmaktad\u0131r.&nbsp;(96,98,103,104,105,106,107,108,109). LH (luteinizing hormon) miktar\u0131n\u0131n artmas\u0131 erkeklik hormonlar\u0131n\u0131n yumurtal\u0131kta yap\u0131m\u0131n\u0131 artt\u0131rmakta (hiperandrogenism) ve yumurtlama \u00f6ncesi olgun folik\u00fcl (dominant) geli\u015fimini ve yumurtlamay\u0131 (ovulasyon) engellemektedir.&nbsp;(98,109,110,111,112,113,114,115,116,117,118).<\/p>\n\n\n\n<p class=\"has-text-align-center wp-embed-aspect-16-9 wp-has-aspect-ratio\"><strong>Tablo-2<\/strong><\/p>\n\n\n\n<p class=\"has-text-align-center wp-embed-aspect-16-9 wp-has-aspect-ratio\"><strong>GnRH hormonu salg\u0131layan jenerat\u00f6r\u00fc etkileyerek LH (luteinizing hormon) miktar\u0131n\u0131 azaltan bitkiler;<\/strong><\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"189\" src=\"https:\/\/polikistikover.net\/yeni\/wp-content\/uploads\/2025\/09\/image-43-1024x189.png\" alt=\"\" class=\"wp-image-6534\" srcset=\"https:\/\/polikistikover.net\/yeni\/wp-content\/uploads\/2025\/09\/image-43-1024x189.png 1024w, https:\/\/polikistikover.net\/yeni\/wp-content\/uploads\/2025\/09\/image-43-300x55.png 300w, https:\/\/polikistikover.net\/yeni\/wp-content\/uploads\/2025\/09\/image-43-768x142.png 768w, https:\/\/polikistikover.net\/yeni\/wp-content\/uploads\/2025\/09\/image-43.png 1280w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><\/figure>\n\n\n\n<p class=\"has-text-align-center wp-embed-aspect-16-9 wp-has-aspect-ratio\"><br><strong><mark style=\"background-color:#fbd705\" class=\"has-inline-color\">C-grubu<\/mark><\/strong><\/p>\n\n\n\n<p class=\"has-text-align-center wp-embed-aspect-16-9 wp-has-aspect-ratio\">&nbsp;<strong>Erkeklik hormonu (testosteron, dihidrotestosteron) \u00fcretimini azaltarak etki g\u00f6steren bitkiler&nbsp;(Tablo-3);<\/strong>&nbsp;<\/p>\n\n\n\n<p class=\"wp-embed-aspect-16-9 wp-has-aspect-ratio\">Kad\u0131nlarda erkeklik hormonlar\u0131n\u0131n (testosteron, dihidrotestosteron) b\u00fcy\u00fck bir k\u0131sm\u0131 b\u00f6brek \u00fcst\u00fc bezinde \u00fcretilen DHEA (Dehydroepiandrosterone) ve Androstenedione hormonlar\u0131ndan deri, meme, ve ya\u011f dokusunda \u00fcretilmektedir(119,120). Erkeklik hormonlar\u0131n\u0131n k\u00fc\u00e7\u00fck bir k\u0131sm\u0131 ise yumurtal\u0131k ve b\u00f6brek \u00fcst\u00fc bezinde \u00fcretilmektedir(120,121). Kan dola\u015f\u0131m\u0131nda bulunan testosteron yumurtal\u0131k ve b\u00f6brek \u00fcst\u00fc bezinde \u00fcretilen miktar\u0131 g\u00f6stermektedir. Testosteron hormonunun b\u00fcy\u00fck k\u0131sm\u0131n\u0131n \u00fcretildi\u011fi deri, ya\u011f dokusu, meme gibi organlardan sadece k\u00fc\u00e7\u00fck bir miktar (%10) testosteron kan dola\u015f\u0131m\u0131na girmektedir(121).<\/p>\n\n\n\n<p class=\"has-text-align-center wp-embed-aspect-16-9 wp-has-aspect-ratio\"><strong>Tablo-3<\/strong><\/p>\n\n\n\n<p class=\"has-text-align-center wp-embed-aspect-16-9 wp-has-aspect-ratio\"><strong>Erkeklik hormonu (testosteron, dihidrotestosteron) \u00fcretimini azaltarak etki g\u00f6steren bitkiler;<\/strong><\/p>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"576\" src=\"https:\/\/polikistikover.net\/yeni\/wp-content\/uploads\/2025\/09\/image-45-1024x576.png\" alt=\"\" class=\"wp-image-6539\" srcset=\"https:\/\/polikistikover.net\/yeni\/wp-content\/uploads\/2025\/09\/image-45-1024x576.png 1024w, https:\/\/polikistikover.net\/yeni\/wp-content\/uploads\/2025\/09\/image-45-300x169.png 300w, https:\/\/polikistikover.net\/yeni\/wp-content\/uploads\/2025\/09\/image-45-768x432.png 768w, https:\/\/polikistikover.net\/yeni\/wp-content\/uploads\/2025\/09\/image-45.png 1280w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><\/figure>\n<\/div>\n\n\n<p class=\"wp-embed-aspect-16-9 wp-has-aspect-ratio\"><strong><mark style=\"background-color:#fb6408\" class=\"has-inline-color\">C1-<\/mark><\/strong>Kan dola\u015f\u0131m\u0131nda olmayan testosteron hormonunun b\u00fcy\u00fck \u00e7o\u011funlu\u011fu 5- \u03b1 reduktaz (reductase) enzimi taraf\u0131ndan \u00fcretildi\u011fi organda testosteron hormonundan 10 kat daha g\u00fc\u00e7l\u00fc bir etkiye sahip olan dihidrotestosteron hormonuna d\u00f6n\u00fc\u015fmektedir(122,123,124,125). Dihidrotestosteron hormonunun etkili olabilmesi i\u00e7in erkeklik hormonu al\u0131c\u0131s\u0131na (androgen receptor) tutunmas\u0131 gerekmektedir(126,127,128);<\/p>\n\n\n\n<p class=\"wp-embed-aspect-16-9 wp-has-aspect-ratio\"><strong>1-<\/strong>Erkeklik hormonu al\u0131c\u0131lar\u0131 deride en \u00e7ok ya\u011f bezlerinde (sebaceous glands), k\u0131l k\u00f6klerinde (dermal papilla) ve ter bezlerinde bulunmaktad\u0131r(129,130,131). Bu al\u0131c\u0131lara tutunan dihidrotestosteron hormonu polikistik over sendromu olan kad\u0131nlarda t\u00fcylenme art\u0131\u015f\u0131, sivilce ve sa\u00e7 d\u00f6k\u00fclmesine neden olmaktad\u0131r.<\/p>\n\n\n\n<p class=\"has-text-align-center wp-embed-aspect-16-9 wp-has-aspect-ratio\"><br><\/p>\n\n\n\n<p class=\"wp-embed-aspect-16-9 wp-has-aspect-ratio\"><strong>2-<\/strong>Erkeklik hormonlar\u0131 yumurtal\u0131klarda al\u0131c\u0131lara tutunarak folik\u00fcl se\u00e7imi a\u015famas\u0131 \u00f6ncesinde bulunan ve daha k\u00fc\u00e7\u00fck (&lt; 2 mm) folik\u00fcllerin say\u0131s\u0131n\u0131 artt\u0131r\u0131rken folik\u00fcl se\u00e7imi a\u015famas\u0131ndaki (5-10 mm) folik\u00fcllerden bir tanesinin se\u00e7ilerek daha ileri a\u015famaya ula\u015fmas\u0131n\u0131 da engellemektedir (arrested follicles)&nbsp;(132,133,134,135,136,137,138,139). Yumurtlama \u00f6ncesi olgunlu\u011funa ula\u015fm\u0131\u015f bir folik\u00fcl olu\u015fmad\u0131\u011f\u0131 i\u00e7in polikistik over sendromu olan kad\u0131nlarda adet d\u00fczensizli\u011fi ortaya \u00e7\u0131kmaktad\u0131r(111,112,113,141). Bu kad\u0131nlarda \u00e7o\u011funlukla 35 g\u00fcn ile 3 ay aras\u0131nda de\u011fi\u015fen aral\u0131klarla (oligomenorrhea) adet kanamalar\u0131 olmaktad\u0131r(141,142,144,145,146,147). Bir k\u0131sm\u0131nda ise 3 aydan daha uzun aral\u0131klarla (amenorrhea) adet kanamalar\u0131 g\u00f6r\u00fclmektedir(141,143,144,145,146,147).<\/p>\n\n\n\n<p class=\"wp-embed-aspect-16-9 wp-has-aspect-ratio\"><strong><mark style=\"background-color:#fb760b\" class=\"has-inline-color\">C2-<\/mark><\/strong>Yumurtal\u0131klarda erkeklik hormonlar\u0131 teka h\u00fccrelerinde \u00fcretilmektedir(87,148). \u0130ns\u00fclin ve LH\u2019 n\u0131n teka h\u00fccrelerinde erkeklik hormonlar\u0131n\u0131n \u00fcretimini artt\u0131rmas\u0131n\u0131n yan\u0131nda polikistik over sendromu olan kad\u0131nlar\u0131n bir k\u0131sm\u0131nda hem teka h\u00fccrelerinin say\u0131s\u0131 fazla oldu\u011fu i\u00e7in hem de her bir teka h\u00fccresinde erkeklik hormonu \u00fcreten enzimin (CYP17 ) \u00fcretim kapasitesi y\u00fcksek oldu\u011fu i\u00e7in fazla miktarda erkeklik hormonu \u00fcretilmektedir(86,87,126,127,148,149,150).<\/p>\n\n\n\n<p class=\"has-text-align-center wp-embed-aspect-16-9 wp-has-aspect-ratio\"><br><strong><mark style=\"background-color:rgba(0, 0, 0, 0)\" class=\"has-inline-color has-dark-pink-color\">Bitkiler, tedavi ve hastal\u0131klardan korunma amac\u0131yla \u00e7ok uzun zamandan beri yayg\u0131n olarak kullan\u0131lmaktad\u0131r(1,2,3,8,11,12,13,20,21,22,23). G\u00fcn\u00fcm\u00fczde kullan\u0131lan ila\u00e7lar\u0131n b\u00fcy\u00fck \u00e7o\u011funlu\u011fu bitkilerden elde edilen do\u011fal maddelerin taklit edilmesiyle suni (sentetik) olarak \u00fcretilmektedir(4,5,6). Fakat, ila\u00e7lar\u0131n bir k\u0131sm\u0131 h\u00e2l\u00e2 bitkilerden elde edilen maddelerden yap\u0131lmaya devam etmektedir(4,5,6). Bitkiler, ila\u00e7 tedavisinin yerine tek ba\u015f\u0131na veya sentetik ya da bitki kaynakl\u0131 ila\u00e7larla birlikte destek amac\u0131yla kullan\u0131lmaktad\u0131r(7,8,9,10,11,12,13). Bitkisel tedavi \u00e7o\u011funlukla deneysel \u00e7al\u0131\u015fmalara ba\u011fl\u0131 bilimsel verilerin yerine daha \u00e7ok ku\u015faktan ku\u015fa\u011fa aktar\u0131lan g\u00f6zleme dayal\u0131 bilgilere dayanmaktad\u0131r. Fakat buna kar\u015f\u0131l\u0131k, \u00f6zellikle son 50 y\u0131l i\u00e7inde bitkilerin tedavi amac\u0131yla kullan\u0131lmas\u0131 ile ilgili yap\u0131lan bilimsel \u00e7al\u0131\u015fmalar\u0131n say\u0131s\u0131 giderek artm\u0131\u015ft\u0131r(14,15).<\/mark><\/strong><\/p>\n\n\n\n<p class=\"has-text-align-center wp-embed-aspect-16-9 wp-has-aspect-ratio\"><br><strong>B\u0130TK\u0130LER\u0130N SAKINCALARI<\/strong><\/p>\n\n\n\n<p class=\"wp-embed-aspect-16-9 wp-has-aspect-ratio\"><strong><mark style=\"background-color:#f90808\" class=\"has-inline-color\">1-<\/mark><\/strong>Hormon bozukluklar\u0131nda bitkiler miktar\u0131 azalm\u0131\u015f olan hormonun artt\u0131r\u0131lmas\u0131 ya da miktar\u0131 artm\u0131\u015f olan hormonun da azalt\u0131lmas\u0131 amac\u0131yla kullan\u0131lmaktad\u0131r. Bitkilerin gere\u011finden fazla miktarlarda kullan\u0131lmas\u0131 azalm\u0131\u015f olan hormonun gere\u011finden fazla artmas\u0131na veya artm\u0131\u015f olan hormonun da gere\u011finden fazla azalmas\u0131na neden olmaktad\u0131r(10).<\/p>\n\n\n\n<p class=\"wp-embed-aspect-16-9 wp-has-aspect-ratio\"><strong><mark style=\"background-color:#fb0707\" class=\"has-inline-color\">2-<\/mark><\/strong>Bitkilerin gere\u011finden fazla miktarlarda kullan\u0131lmas\u0131na ba\u011fl\u0131 bitkinin i\u00e7indeki etken maddelerin v\u00fccutta birikmesine ba\u011fl\u0131 karaci\u011fer hasar\u0131 g\u00f6r\u00fclebilmektedir(24). Zay\u0131flama amac\u0131yla kullan\u0131lan baz\u0131 bitkisel tedaviler b\u00f6brek nakli (transplantasyon) ile sonu\u00e7lanan b\u00f6brek hasar\u0131na (interstitial renal fibrosis) neden olmaktad\u0131r(25,26,27,28). Bitkilerin bir k\u0131sm\u0131 kalp ve damar sistemi \u00fczerine toksik etki g\u00f6stermektedir. Bu bitkileri kullananlarda kan bas\u0131nc\u0131 d\u00fc\u015f\u00fckl\u00fc\u011f\u00fc (hipotansiyon), hipertansiyon, \u00e7arp\u0131nt\u0131, kalp krizi ve kalp yetmezli\u011fi ortaya \u00e7\u0131kabilmektedir(29,30,31,32,33).<\/p>\n\n\n\n<p class=\"has-text-align-center wp-embed-aspect-16-9 wp-has-aspect-ratio\"><strong><mark style=\"background-color:rgba(0, 0, 0, 0)\" class=\"has-inline-color has-dark-pink-color\">So\u011fan (Allium cepa) bitkisinin belirli bir miktar\u0131n \u00fczerinde kullan\u0131lmas\u0131, i\u00e7inde bulunan baz\u0131 maddeler&nbsp;(thiols, disulfides) nedeniyle so\u011fan zehirlenmesine (toxicity) neden olmaktad\u0131r(266).&nbsp;Bu miktar ki\u015fiden ki\u015fiye g\u00f6re de\u011fi\u015fmektedir. K\u0131rm\u0131z\u0131 kan h\u00fccrelerinde (eritrositler) bulunan oksijeni ta\u015f\u0131yan maddenin (hemoglobin) i\u00e7indeki demir (Fe), so\u011fan i\u00e7inde bulunan maddeler (thiols, disulfides) taraf\u0131ndan oksitlenerek kan h\u00fccrelerinin par\u00e7alanmas\u0131na neden olmaktad\u0131r(267,268).&nbsp;Bunun sonucunda bu ki\u015filerde ani ba\u015flayan, \u015fiddetli kans\u0131zl\u0131k (hemolytic anemia) ortaya \u00e7\u0131kmaktad\u0131r. K\u0131rm\u0131z\u0131 kan h\u00fccrelerini Glucose-6-phosphate dehydrogenase (G6PD) enzimi zararl\u0131 maddelere kar\u015f\u0131 korumaktad\u0131r. T\u00fcrkiye\u2019 de baz\u0131 b\u00f6lgelerde s\u0131k g\u00f6r\u00fclen G6PD enziminin do\u011fu\u015ftan (genetik) eksikli\u011fi \u00e7o\u011funlukla hi\u00e7bir belirti g\u00f6stermezken, so\u011fan t\u00fcketimi bu ki\u015filerde ani ba\u015flayan \u015fiddetli kans\u0131zl\u0131\u011fa neden olabilmektedir(269,270,271).<\/mark><\/strong><\/p>\n\n\n\n<p class=\"has-text-align-center wp-embed-aspect-16-9 wp-has-aspect-ratio\"><strong>Bu t\u00fcr masum gibi g\u00f6r\u00fcnen bitkilerin bilin\u00e7sizce kullan\u0131lmas\u0131 fayda sa\u011flamayaca\u011f\u0131 gibi hayati tehlikeye de neden olabilmektedir.<\/strong><\/p>\n\n\n\n<p class=\"wp-embed-aspect-16-9 wp-has-aspect-ratio\">Baz\u0131 bitkilerin olu\u015fturdu\u011fu allerjik reaksiyon akci\u011fer hasar\u0131na (interstitial pneumonitis) neden olmaktad\u0131r(34,35). Bitkilerin bir k\u0131sm\u0131 kan p\u0131ht\u0131la\u015fmas\u0131n\u0131 (coagulation) azaltmaktad\u0131r(36,37). Bu bitkileri kullananlarda ameliyat s\u0131ras\u0131nda kanama e\u011filimi ortaya \u00e7\u0131kabilmektedir(36,37,38). Bitkilerin i\u00e7inde bulunan maddelerin yan etkileri sonucunda bir \u00e7ok ki\u015fi de hastanelerin acil servislerine zehirlenme (toxicity) nedeniyle ba\u015fvurmak zorunda kalmaktad\u0131r(5,39,40,41,45).<\/p>\n\n\n\n<p class=\"wp-embed-aspect-16-9 wp-has-aspect-ratio\"><strong><mark style=\"background-color:#f90a0a\" class=\"has-inline-color\">3-<\/mark><\/strong>Bitkisel tedavide bazen tek bir bitki veya bitkiden elde edilen (extraction) maddeler kullan\u0131l\u0131rken genellikle bu maddelerin kar\u0131\u015f\u0131mlar\u0131 kullan\u0131lmaktad\u0131r(2,7,8,10,11). Birden fazla bitkinin birlikte kullan\u0131lmas\u0131 bazen bitkilerin tek ba\u015f\u0131na olan etkilerini artt\u0131rd\u0131\u011f\u0131 (synergistic) gibi bazen de tek ba\u015f\u0131na olan etkilerini (antagonistic) yok etmektedir(42,43,44). Bitkilerin birlikte kullan\u0131lmas\u0131 etkin maddenin kan dola\u015f\u0131m\u0131nda bulunan miktar\u0131n\u0131n artmas\u0131 sonucunda tek ba\u015f\u0131na kullan\u0131ld\u0131klar\u0131nda g\u00f6r\u00fclmeyen beyin (neurotoxicity), karaci\u011fer (hepatotoxicity) ve b\u00f6brek (nephrotoxicity) \u00fczerinde toksik etkilerin ortaya \u00e7\u0131kmas\u0131na neden olmaktad\u0131r(42,44).<\/p>\n\n\n\n<p class=\"wp-embed-aspect-16-9 wp-has-aspect-ratio\"><strong><mark style=\"background-color:#fa0b0b\" class=\"has-inline-color\">4-<\/mark><\/strong>\u0130la\u00e7larla birlikte kullan\u0131lan bitkiler ilac\u0131n emilerek kan dola\u015f\u0131m\u0131na ge\u00e7mesini (absorption), kan dola\u015f\u0131m\u0131nda ta\u015f\u0131nmas\u0131n\u0131 ve par\u00e7aland\u0131ktan (metabolism) sonra da b\u00f6breklerden at\u0131lmas\u0131n\u0131 (clearance) etkilemektedir(46,47,48).<\/p>\n\n\n\n<p class=\"wp-embed-aspect-16-9 wp-has-aspect-ratio\">Bitkilerin ila\u00e7larla birlikte kullan\u0131lmas\u0131 ila\u00e7lar\u0131n etkinli\u011fini de\u011fi\u015ftirebildi\u011fi gibi yan etkilere ve toksik etkilere de neden olabilmektedir(46,49,50). Baz\u0131 bitkiler kanama zaman\u0131n\u0131 uzatt\u0131klar\u0131 i\u00e7in kan suland\u0131r\u0131c\u0131 ila\u00e7lar ile birlikte kullan\u0131ld\u0131klar\u0131nda morarma ve kanama e\u011filimine neden olabilmektedir(48,49,50,51). Baz\u0131 bitkiler karaci\u011fer hasar\u0131 yapma ihtimali olan ila\u00e7larla birlikte kullan\u0131ld\u0131klar\u0131nda karaci\u011fer hasar\u0131na (hepatotoxicity) neden olabilmektedir(46,49). Bitkilerin bir k\u0131sm\u0131 kalp ila\u00e7lar\u0131n\u0131n etkinli\u011fini artt\u0131rarak toksik etkilere neden olurken, bir k\u0131sm\u0131 da azaltarak bu ila\u00e7lar\u0131n i\u015flevini engellemektedir(52,60). Kan \u015fekerini etkileyen baz\u0131 bitkiler diyabet tedavisinde kullan\u0131lan ins\u00fclin ve ila\u00e7lar\u0131n etkinli\u011fini de\u011fi\u015ftirmektedir(53,54,55).<\/p>\n\n\n\n<p>Ya\u015flanma (Aging) ile birlikte s\u00fcreklili\u011fi olan iltihap (kronik inflamasyon) art\u0131\u015f\u0131 g\u00f6r\u00fclmektedir(7,56,57). Ya\u015fl\u0131l\u0131\u011fa neden olan kronik inflamasyon (inflamm-aging) oksidatif stres (oxidative stress) kar\u015f\u0131s\u0131nda antioksidan (antioxidant) sistemin zay\u0131flamas\u0131 sonucunda ortaya \u00e7\u0131kmaktad\u0131r(56,57). Ya\u015flanmaya neden olan kronik inflamasyonu azaltmak amac\u0131yla kullan\u0131lan baz\u0131 bitkiler ast\u0131m ve romatolojik hastal\u0131klar\u0131n tedavisinde kullan\u0131lan anti-inflamatuar ila\u00e7lar\u0131n etkilerini artt\u0131rarak yan etkilere ve toksik etkilere neden olabilmektedir(58,59).<\/p>\n\n\n\n<p class=\"has-text-align-center\"><strong><mark style=\"background-color:rgba(0, 0, 0, 0)\" class=\"has-inline-color has-dark-pink-color\">Polikistik over sendromu nedeniyle ortaya \u00e7\u0131kan sivilce tedavisinde yukar\u0131da anlatt\u0131\u011f\u0131m tedavi se\u00e7eneklerinden hangisinin uygulanaca\u011f\u0131 ki\u015fiden ki\u015fiye g\u00f6re de\u011fi\u015fmektedir. \u00c7o\u011funlukla&nbsp;birden fazla tedavi se\u00e7ene\u011fi birlikte uygulanmaktad\u0131r.<\/mark><\/strong><\/p>\n\n\n\n<p class=\"has-text-align-center\"><strong>Kaynaklar<\/strong><\/p>\n\n\n\n<p>1-Ancient-modern concordance in Ayurvedic plants: some examples. Dev S. Environ Health Perspect. 1999 Oct;107(10):783-9.<\/p>\n\n\n\n<p>2-Conpendium of materia medica (Bencau Gangmu). (cited 2016 April 15). Li S. https:\/\/www.wdl.org\/en\/item\/4678\/<\/p>\n\n\n\n<p>3-Nature\u2019s Medicine: Plants That Heal. Swerdlow JL. National Geographic Society. 2000.<\/p>\n\n\n\n<p>4-The influence of natural products upon drug discovery. Newman DJ, Cragg GM, Snader KM. Nat Prod Rep. 2000 Jun;17(3):215-34.<\/p>\n\n\n\n<p>5-Plants as source of drugs. Rates SM. Toxicon. 2001 May;39(5):603-13.<\/p>\n\n\n\n<p>6-Plants and human health in the twenty-first century. Raskin I, Ribnicky DM, Komarnytsky S, Ilic N, Poulev A, Borisjuk N, Brinker A, Moreno DA, Ripoll C, Yakoby N, O\u2019Neal JM, Cornwell T, Pastor I, Fridlender B. Trends Biotechnol. 2002 Dec;20(12):522-31.<\/p>\n\n\n\n<p>7-Herbal Medicines: challenges in the modern world. Part 5. status and current directions of complementary and alternative herbal medicine worldwide. Enioutina EY, Salis ER, Job KM, Gubarev MI, Krepkova LV, Sherwin CM. Expert Rev Clin Pharmacol. 2017 Mar;10(3):327-338.<\/p>\n\n\n\n<p>8-Herbal Medicines: challenges in the modern world. Part 3. China and Japan. Teng L, Zu Q, Li G, Yu T, Job KM, Yang X, Di L, Sherwin CM, Enioutina EY. Expert Rev Clin Pharmacol. 2016 Sep;9(9):1225-33.<\/p>\n\n\n\n<p>9-World Health Organization. WHO traditional medicine strategy: 2014-2023; (cited 2016 Oct 20). http:\/\/apps.who.int\/iris\/bitstream\/10665\/92455\/1\/9789241506090_eng.pdf<\/p>\n\n\n\n<p>10-ABC of complementary medicine: herbal medicine. Vickers A, Zollman C. BMJ. 1999 Oct 16;319(7216):1050-3.<\/p>\n\n\n\n<p>11-Ibn Sina (Avicenna) Senior Press Superintendent, Jamia Hamdard Printing Press; New Delhi:1998. Kit\u0101b al-Q\u0101n\u016bn f\u012b al-Tibb (Canon of medicine). https:\/\/www.herbcraft.org\/canon2.pdf<\/p>\n\n\n\n<p>12-Khare C.P. Springer: New York : 2007. Indian Medicinal Plants. https:\/\/archive.org\/details\/indianmedicinalplantsillustrateddictionarykharec.p._201_R<\/p>\n\n\n\n<p>13-Royal College of Physicians of London. The London Pharmacopoeia. London: Edward Griffin; 1618. https:\/\/archive.org\/details\/2548018R.nlm.nih.gov\/mode\/2up<\/p>\n\n\n\n<p>14-Quantification of the scientific research in the United States about popular herbal remedies referenced on PubMed. Hall M, Nazir N. Altern Ther Health Med. 2005 May-Jun;11(3):34-7.<\/p>\n\n\n\n<p>15-Trends in publications on complementary and alternative medicine in the medical literature. Treister-Goltzman Y, Peleg R. J Complement Integr Med. 2015 Jun;12(2):111-5.<\/p>\n\n\n\n<p>16-Diagnostic and treatment characteristics of polycystic ovary syndrome: descriptive measurements of patient perception and awareness from 657 confidential self-reports. Sills ES, Perloe M, Tucker MJ, Kaplan CR, Genton MG, Schattman GL BMC Womens Health. 2001;1(1):3.<\/p>\n\n\n\n<p>17-Herbal medicine for the management of polycystic ovary syndrome (PCOS) and associated oligo\/amenorrhoea and hyperandrogenism; a review of the laboratory evidence for effects with corroborative clinical findings. Arentz S, Abbott JA, Smith CA, Bensoussan A. BMC Complement Altern Med. 2014 Dec 18;14:511.<\/p>\n\n\n\n<p>18-Phytotheraphy for polycystic ovarian syndrome: a review of the literature and evaluation of practitioners\u2019 experiences. Rooney S, Pendry B. J Herbal Med. 2014 ;4:159-71.<\/p>\n\n\n\n<p>19-A survey of the use of complementary medicine by a self-selected community group of Australian women with polycystic ovary syndrome. Arentz S, Smith CA, Abbott JA, Bensoussan A. BMC Complement Altern Med. 2014 Dec 6;14:472.<\/p>\n\n\n\n<p>20-Unconventional medicine in the United States. Prevalence, costs, and patterns of use. Eisenberg DM, Kessler RC, Foster C, Norlock FE, Calkins DR, Delbanco TL. N Engl J Med. 1993 Jan 28;328(4):246-52.<\/p>\n\n\n\n<p>21-Herbal medicines: challenges in the modern world. Part 1. Australia and New Zealand. Barnes J, McLachlan AJ, Sherwin CM, Enioutina EY. Expert Rev Clin Pharmacol. 2016 Jul;9(7):905-15.<\/p>\n\n\n\n<p>22-Herbal medicines: challenges in the modern world. Part 2. European Union and Russia. Sammons HM, Gubarev MI, Krepkova LV, Bortnikova VV, Corrick F, Job KM, Sherwin CM, Enioutina EY. Expert Rev Clin Pharmacol. 2016 Aug;9(8):1117-27.<\/p>\n\n\n\n<p>23-Herbal medicines: challenges in the modern world. Part 4. Canada and United States. Job KM, Kiang TK, Constance JE, Sherwin CM, Enioutina EY. Expert Rev Clin Pharmacol. 2016 Dec;9(12):1597-1609.<\/p>\n\n\n\n<p>24-Systematic review of published data on herb induced liver injury. Byeon JH, Kil JH, Ahn YC, Son CG. J Ethnopharmacol. 2019 Apr 6;233:190-196.<\/p>\n\n\n\n<p>25-Acute renal failure associated with prolonged intake of slimming pills containing anthraquinones. Kwan TH, Tong MK, Leung KT, Lai CK, Poon WT, Chan YW, Lo WH, Au TC. Hong Kong Med J. 2006 Oct;12(5):394-7.<\/p>\n\n\n\n<p>26-Rapidly progressive interstitial renal fibrosis in young women: association with slimming regimen including Chinese herbs. Vanherweghem JL, Depierreux M, Tielemans C, Abramowicz D, Dratwa M, Jadoul M, Richard C, Vandervelde D, Verbeelen D, Vanhaelen-Fastre R. Lancet. 1993 Feb 13;341(8842):387-91.<\/p>\n\n\n\n<p>27-Chinese herbs nephropathy presentation, natural history and fate after transplantation. Reginster F, Jadoul M, van Ypersele de Strihou C. Nephrol Dial Transplant. 1997 Jan;12(1):81-6.<\/p>\n\n\n\n<p>28-Kidney toxicity related to herbs and dietary supplements: Online table of case reports. Part 3 of 5 series. Brown AC. Food Chem Toxicol. 2017 Sep;107(Pt A):502-519.<\/p>\n\n\n\n<p>29-Heart Toxicity Related to Herbs and Dietary Supplements: Online Table of Case Reports. Part 4 of 5. Brown AC. J Diet Suppl. 2018 Jul 4;15(4):516-555.<\/p>\n\n\n\n<p>30-Incidence and Causes of Aconitum Alkaloid Poisoning in Hong Kong from 1989 to 2010. Chan TY. Phytother Res. 2015 Aug;29(8):1107-11.<\/p>\n\n\n\n<p>31-Aconite poisoning presenting as hypotension and bradycardia. Chan TY. Hum Exp Toxicol. 2009 Dec;28(12):795-7.<\/p>\n\n\n\n<p>32-Acute effects of ephedra on autonomic nervous modulation in healthy young adults. Chen WL , Tsai TH, Yang CC, Kuo TB. Clin Pharmacol Ther. 2010 Jul;88(1):39-44.<\/p>\n\n\n\n<p>33-Adverse cardiovascular and central nervous system events associated with dietary supplements containing ephedra alkaloids. Haller CA, Benowitz NL. N Engl J Med. 2000 Dec 21;343(25):1833-8.<\/p>\n\n\n\n<p>34-Japanese herbal medicine-induced pneumonitis: A review of 73 patients.Enomoto Y, Nakamura Y, Enomoto N, Fujisawa T, Inui N, Suda T. Respir Investig. 2017 Mar;55(2):138-144.<\/p>\n\n\n\n<p>35-Clinical features of pneumonitis induced by herbal drugs. Mizushima Y, Oosaki R, Kobayashi M. Phyto ther Res. 1997;11(4):295-298.<\/p>\n\n\n\n<p>36-The influence of herbal medicine on platelet function and coagulation: a narrative review. McEwen BJ. Semin Thromb Hemost. 2015 Apr;41(3):300-14.<\/p>\n\n\n\n<p>37-Commonly Used Dietary Supplements on Coagulation Function during Surgery. Wang CZ, Moss J, Yuan CS. Medicines (Basel). 2015 Sep;2(3):157-185.<\/p>\n\n\n\n<p>38-Top-10 list of herbal and supplemental medicines used by cosmetic patients: what the plastic surgeon needs to know. Heller J, Gabbay JS, Ghadjar K, Jourabchi M, O\u2019Hara C, Heller M, Bradley JP. Plast Reconstr Surg. 2006 Feb;117(2):436-45; discussion 446-7.<\/p>\n\n\n\n<p>39-Emergency Department Visits for Adverse Events Related to Dietary Supplements. Geller AI, Shehab N, Weidle NJ, Lovegrove MC, Wolpert BJ, Timbo BB, Mozersky RP, Budnitz DS. N Engl J Med. 2015 Oct 15;373(16):1531-40.<\/p>\n\n\n\n<p>40-Assessment of complementary and alternative medicine use among patients admitted to the emergency room: a descriptive study from a Turkish hospital. Hakkoymaz H, Ko\u00e7yi\u011fit BF. Peer J. 2019 Aug 20;7:e7584.<\/p>\n\n\n\n<p>41-Use and toxicity of complementary and alternative medicines among patients visiting emergency department: Systematic review. Jatau AI, Aung MM, Kamauzaman TH, Chedi BA, Sha\u2019aban A, Rahman AF. J Intercult Ethnopharmacol. 2016 Mar 2;5(2):191-7.<\/p>\n\n\n\n<p>42-Analysis of Herb-Herb Interaction When Decocting Together by Using Ultra-High-Performance Liquid Chromatography-Tandem Mass Spectrometry and Fuzzy Chemical Identification Strategy With Poly-Proportion Design. Juan Shen , Xuan Mo, Yuping Tang, Li Zhang, Hanqing Pang, Yefei Qian, Yanyan Chen, Weiwei Tao, Sheng Guo, Erxin Shang, Shaoqing Zhu, Yunhe Ding, Jianming Guo, Pei Liu, Shulan Su, Dawei Qian, Jin-ao Duan. J Chromatogr. 2013 Jul 5;1297:168-178.<\/p>\n\n\n\n<p>43-Revealing the Effects of the Herbal Pair of Euphorbia Kansui and Glycyrrhiza on Hepatocellular Carcinoma Ascites With Integrating Network Target Analysis and Experimental Validation. Yanqiong Zhang, Ya Lin, Haiyu Zhao, Qiuyan Guo, Chen Yan, Na Lin. Int J Biol Sci . 2016 Mar 25;12 (5), 594-606.<\/p>\n\n\n\n<p>44-Analysis of Bioactive Components and Pharmacokinetic Study of Herb-Herb Interactions in the Traditional Chinese Patent Medicine Tongmai Yangxin Pill. Yaya Fan, Shuli Man, Hongfa Li , Yuanxue Liu, Zhen Liu, Wenyuan Gao. J Pharm Biomed Anal. 2016 Feb 2;120, 364-73.<\/p>\n\n\n\n<p>45-African Burkitt\u2019s lymphoma and an Epstein-Barr virus-enhancing plant Euphorbia tirucalli. Osato T, Mizuno F, Imai S, Aya T, Koizumi S, Kinoshita T, Tokuda H, Ito Y, Hirai N, Hirota M. Lancet. 1987 May 30;1(8544):1257-8.<\/p>\n\n\n\n<p>46-A prospective study on the safety of herbal medicines, used alone or with conventional medicines. Jeong TY, Park BK, Cho JH, Kim YI, Ahn YC, Son CG. J Ethnopharmacol. 2012 Oct 11;143(3):884-8.<\/p>\n\n\n\n<p>47-Underestimating the toxicological challenges associated with the use of herbal medicinal products in developing countries. Neergheen-Bhujun VS. Biomed Res Int. 2013;2013 :804086.<\/p>\n\n\n\n<p>48-Clinical herbal interactions with conventional drugs: from molecules to maladies. Chen XW, Serag ES, Sneed KB, Liang J, Chew H, Pan SY, Zhou SF. Curr Med Chem. 2011;18(31):4836-50.<\/p>\n\n\n\n<p>49-Herbal medicinals: selected clinical considerations focusing on known or potential drug-herb interactions. Miller LG. Arch Intern Med. 1998 Nov 9;158(20):2200-11.<\/p>\n\n\n\n<p>50-Herb-drug interactions. Fugh-Berman A. Lancet. 2000 Jan 8;355(9198):134-8.<\/p>\n\n\n\n<p>51-Potential interactions between complementary\/alternative products and conventional medicines in a Medicare population. Elmer GW, Lafferty WE, Tyree PT, Lind BK. Ann Pharmacother. 2007 Oct;41(10):1617-24.<\/p>\n\n\n\n<p>52-Traditional herbs: a remedy for cardiovascular disorders. Rastogi S, Pandey MM, Rawat AK. Phytomedicine. 2016 Oct 15;23(11):1082-9.<\/p>\n\n\n\n<p>53-Review of Ginseng Anti-Diabetic Studies. Chen W, Balan P, Popovich DG. Molecules. 2019 Dec 9;24(24).<\/p>\n\n\n\n<p>54-Chinese herbal medicines for people with impaired glucose tolerance or impaired fasting blood glucose. Grant SJ, Bensoussan A, Chang D, Kiat H, Klupp NL, Liu JP, Li X. Cochrane Database Syst Rev. 2009 Oct 7;(4):CD006690.<\/p>\n\n\n\n<p>55-Ginsenoside Rb1 as an Anti-Diabetic Agent and Its Underlying Mechanism Analysis. Zhou P, Xie W, He S, Sun Y, Meng X, Sun G, Sun X. Cells. 2019 Feb 28;8(3).<\/p>\n\n\n\n<p>56-Inflamm-aging. An evolutionary perspective on immunosenescence. Franceschi C, Bonaf\u00e8 M, Valensin S, Olivieri F, De Luca M, Ottaviani E, De Benedictis G. Ann N Y Acad Sci. 2000 Jun;908:244-54.<\/p>\n\n\n\n<p>57-Inflammaging and Oxidative Stress in Human Diseases: From Molecular Mechanisms to Novel Treatments. Zuo L, Prather ER, Stetskiv M, Garrison DE, Meade JR, Peace TI, Zhou T. Int J Mol Sci. 2019 Sep 10;20(18).<\/p>\n\n\n\n<p>58-An Update on Inflamm-Aging: Mechanisms, Prevention, and Treatment. Xia S, Zhang X, Zheng S, Khanabdali R, Kalionis B, Wu J, Wan W, Tai X. J Immunol Res.2016;2016:8426874.<\/p>\n\n\n\n<p>59-Inflammaging and cardiovascular disease: Management by medicinal plants. Shayganni E, Bahmani M, Asgary S, Rafieian-Kopaei M. Phytomedicine. 2016 Oct 15;23(11):1119-26.<\/p>\n\n\n\n<p>60-Cytochrome P450 isoforms involved in metabolism of the enantiomers of verapamil and norverapamil. Tracy TS, Korzekwa KR, Gonzalez FJ, Wainer IW. Br J Clin Pharmacol. 1999 May;47(5):545-52.<\/p>\n\n\n\n<p>61-Profound peripheral insulin resistance, independent of obesity, in polycystic ovary syndrome. Dunaif A, Segal KR, Futterweit W, Dobrjansky A. Diabetes. 1989 Sep;38(9):1165-74.<\/p>\n\n\n\n<p>62-Prediction models for insulin resistance in the polycystic ovary syndrome. Gennarelli G, Holte J, Berglund L, Berne C, Massobrio M, Lithell H. Hum Reprod. 2000 Oct;15(10):2098-102.<\/p>\n\n\n\n<p>63-Use of fasting blood to assess the prevalence of insulin resistance in women with polycystic ovary syndrome. Carmina E , Lobo RA. Fertil Steril. 2004 Sep;82(3):661-5.<\/p>\n\n\n\n<p>64-Prevalence of insulin resistance in the polycystic ovary syndrome using the homeostasis model assessment. DeUgarte CM, Bartolucci AA, Azziz R. Fertil Steril. 2005 May;83(5):1454-60.<\/p>\n\n\n\n<p>65-Prevalence and predictors of risk for type 2 diabetes mellitus and impaired glucose tolerance in polycystic ovary syndrome: a prospective, controlled study in 254 affected women. Legro RS, Kunselman AR, Dodson WC, Dunaif A. J Clin Endocrinol Metab. 1999 Jan;84(1):165-9.<\/p>\n\n\n\n<p>66-Prevalence of impaired glucose tolerance and diabetes in women with polycystic ovary syndrome. Ehrmann DA, Barnes RB, Rosenfield RL, Cavaghan MK, Imperial J. Diabetes Care. 1999 Jan;22(1):141-6.<\/p>\n\n\n\n<p>67-Screening for abnormal glucose tolerance in adolescents with polycystic ovary syndrome. Palmert MR, Gordon CM, Kartashov AI, Legro RS, Emans SJ, Dunaif A. J Clin Endocrinol Metab. 2002 Mar;87(3):1017-23.<\/p>\n\n\n\n<p>68-Polycystic ovarian syndrome (PCOS): a significant contributor to the overall burden of type 2 diabetes in women. Talbott EO, Zborowski JV, Rager JR, Kip KE, Xu X, Orchard TJ. J Womens Health (Larchmt). 2007 Mar;16(2):191-7.<\/p>\n\n\n\n<p>69-Relative risk of conversion from normoglycaemia to impaired glucose tolerance or non-insulin dependent diabetes mellitus in polycystic ovarian syndrome. Norman RJ, Masters L, Milner CR, Wang JX, Davies MJ. Hum Reprod. 2001 Sep;16(9):1995-8.<\/p>\n\n\n\n<p>70-Glucose intolerance in a large cohort of mediterranean women with polycystic ovary syndrome: phenotype and associated factors. Gambineri A, Pelusi C, Manicardi E, Vicennati V, Cacciari M, Morselli-Labate AM, Pagotto U, Pasquali R. Diabetes. 2004 Sep;53(9):2353-8.<\/p>\n\n\n\n<p>71-Predictors of progression from impaired glucose tolerance to NIDDM: an analysis of six prospective studies. Edelstein SL, Knowler WC, Bain RP, Andres R, Barrett-Connor EL, Dowse GK, Haffner SM, Pettitt DJ, Sorkin JD, Muller DC, Collins VR, Hamman RF. Diabetes. 1997 Apr;46(4):701-10.<\/p>\n\n\n\n<p>72-Changes in glucose tolerance over time in women with polycystic ovary syndrome: a controlled study. Legro RS, Gnatuk CL, Kunselman AR, Dunaif A. J Clin Endocrinol Metab. 2005 Jun;90(6):3236-42.<\/p>\n\n\n\n<p>73-Follicle dynamics and anovulation in polycystic ovary syndrome. Franks S, Stark J, Hardy K. Hum Reprod Update. 2008 Jul-Aug;14(4):367-78.<\/p>\n\n\n\n<p>74-Long-term follow-up of patients with polycystic ovary syndrome: reproductive outcome and ovarian reserve. Hudecova M, Holte J, Olovsson M, Sundstr\u00f6m Poromaa I. Hum Reprod. 2009 May;24(5):1176-83.<\/p>\n\n\n\n<p>75-The severity of menstrual dysfunction as a predictor of insulin resistance in PCOS. Brower M, Brennan K, Pall M, Azziz R. J Clin Endocrinol Metab. 2013 Dec;98(12):E1967-71.<\/p>\n\n\n\n<p>76-The relationship of insulin insensitivity to menstrual pattern in women with hyperandrogenism and polycystic ovaries. Robinson S, Kiddy D, Gelding SV, Willis D, Niththyananthan R, Bush A, Johnston DG, Franks S. Clin Endocrinol (Oxf). 1993 Sep;39(3):351-5.<\/p>\n\n\n\n<p>77-Characterization of groups of hyperandrogenic women with acanthosis nigricans, impaired glucose tolerance, and\/or hyperinsulinemia. Dunaif A, Graf M, Mandeli J, Laumas V, Dobrjansky A. J Clin Endocrinol Metab. 1987 Sep;65(3):499-507.<\/p>\n\n\n\n<p>78-Menstrual Cycle Irregularity and Metabolic Disorders: A Population-Based Prospective Study. Rostami Dovom M, Ramezani Tehrani F, Djalalinia S, Cheraghi L, Behboudi Gandavani S, Azizi F. PLoS One. 2016 Dec 16;11(12):e0168402.<\/p>\n\n\n\n<p>79-Long or highly irregular menstrual cycles as a marker for risk of type 2 diabetes mellitus. Solomon CG, Hu FB, Dunaif A, Rich-Edwards J, Willett WC, Hunter DJ, Colditz GA, Speizer FE, Manson JE. JAMA. 2001 Nov 21;286(19):2421-6.<\/p>\n\n\n\n<p>80-Insulin stimulates testosterone biosynthesis by human thecal cells from women with polycystic ovary syndrome by activating its own receptor and using inositolglycan mediators as the signal transduction system. Nestler JE, Jakubowicz DJ, de Vargas AF, Brik C, Quintero N, Medina F. J Clin Endocrinol Metab. 1998 Jun;83(6):2001-5.<\/p>\n\n\n\n<p>81-Insulin stimulates androgen accumulation in incubations of human ovarian stroma and theca. Barbieri RL, Makris A, Ryan KJ. Obstet Gynecol. 1984 Sep;64(3 Suppl):73S-80S.<\/p>\n\n\n\n<p>82-Insulin stimulates androgen accumulation in incubations of ovarian stroma obtained from women with hyperandrogenism. Barbieri RL, Makris A, Randall RW, Daniels G, Kistner RW, Ryan KJ. J Clin Endocrinol Metab. 1986 May;62(5):904-10.<\/p>\n\n\n\n<p>83-Metabolic regulation of androgen production by human thecal cells in vitro. Nahum R, Thong KJ, Hillier SG. Hum Reprod. 1995 Jan;10(1):75-81.<\/p>\n\n\n\n<p>84-Regulation of androgen production in cultured human thecal cells by insulin-like growth factor I and insulin. Bergh C , Carlsson B, Olsson JH, Selleskog U, Hillensj\u00f6 T. Fertil Steril. 1993 Feb;59(2):323-31.<\/p>\n\n\n\n<p>85-Differential effects of insulin sensitivity on androgens in obese women with polycystic ovary syndrome or normal ovulation. Asagami T, Holmes TH, Reaven G. Metabolism. 2008 Oct;57(10):1355-60.<\/p>\n\n\n\n<p>86-Thecal cell sensitivity to luteinizing hormone and insulin in polycystic ovarian syndrome. Cadagan D, Khan R, Amer S. Reprod Biol. 2016 Mar;16(1):53-60.<\/p>\n\n\n\n<p>87-Hypersecretion of androstenedione by isolated thecal cells from polycystic ovaries. Gilling-Smith C, Willis DS, Beard RW, Franks S. J Clin Endocrinol Metab. 1994 Oct;79(4):1158-65.<\/p>\n\n\n\n<p>88-Insulin action in the normal and polycystic ovary. Franks S, Gilling-Smith C, Watson H, Willis D. Endocrinol Metab Clin North Am. 1999 Jun;28(2):361-78.<\/p>\n\n\n\n<p>89-Hyperinsulinemia amplifies GnRH agonist stimulated ovarian steroid secretion in women with polycystic ovary syndrome. Tosi F, Negri C, Perrone F, Dorizzi R, Castello R, Bonora E, Moghetti P. J Clin Endocrinol Metab. 2012 May;97(5):1712-9.<\/p>\n\n\n\n<p>90-Oestradiol feedback stimulation of androgen biosynthesis by human theca cells. Gilling-Smith C, Willis DS, Franks S. Hum Reprod. 1997 Aug;12(8):1621-8.<\/p>\n\n\n\n<p>91-Secretion of testosterone-estradiol-binding globulin by a human hepatoma-derived cell line. Khan MS, Knowles BB, Aden DP, Rosner W. J Clin Endocrinol Metab. 1981 Aug;53(2):448-9.<\/p>\n\n\n\n<p>92-Molecular properties of corticosteroid binding globulin and the sex-steroid binding proteins. Hammond GL. Endocr Rev. 1990 Feb;11(1):65-79.<\/p>\n\n\n\n<p>93-Regulation of production and secretion of sex hormone-binding globulin in HepG2 cell cultures by hormones and growth factors. Loukovaara M, Carson M, Adlercreutz H. J Clin Endocrinol Metab. 1995 Jan;80(1):160-4.<\/p>\n\n\n\n<p>94-Pituitary stalk portal blood collection in rhesus monkeys: evidence for pulsatile release of gonadotropin-releasing hormone (GnRH). Carmel PW, Araki S, Ferin M. Endocrinology. 1976 Jul;99(1):243-8.<\/p>\n\n\n\n<p>95-Frequency and amplitude of gonadotropin-releasing hormone stimulation and gonadotropin secretion in the rhesus monkey. Wildt L, H\u00e4usler A, Marshall G, Hutchison JS, Plant TM, Belchetz PE, Knobil E. Endocrinology. 1981 Aug;109(2):376-85.<\/p>\n\n\n\n<p>96-GnRH pulse frequency-dependent differential regulation of LH and FSH gene expression. Thompson IR, Kaiser UB. Mol Cell Endocrinol. 2014 Mar 25;385(1-2):28-35.<\/p>\n\n\n\n<p>97-The frequency of gonadotropin-releasing-hormone stimulation differentially regulates gonadotropin subunit messenger ribonucleic acid expression. Dalkin AC, Haisenleder DJ, Ortolano GA, Ellis TR, Marshall JC. Endocrinology. 1989 Aug;125(2):917-24.<\/p>\n\n\n\n<p>98-The origins and sequelae of abnormal neuroendocrine function in polycystic ovary syndrome. Blank SK, McCartney CR, Marshall JC. Hum Reprod Update. 2006 Jul-Aug;12(4):351-61.<\/p>\n\n\n\n<p>99-Kisspeptins and reproduction: physiological roles and regulatory mechanisms. Pinilla L, Aguilar E, Dieguez C, Millar RP, Tena-Sempere M. Physiol Rev. 2012 Jul;92(3):1235-316.<\/p>\n\n\n\n<p>100-Polycystic ovarian syndrome: evidence that flutamide restores sensitivity of the gonadotropin-releasing hormone pulse generator to inhibition by estradiol and progesterone. Eagleson CA, Gingrich MB, Pastor CL, Arora TK, Burt CM, Evans WS, Marshall JC. J Clin Endocrinol Metab. 2000 Nov;85(11):4047-52.<\/p>\n\n\n\n<p>101-Ontogeny and reversal of brain circuit abnormalities in a preclinical model of PCOS. Silva MS, Prescott M, Campbell RE. JCI Insight. 2018 Apr 5;3(7).<\/p>\n\n\n\n<p>102-The neuroendocrine genesis of polycystic ovary syndrome: A role for arcuate nucleus GABA neurons. Moore AM, Campbell RE. J Steroid Biochem Mol Biol. 2016 Jun;160:106-17.<\/p>\n\n\n\n<p>103-Circulating luteinizing hormone pulse frequency in women with polycystic ovary syndrome. Kazer RR, Kessel B, Yen SS. J Clin Endocrinol Metab. 1987 Aug;65(2):233-6.<\/p>\n\n\n\n<p>104-Opioidergic regulation of LH pulsatility in women with polycystic ovary syndrome. Berga SL, Yen SS. Clin Endocrinol (Oxf). 1989 Feb;30(2):177-84.<\/p>\n\n\n\n<p>105-Inappropriate secretion of follicle-stimulating hormone and luteinizing hormone in polycystic ovarian disease. Yen SS, Vela P, Rankin J. J Clin Endocrinol Metab. 1970 Apr;30(4):435-42.<\/p>\n\n\n\n<p>106-Determinants of abnormal gonadotropin secretion in clinically defined women with polycystic ovary syndrome. Taylor AE, McCourt B, Martin KA, Anderson EJ, Adams JM, Schoenfeld D, Hall JE. J Clin Endocrinol Metab. 1997 Jul;82(7):2248-56.<\/p>\n\n\n\n<p>107-Hyperfunction of the hypothalamic-pituitary axis in women with polycystic ovarian disease: indirect evidence for partial gonadotroph desensitization. Waldstreicher J, Santoro NF, Hall JE, Filicori M, Crowley WF Jr. J Clin Endocrinol Metab. 1988 Jan;66(1):165-72.<\/p>\n\n\n\n<p>108-Genome-wide association of polycystic ovary syndrome implicates alterations in gonadotropin secretion in European ancestry populations. Hayes MG, Urbanek M, Ehrmann DA, Armstrong LL, Lee JY, Sisk R, Karaderi T, Barber TM, McCarthy MI, Franks S,Lindgren CM, Welt CK, Diamanti-Kandarakis E, Panidis D, Goodarzi MO, Azziz R, Zhang Y, James RG, Olivier M,Kissebah AH; Reproductive Medicine Network, Stener-Victorin E, Legro RS, Dunaif A. Nat Commun. 2015 Aug 18;6:7502.<\/p>\n\n\n\n<p>109-Metabolic regulation of androgen production by human thecal cells in vitro. Nahum R, Thong KJ, Hillier SG. Hum Reprod. 1995 Jan;10(1):75-81.<\/p>\n\n\n\n<p>110-Estradiol production by granulosa cells of normal and polycystic ovaries: relationship to menstrual cycle history and concentrations of gonadotropins and sex steroids in follicular fluid. Mason HD, Willis DS, Beard RW, Winston RM, Margara R, Franks S. J Clin Endocrinol Metab. 1994 Nov;79(5):1355-60.<\/p>\n\n\n\n<p>111-Premature response to luteinizing hormone of granulosa cells from anovulatory women with polycystic ovary syndrome: relevance to mechanism of anovulation. Willis DS, Watson H, Mason HD, Galea R, Brincat M, Franks S. J Clin Endocrinol Metab. 1998 Nov;83(11):3984-91.<\/p>\n\n\n\n<p>112-Etiology of anovulation in polycystic ovary syndrome. Franks S, Mason H, White D, Willis D. Steroids. 1998 May-Jun;63(5-6):306-7.<\/p>\n\n\n\n<p>113-Follicle dynamics and anovulation in polycystic ovary syndrome. Franks S, Stark J, Hardy K. Hum Reprod Update. 2008 Jul-Aug;14(4):367-78.<\/p>\n\n\n\n<p>114-Increased protein expression of LHCG receptor and 17\u03b1-hydroxylase\/17-20-lyase in human polycystic ovaries. Comim FV, Teerds K, Hardy K, Franks S. Hum Reprod. 2013 Nov;28(11):3086-92.<\/p>\n\n\n\n<p>115-Developmental programming: rescuing disruptions in preovulatory follicle growth and steroidogenesis from prenatal testosterone disruption. Veiga-Lopez A, Moeller J, Abbott DH, Padmanabhan V. J Ovarian Res. 2016 Jun 29;9(1):39.<\/p>\n\n\n\n<p>116-Current concepts of the roles of follicle stimulating hormone and luteinizing hormone in folliculogenesis. Hillier SG. Hum Reprod. 1994 Feb;9(2):188-91.<\/p>\n\n\n\n<p>117-Cellular aspects of pre-ovulatory folliculogenesis in primate ovaries. Hillier SG, Harlow CR, Shaw HJ, Wickings EJ, Dixson AF, Hodges JK. Hum Reprod. 1988 May;3(4):507-11.<\/p>\n\n\n\n<p>118-Intrafollicular paracrine function of ovarian androgen. Hillier SG. J Steroid Biochem. 1987;27(1-3):351-7.<\/p>\n\n\n\n<p>119-Intracrinology. Labrie F. Mol Cell Endocrinol. 1991 Jul;78(3):C113-8.<\/p>\n\n\n\n<p>120-Endocrine and intracrine sources of androgens in women: inhibition of breast cancer and other roles of androgens and their precursor dehydroepiandrosterone. Labrie F, Luu-The V, Labrie C, B\u00e9langer A, Simard J, Lin SX, Pelletier G. Endocr Rev. 2003 Apr;24(2):152-82.<\/p>\n\n\n\n<p>121-DHEA and its transformation into androgens and estrogens in peripheral target tissues: intracrinology. Labrie F, Luu-The V, Labrie C, Simard J. Front Neuroendocrinol. 2001 Jul;22(3):185-212.<\/p>\n\n\n\n<p>122-Sexual hormones in human skin. Zouboulis CC, Chen WC, Thornton MJ, Qin K, Rosenfield R. Horm Metab Res. 2007 Feb;39(2):85-95.<\/p>\n\n\n\n<p>123-Dihydrotestosterone is a peripheral paracrine hormone. Horton R. J Androl. 1992 Jan-Feb;13(1):23-7.<\/p>\n\n\n\n<p>124-Tissue distribution and ontogeny of steroid 5 alpha-reductase isozyme expression. Thigpen AE, Silver RI, Guileyardo JM, Casey ML, McConnell JD, Russell DW. J Clin Invest. 1993 Aug;92(2):903-10.<\/p>\n\n\n\n<p>125-Relative binding affinity of anabolic-androgenic steroids: comparison of the binding to the androgen receptors in skeletal muscle and in prostate, as well as to sex hormone-binding globulin. Saartok T, Dahlberg E, Gustafsson JA. Endocrinology. 1984 Jun;114(6):2100-6.<\/p>\n\n\n\n<p>126-The biochemical basis for increased testosterone production in theca cells propagated from patients with polycystic ovary syndrome. Nelson VL, Qin KN, Rosenfield RL, Wood JR, Penning TM, Legro RS, Strauss JF 3rd, McAllister JM. J Clin Endocrinol Metab. 2001 Dec;86(12):5925-33.<\/p>\n\n\n\n<p>127-Luteinizing hormone receptor, steroidogenesis acute regulatory protein, and steroidogenic enzyme messenger ribonucleic acids are overexpressed in thecal and granulosa cells from polycystic ovaries. Jakimiuk AJ, Weitsman SR, Navab A, Magoffin DA. J Clin Endocrinol Metab. 2001 Mar;86(3):1318-23.<\/p>\n\n\n\n<p>128-Genetic and pharmacological evidence for more than one human steroid 5 alpha-reductase. Jenkins EP, Andersson S, Imperato-McGinley J, Wilson JD, Russell DW. J Clin Invest. 1992 Jan;89(1):293-300.<\/p>\n\n\n\n<p>129-Localization of androgen receptors in human skin by immunohistochemistry: implications for the hormonal regulation of hair growth, sebaceous glands and sweat glands. Choudhry R, Hodgins MB, Van der Kwast TH, Brinkmann AO, Boersma WJ. J Endocrinol. 1992 Jun;133(3):467-75.<\/p>\n\n\n\n<p>130-Location of androgen receptor in human skin. Bl\u00e4uer M, Vaalasti A, Pauli SL, Ylikomi T, Joensuu T, Tuohimaa P. J Invest Dermatol. 1991 Aug;97(2):264-8.<\/p>\n\n\n\n<p>131-Immunocytochemical localization of androgen receptors in human skin using monoclonal antibodies against the androgen receptor. Liang T, Hoyer S, Yu R, Soltani K, Lorincz AL, Hiipakka RA, Liao S. J Invest Dermatol. 1993 May;100(5):663-6.<\/p>\n\n\n\n<p>132-5alpha-reductase 1 and 2 expression and activity in human ovarian follicles, stroma and corpus luteum as compared to neonatal foreskin. Haning RV, Jr, Tantravahi U, Zhao Q, Hackett RJ, Canick JA. J Steroid Biochem Mol Biol. 1996 Oct;59(2):199-204.<\/p>\n\n\n\n<p>133-5alpha-reductase activity in women with polycystic ovary syndrome. Jakimiuk AJ, Weitsman SR, Magoffin DA. J Clin Endocrinol Metab. 1999 Jul;84(7):2414-8.<\/p>\n\n\n\n<p>134-Stage-specific expression of androgen receptor, follicle-stimulating hormone receptor, and anti-M\u00fcllerian hormone type II receptor in single, isolated, human preantral follicles: relevance to polycystic ovaries. Rice S, Ojha K, Whitehead S, Mason H. J Clin Endocrinol Metab. 2007 Mar;92(3):1034-40.<\/p>\n\n\n\n<p>135-In human granulosa cells from small antral follicles, androgen receptor mRNA and androgen levels in follicular fluid correlate with FSH receptor mRNA. Nielsen ME, Rasmussen IA, Kristensen SG, Christensen ST, M\u00f8llg\u00e5rd K, Wreford Andersen E, Byskov AG, Andersen C. Mol Hum Reprod. 2011 Jan;17(1):63-70.<\/p>\n\n\n\n<p>136-Androgens regulate ovarian follicular development by increasing follicle stimulating hormone receptor and microRNA-125b expression. Sen A, Prizant H, Light A, Biswas A, Hayes E, Lee HJ, Barad D, Gleicher N, Hammes SR. Proc Natl Acad Sci U S A. 2014 Feb 25;111(8):3008-13.<\/p>\n\n\n\n<p>137-Cloning of human androgen receptor complementary DNA and localization to the X chromosome. Lubahn DB, Joseph DR, Sullivan PM, Willard HF, French FS, Wilson EM. Science. 1988 Apr 15;240(4850):327-30.<\/p>\n\n\n\n<p>138-The prevalence of polycystic ovaries in patients with congenital adrenal hyperplasia and their close relatives. Hague WM, Adams J, Rodda C, Brook CG, de Bruyn R, Grant DB, Jacobs HS. Clin Endocrinol (Oxf). 1990 Oct;33(4):501-10.<\/p>\n\n\n\n<p>139-Polycystic ovaries in female-to-male transsexuals. Pache TD, Fauser BC. Clin Endocrinol (Oxf). 1993 Dec;39(6):702-3.<\/p>\n\n\n\n<p>140-Nutrition, insulin and polycystic ovary syndrome. Franks S, Robinson S, Willis DS. Rev Reprod. 1996 Jan;1(1):47-53.<\/p>\n\n\n\n<p>141-The severity of menstrual dysfunction as a predictor of insulin resistance in PCOS. Brower M, Brennan K, Pall M, Azziz R. J Clin Endocrinol Metab. 2013 Dec;98(12):E1967-71.<\/p>\n\n\n\n<p>142-Women with polycystic ovary syndrome wedge resected in 1956 to 1965: a long-term follow-up focusing on natural history and circulating hormones. Dahlgren E, Johansson S, Lindstedt G, Knutsson F, Od\u00e9n A, Janson PO, Mattson LA, Crona N, Lundberg PA. Fertil Steril. 1992 Mar;57(3):505-13.<\/p>\n\n\n\n<p>143-Amenorrhea associated with bilateral polycystic ovaries. Stein IF, Leventhal ML. Am J Obstet Gynecol. 1935, 29(2):181-191.<\/p>\n\n\n\n<p>144-Variation of the human menstrual cycle through reproductive life. Treloar AE, Boynton RE, Behn BG, Brown BW. Int J Fertil. 1967 Jan-Mar;12(1 Pt 2):77-126.<\/p>\n\n\n\n<p>145-Polycystic ovary syndrome: the spectrum of the disorder in 1741 patients. Balen AH, Conway GS, Kaltsas G, TechatrasakK, Manning PJ, West C, Jacobs HS. Hum Reprod. 1995 Aug;10(8):2107-11.<\/p>\n\n\n\n<p>146-Heterogeneity of the polycystic ovary syndrome: clinical, endocrine and ultrasound features in 556 patients. Conway GS, Honour JW, Jacobs HS. Clin Endocrinol (Oxf). 1989 Apr;30(4):459-70.<\/p>\n\n\n\n<p>147-Androgen excess in women: experience with over 1000 consecutive patients. Azziz R, Sanchez LA, Knochenhauer ES, Moran C, Lazenby J, Stephens KC, Taylor K, Boots LR. J Clin Endocrinol Metab. 2004 Feb;89(2):453-62.<\/p>\n\n\n\n<p>148-The ovarian androgen producing cells: a review of structure\/function relationships. Erickson GF, Magoffin DA, Dyer CA, Hofeditz C. Endocr Rev. 1985 Summer;6(3):371-99.<\/p>\n\n\n\n<p>149-Evidence for a primary abnormality of thecal cell steroidogenesis in the polycystic ovary syndrome. Gilling-Smith C, Story H, Rogers V, Franks S. Clin Endocrinol (Oxf). 1997 Jul;47(1):93-9.<\/p>\n\n\n\n<p>150-Ovarian enzyme activities in women with polycystic ovary syndrome. Magoffin DA. Fertil Steril. 2006 ul;86 Suppl 1:S9-S11.<\/p>\n\n\n\n<p>151-Anti-androgenic activities of Ganoderma lucidum. Fujita R, Liu J, Shimizu K, Konishi F, Noda K, Kumamoto S, Ueda C, Tajiri H, Kaneko S, Suimi Y, Kondo R. J Ethnopharmacol. 2005 Oct 31;102(1):107-12.<\/p>\n\n\n\n<p>152-Evaluation of 5\u03b1-reductase inhibitory activity of certain herbs useful as antiandrogens. Nahata A, Dixit VK. Andrologia. 2014 Aug;46(6):592-601.<\/p>\n\n\n\n<p>153-Ganoderma lucidum is an inhibitor of testosterone-induced prostatic hyperplasia in rats. Nahata A, Dixit VK. Andrologia. 2012 May;44 Suppl 1:160-74.<\/p>\n\n\n\n<p>154-Effect of traditional herbal medicine, shakuyaku-kanzo-to on total and free serum testosterone levels. Takeuchi T, Nishii O, Okamura T, Yaginuma T.&nbsp;Am J Chin Med. 1989;17(1-2):35-44.<\/p>\n\n\n\n<p>155-Licorice reduces serum testosterone in healthy women. Armanini D, Mattarello MJ, Fiore C, Bonanni G, Scaroni C, Sartorato P, Palermo M.&nbsp;Steroids.2004 Oct-Nov;69(11-12):763-6.<\/p>\n\n\n\n<p>156-Treatment of polycystic ovary syndrome with spironolactone plus licorice. Armanini D, Castello R, Scaroni C, Bonanni G, Faccini G, Pellati D, Bertoldo A, Fiore C, Moghetti P.&nbsp;Eur J Obstet Gynecol Reprod Biol.2007&nbsp; Mar;131(1):61-67.<\/p>\n\n\n\n<p>157-Estrogen-like activity of glabrene and other constituents isolated from licorice root. Tamir S, Eizenberg M, Somjen D, Izrael S, Vaya J.&nbsp;J Steroid Biochem Mol Biol. 2001 Sep;78(3):291-8.<\/p>\n\n\n\n<p>158-Estrogen-like activity of glabrene and other constituents isolated from licorice root.&nbsp;Tamir S, Eizenberg M, Somjen D, Izrael S, Vaya J.&nbsp;J Steroid Biochem Mol Biol. 2001 Sep;78(3):291-8.<\/p>\n\n\n\n<p>159-Effect of TJ-68 (shakuyaku-kanzo-to) on polycystic ovarian disease. Takahashi K, Kitao M.&nbsp;Int J Fertil Menopausal Stud. 1994 Mar-Apr;39(2):69-76.<\/p>\n\n\n\n<p>160-Alopecia: herbal remedies.&nbsp;Kaushik R, Gupta D, Yadav R.&nbsp;Int J Pharm Sci Res. 2011;2:1631-1637.<\/p>\n\n\n\n<p>161-Hair growth stimulating effect and phytochemical evaluation of hydro-alcoholic extract of glycyrrhiza glabra. Saumendu DR, Raj KP.&nbsp;Glob J Res Med plants Indig Med.&nbsp; 2014;3:40-47.<\/p>\n\n\n\n<p>162-Potentially of petroleum ether (60-80)\u00baC extract of Glycyrrhiza glabra on androgenic alopecia. Upadhyay S, Singh V. Asian J Pharm Clin Res. 2013;6:52-55.<\/p>\n\n\n\n<p>163-Glycyrrhiza glabra: a phytopharmacological review. Int J Pharm Sci Res. 2013;4:2470-2477.<\/p>\n\n\n\n<p>164-The effect of extracts of the roots of the stinging nettle (Urtica dioica) on the interaction of SHBG with its receptor on human prostatic membranes. Hryb DJ, Khan MS, Romas NA, Rosner W.&nbsp;Planta Med. 1995 Feb;61(1):31-2.<\/p>\n\n\n\n<p>165-Ameliorative effects of stinging nettle (Urtica dioica) on testosterone-induced prostatic hyperplasia in rats. Nahata A, Dixit VK.&nbsp;Andrologia. 2012 May;44 Suppl 1:396-409.<\/p>\n\n\n\n<p>166-Therapeutic effects of stinging nettle (Urtica dioica) in women with hyperandrogenism. Najafipour F, Rahimi AO, Mobaseri M, Aliasgharzadeh A. Int J Current Res Acad Rev. 2014;2(7):153-160.<\/p>\n\n\n\n<p>167-Lignans from the roots of Urtica dioica and their metabolites bind to human sex hormone binding globulin (SHBG). Sch\u00f6ttner M, Gansser D, Spiteller G.&nbsp;Planta Med. 1997 Dec;63(6):529-32.<\/p>\n\n\n\n<p>168-The effect of Permixon on androgen receptors. el-Sheikh MM, Dakkak MR, Saddique A.&nbsp;Acta Obstet Gynecol Scand. 1988;67(5):397-9.<\/p>\n\n\n\n<p>169-Comparitive effectiveness of finasteride vs serenoa repens in male androgenetic alopecia: a two-year study. Rossi A, Mari E, Scarno M, Garelli V, Maxia C, Scali E, Iorio A, Carlesimo M.&nbsp;Int J Immunopathol Pharmacol. 2012 Oct-Dec;25(4):1167-73.<\/p>\n\n\n\n<p>170-&nbsp;Serenoa Repens: Does it have Any Role in the Managenent of Androgenetic Alopecia? Murugusundram S.&nbsp;J Cutan Aesthet Surg. 2009 Jan;2(1):31-2.<\/p>\n\n\n\n<p>171-Determination of the potency of a novel saw palmetto supercritical CO2 extract (SPSE) for 5\u03b1-reductase isoform II inhibition using a cell-free in vitro test system. Pais P, Villar A, Rull S.&nbsp;Res Rep Urol. 2016 Apr 21;8:41-9.<\/p>\n\n\n\n<p>172-A randomized, double-blind, placebo-controlled trial to determine the effectiveness of botanically derived inhibitors of 5-alpha-reductase in the treatment of androgenetic alopecia. Prager N, Bickett K, French N, Marcovici G.&nbsp;J Altern Complement Med. 2002 Apr;8(2):143-52.<\/p>\n\n\n\n<p>173-Tissue effects of saw palmetto and finasteride: use of biopsy cores for in situ quantification of prostatic androgens. Marks LS, Hess DL, Dorey FJ, Luz Macairan M, Cruz Santos PB, Tyler VE.&nbsp;Urology. 2001 May;57(5):999-1005.<\/p>\n\n\n\n<p>174-Herbal preperations for the treatment of hair loss. Zgonc \u0160kulj A, Polj\u0161ak N, Ko\u010devar Glava\u010d N, Kreft S.&nbsp;Arch Dermatol Res. 2019 Nov 3.<\/p>\n\n\n\n<p>175-Effect of green tea on metabolic and hormonal aspect of polycystic ovarian syndrome in overweight and obese women suffering from polycystic ovarian syndrome: A clinical trial. Tehrani HG, Allahdadian M, Zarre F, Ranjbar H, Allahdadian F.&nbsp;J Educ Health Promot. 2017 May 5;6:36.<\/p>\n\n\n\n<p>176-Effects of Chinese green tea on weight, and hormonal and biochemical profiles in obese patients with polycystic ovary syndrome\u2013a randomized placebo-controlled trial. Chan CC, Koo MW, Ng EH, Tang OS, Yeung WS, Ho PC.&nbsp;J Soc Gynecol Investig. 2006 Jan;13(1):63-8.<\/p>\n\n\n\n<p>177-Green Tea: A magical herb with miraculous outcomes. Jigisha A, Nishant R, Navin K, Pankaj G. IRJP. 2012;3(5):139-148.<\/p>\n\n\n\n<p>178-The effects of tea polyphenolic compounds on hair loss among rodents. Esfandiari A, Kelly AP.&nbsp;J Natl Med Assoc.2005 Aug;97(8):1165-9.<\/p>\n\n\n\n<p>179-Structure-activity relationships for inhibition of human 5alpha-reductases by polyphenols. Hiipakka RA, Zhang HZ, Dai W, Dai Q, Liao S.&nbsp;Biochem Pharmacol. 2002 Mar 15;63(6):1165-76.<\/p>\n\n\n\n<p>180-Human hair growth enhancement in vitro by green tea epigallocatechin-3-gallate (EGCG). Kwon OS, Han JH, Yoo HG, Chung JH, Cho KH, Eun HC, Kim KH.&nbsp;Phytomedicine. 2007 Aug;14(7-8):551-5.<\/p>\n\n\n\n<p>181-Effect of pumpkin seed oil on hair growth in men with androgenetic alopecia: a randomized, double-blind, placebo-controlled trial. Cho YH, Lee SY, Jeong DW, Choi EJ, Kim YJ, Lee JG, Yi YH, Cha HS.&nbsp;Evid Based Complement Alternat Med. 2014;2014:549721.<\/p>\n\n\n\n<p>182-Inhibition of testosterone-induced hyperplasia of the prostate&nbsp; of sprague-dawley rats by pumpkin seed oil.&nbsp;Gossell-Williams M, Davis a, O\u2019Connor N.&nbsp;J Med Food. 2006 Summer;9(2):284-6.<\/p>\n\n\n\n<p>183-Promotion of hair growth by Rosmarinus officinalis leaf extract.&nbsp;Murata K, Noguchi K, Kondo M, Onishi M, Watanabe N, Okamura K, Matsuda H.&nbsp;Phytother Res. 2013 Feb;27(2):212-7.<\/p>\n\n\n\n<p>184-Rosemary oil vs minoxidil 2% for the treatment of androgenetic alopecia: a randomized comparative trial. Panahi Y, Taghizadeh M, Marzony ET, Sahebkar A.&nbsp;Skinmed. 2015 Jan-Feb;13(1):15-21.<\/p>\n\n\n\n<p>185-Proanthocyanidins from grape seeds promote proliferation of mouse hair follicle cells in vitro and convert hair cycle in vivo. Takahashi T, Kamiya T, Yokoo Y.&nbsp;Acta Derm Venereol. 1998 Nov;78(6):428-32.<\/p>\n\n\n\n<p>186-Grape Seed Oil Compounds: Biological and Chemical Actions for Health. Garavaglia J, Markoski MM, Oliveira A, Marcadenti A.&nbsp;Nutr Metab Insights. 2016Aug 16;9:59-64.<\/p>\n\n\n\n<p>187-Effect of Benincasa hispida fruits on testosterone-induced prostatic hypertrophy in albino rats. Nandecha C, Nahata A, Dixit VK.&nbsp;Curr Ther Res Clin Exp. 2010 Oct;71(5):331-43.<\/p>\n\n\n\n<p>188-Effect of spearmint (Mentha spicata Labiatae) teas on androgen levels in women with hirsutism.&nbsp;Akdo\u011fan M, Tamer MN, C\u00fcre E, C\u00fcre MC, K\u00f6ro\u011flu BK, Deliba\u015f N.&nbsp;Phytother Res.2007 May;21(5):444-7.<\/p>\n\n\n\n<p>189-Spearmint herbal tea has significant anti-androgen effects in polycystic ovarian syndrome. A randomized controlled trial.&nbsp; Grant P.&nbsp;Phytother Res. 2010 Feb;24(2):186-8.<\/p>\n\n\n\n<p>190-Effects of peppermint teas on plasma testosterone, follicle-stimulating hormone, and luteinizing hormone levels and testicular tissue in rats. Akdo\u011fan M, Ozguner M, Kocak A, Oncu M, Cicek E.&nbsp;Urology.2004 Aug;64(2):394-8.<\/p>\n\n\n\n<p>191-Role of Essential Oil of Mentha Spicata (Spearmint) in Addressing Reverse Hormonal and Folliculogenesis Disturbances in a Polycystic Ovarian Syndrome in a Rat Model.&nbsp;Sadeghi Ataabadi M, Alaee S, Bagheri MJ, Bahmanpoor S.&nbsp;Adv Pharm Bull. 2017 Dec;7(4):651-654.<\/p>\n\n\n\n<p>192-A combination of spearmint and flaxseed extract improved endocrine and histomorphology of ovary in experimental PCOS.&nbsp;Mehraban M, Jelodar G, Rahmanifar F.&nbsp;J Ovarian Res. 2020 Mar 20;13(1):32.<\/p>\n\n\n\n<p>193-Antitumor agents. 217. Curcumin analogues as novel androgen receptor antagonists with potential as anti-prostate cancer agents. Ohtsu H, Xiao Z, Ishida J, Nagai M, Wang HK, Itokawa H, Su CY, Shih C, Chiang T, Chang E, Lee Y, Tsai MY, Chang C, Lee KH.&nbsp;J Med Chem. 2002 Nov 7;45(23):5037-42.<\/p>\n\n\n\n<p>194-Sesquiterpene-Enriched Extract of Curcuma aeruginosa Roxb. Retards Axillary Hair Growth: A Randomised, Placebo-Controlled, Double-Blind Study. Srivilai J, Nontakhot K, Nutuan T, Waranuch N, Khorana N, Wisuthiprot W, Scholfield CN, Champachaisri K, Ingkaninan K.&nbsp;Skin Pharmacol Physiol. 2018;31(2):99-106.<\/p>\n\n\n\n<p>195-Anti-androgenic effect of sesquiterpenes isolated from the rhizomes of Curcuma aeruginosa Roxb. Suphrom N, Pumthong G, Khorana N, Waranuch N, Limpeanchob N, Ingkaninan K.&nbsp;Fitoterapia. 2012 Jul;83(5):864-71.<\/p>\n\n\n\n<p>196-Cryptotanshinone reverses reproductive and metabolic disturbances in prenatally androgenized rats via regulation of ovarian signaling mechanisms and androgen synthesis. Yang X, Zhang Y, Wu X, Bae CS, Hou L , Kuang H, Wang Y, Stener-Victorin E&nbsp;Am J Physiol Regul Integr Comp Physiol. 2011 Apr;300(4):R869-75.<\/p>\n\n\n\n<p>197-Effects of tanshinone on hyperandrogenism and the quality of life in women with polycystic ovary syndrome: protocol of a double-blind, placebo-controlled, randomised trial.&nbsp;Shen W, Zhang Y, Li W, Cong J, Zhou Y, Ng EH, Wu X. BMJ Open. 2013 Oct 25;3(10): e003646.<\/p>\n\n\n\n<p>198-ReishiMax, mushroom based dietary supplement, inhibits adipocyte differentiation, stimulates glucose uptake and activates AMPK.&nbsp;Thyagarajan-Sahu A, Lane B, Sliva D.&nbsp;BMC Complement Altern Med. 2011 Sep 19;11:74.<\/p>\n\n\n\n<p>199-Antidiabetic activity of&nbsp; Ganoderma lucidum polysaccharides F31 down-regulated hepatic glucose regulatory enzymes in diabetic mice. Xiao C, Wu Q, Zhang J, Xie Y, Cai W, Tan J.&nbsp;J Ethnopharmacol. 2017 Jan 20;196:47-57.<\/p>\n\n\n\n<p>200-A novel PTP1B inhibitor extracted from Ganoderma lucidum ameliorates insulin resistance &nbsp; by regulating IRS1-GLUT4 cascades in the ins\u00fclin signaling pathway.&nbsp;Yang Z , Wu F , He Y , Zhang Q , Zhang Y , Zhou G , Yang H , Zhou P.&nbsp;Food Funct. 2018 Jan 24;9(1):397-406.<\/p>\n\n\n\n<p>201-New Insights into Bioactive Compounds of Traditional Chinese Medicines for \u0131nsulin Resistance Based on Signaling Pathways. He J, Wang H, Vijg J.&nbsp;Chem Biodivers. 2019 Sep;16(9):e1900176.<\/p>\n\n\n\n<p>202-Therapeutic Mechanisms of Herbal Medicines Against Insulin Resistance: A Review. Li J, Bai L, Wei F, Zhao J, Wang D, Xiao Y, Yan W, Wei J.&nbsp;Front Pharmacol. 2019 Jun 14;10:661.<\/p>\n\n\n\n<p>203-Molecular mechanisms of bioactive polysaccharides from Ganoderma&nbsp; (Lingzhi), a review. Lu J, He R, Sun P, Zhang F, Linhardt RJ, Zhang A.&nbsp;Int J Biol Macromol. 2020 May 1;150:765-774.<\/p>\n\n\n\n<p>204-Changes of Insulin resistance and Adipokines Following Supplementation with Glycyrrhiza Glabra L<em>.<\/em>&nbsp;Extract in Combination with a Low-Calorie Diet in Overweight and Obese Subjects: a Randomized Double Blind Clinical Trial. Alizadeh M, Namazi N, Mirtaheri E, Sargheini N, Kheirouri S. Adv Pharm Bull. 2018 Mar;8(1):123-130.<\/p>\n\n\n\n<p>205-Glycyrrhizin ameliorates insulin resistance, hyperglycemia, dyslipidemia and oxidative stress in fructose-induced metabolic syndrome-X in rat model.&nbsp;Sil R, Ray D, Chakraborti AS.&nbsp;Indian J Exp Biol. 2013 Feb;51(2):129-38.<\/p>\n\n\n\n<p>206-Suppression by licorice flavonoids of abdominal fat accumulation and body weight gain in high-fat diet-induced obese C57BL\/6J mice. Aoki F, Honda S, Kishida H, Kitano M, Arai N, Tanaka H, Yokota S, Nakagawa K, Asakura T, Nakai Y, Mae T.&nbsp;Biosci Biotechnol Biochem. 2007 Jan;71(1):206-14.<\/p>\n\n\n\n<p>207-Insulin resistance improvement by cinnamon powder in polycystic ovary syndrome: A randomized double-blind placebo controlled clinical trial.&nbsp;Hajimonfarednejad M, Nimrouzi M, Heydari M, Zarshenas MM, Raee MJ, Jahromi BN.&nbsp;Phytother Res. 2018 Feb;32(2):276-283.<\/p>\n\n\n\n<p>208-The effect of cinnamon extract on insulin resistance parameters in polycystic ovary syndrome: a pilot study. Wang JG, Anderson RA, Graham GM 3rd, Chu MC , Sauer MV, Guarnaccia MM, Lobo RA.&nbsp;Fertil Steril. 2007 Jul;88(1):240-3.<\/p>\n\n\n\n<p>209-Metabolic changes and hormonal disturbances in polycysticovarian syndromr rats and the amelioration effects of metformin and\/or cinnamon extraction. Heibashy M, Mazen G, Shahin M. J Am Sci. 2013, 9(12):54-62.<\/p>\n\n\n\n<p>210-&nbsp;The effect of cinnamon on polycystic ovary syndromr in a Mouse model.&nbsp; Dou L, Zheng Y, Li L, Gui X, Chen Y, Yu M, Guo Y.&nbsp;Reprod Biol Endocrinol. 2018 Oct 19;16(1):99.<\/p>\n\n\n\n<p>211-Cinnamon extract (traditional herb) potentiates in vivo insulin-regulated glucose utilization via enhancing insulin signaling in rats. Qin B, Nagasaki M, Ren M, Bajotto G, Oshida Y, Sato Y. Diabetes Res Clin Pract. 2003 Dec;62(3):139-48.<\/p>\n\n\n\n<p>212-Isolation and characterization of polyphenol type-A polymers from cinnamon with insulin-like biological activity. Anderson RA, Broadhurst CL, Polansky MM, Schmidt WF, Khan A, Flanagan VP, Schoene NW, Graves DJ.&nbsp;J Agric Food Chem. 2004 Jan 14;52(1):65-70.<\/p>\n\n\n\n<p>213-Insulin-like biological activity of culinary and medicinal plant aqueous extracts in vitro.&nbsp;Broadhurst CL, Polansky MM, Anderson RA.&nbsp;J Agric Food Chem. 2000 Mar;48(3):849-52.<\/p>\n\n\n\n<p>214-Efficacy and safety of&nbsp; berberine in the treatment of type 2 diabetes with insulin resistance: Protocol for a systematic review. Wang Y, Yan A, Li S, Liu B, Li H, Yan Y.&nbsp;Medicine (Baltimore). 2019Aug;98(35):e16947.<\/p>\n\n\n\n<p>215-The Effect of Berberine on Reproduction and Metabolism in Women with Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis of Randomized Control Trials.&nbsp;Xie L, Zhang D, Ma H, He H, Xia Q, Shen W, Chang H, Deng Y, Wu Q, Cong J, Wang CC, Wu X.&nbsp;Evid Based Complement Alternat Med. 2019 Dec 13;2019:7918631.<\/p>\n\n\n\n<p>216-The Effect of Berberine on Polycystic Ovary Syndrome Patients with Insulin Resistance (PCOS-IR): A Meta-Analysis and Systematic Review.&nbsp;Li MF, Zhou XM, Li XL.&nbsp;Evid Based Complement Alternat Med. 2018 Nov 14;2018:2532935.<\/p>\n\n\n\n<p>217-Polycystic ovary syndrome management: a review of the possible amazing role of berberine.&nbsp;Rondanelli M, Infantino V, Riva A, Petrangolini G, Faliva MA, Peroni G, Naso M, Nichetti M, Spadaccini D, Gasparri C, Perna S.&nbsp;Arch Gynecol Obstet. 2020 Jan;301(1):53-60.<\/p>\n\n\n\n<p>218-&nbsp;&nbsp;Berberine reduces insulin resistance induced by dexamethasone in theca cells in vitro. Zhao L, Li W, Han F, Hou L, Baillargeon JP, Kuang H, Wang Y, Wu X.&nbsp;Fertil Steril. 2011 Jan;95(1):461-3.<\/p>\n\n\n\n<p>219-Systems pharmacology to investigate the interaction of berberine &nbsp; and other drugs in treating polycystic ovary syndrome. Wang Y, Fu X, Xu J, Wang Q, kuang H.&nbsp;Sci Rep. 2016 Jun 16;6:28089.<\/p>\n\n\n\n<p>220-&nbsp;&nbsp;Berberine-improved visceral white adipose tissue insulin resistance associated with altered sterol regulatory element-binding proteins, liver x receptors, and peroxisome proliferator-activated receptors transcriptional programs in diabetic hamsters.&nbsp;Li GS, Liu XH, Zhu H, Huang L, Liu YL, Ma CM, Qin C.&nbsp;Biol Pharm Bull. 2011;34(5):644-54.<\/p>\n\n\n\n<p>221-&nbsp;Berberine inhibits inflammatory response and ameliorates insulin resistance in hepatocytes. Lou T, Zhang Z, Xi Z, Liu K, Li L, Liu B, Huang F.&nbsp;Inflammation. 2011 Dec;34(6):659-67.<\/p>\n\n\n\n<p>222-Structural changes of gut microbiota during berberine -mediated prevention of obesity and insulin resistance in high-fat diet-fed rats.&nbsp;Zhang X, Zhao Y, Zhang M, Pang X, Xu J, Kang C, Li M, Zhang C, Zhang Z, Zhang Y, Li X, Ning G, Zhao L.&nbsp;PLoS One. 2012;7(8):e42529.<\/p>\n\n\n\n<p>223-&nbsp;Berberine&nbsp; a natural plant product, activates AMP-activated protein kinase with beneficial metabolic effects in diabetic and insulin-resistant states. Lee YS, Kim WS, Kim KH, Yoon MJ, Cho HJ, Shen Y, Ye JM, Lee CH, Oh WK, Kim CT, Hohnen-Behrens C, Gosby A, Kraegen EW, James DE, Kim JB.&nbsp;Diabetes. 2006 Aug;55(8):2256-64.<\/p>\n\n\n\n<p>224-Ethanol extraction preparation of American ginseng (Panax quinquefolius L) and Korean red ginseng (Panax ginseng C.A. Meyer): differential effects on postprandial insulinemia in healthy individuals.De Souza LR, Jenkins AL, Jovanovski E, Raheli\u0107 D, Vuksan V.&nbsp;J Ethnopharmacol. 2015 Jan 15;159:55-61.J.<\/p>\n\n\n\n<p>225-Adaptive thermogenesis in adipocytes: is beige the new brown?Wu P, Cohen BM Spiegelman Genes Dev. 2013, 27:234-50.<\/p>\n\n\n\n<p>226-Ginsenoside Rb1 promotes browning through regulation of PPARg in 3T3-L1 adipocytes. Q. Mu, X. Fang, X. Li, J. Zhao, G. Wang, C. Guo, W. Shang. Biochem. Biophys. Res. Commun. 2015, 466, 530\u2013535.<\/p>\n\n\n\n<p>227-Central infammation and leptin resistance are attenuated by ginsenoside Rb1 treatment inobese mice fed a high-fat diet. Wu, Y, Yu, Y, Szabo, A, Han, M, Huang, X.F.&nbsp; PLoSONE 2014,9,e92618.<\/p>\n\n\n\n<p>228-Ginsenoside Rb1 increases insulin sensitivity by activating AMP-activated protein kinase in male rats. Shen, L, Haas, M, Wang, D.Q, May, A, Lo, C.C, Obici, S, Tso, P.; Woods, S.C, Liu, M.Physiol. Rep. 2015, 3, e12543.<\/p>\n\n\n\n<p>229-Ginsenoside Re reduces insulin resistance through activation of PPAR-\u03b3 pathway and inhibition of TNF-\u03b1 production.&nbsp;Gao Y, Yang MF, Su YP, Jiang HM, You XJ, Yang YJ, Zhang HL.&nbsp;J Ethnopharmacol. 2013 May 20;147(2):509-16.<\/p>\n\n\n\n<p>230-&nbsp;Ginsenoside Rb1 as an Anti-Diabetic Agent and its Underlying Mechanism Analysis.&nbsp; Zhou P, Xie W, He S, Sun Y, Meng X, Sun G, Sun X.&nbsp;Cells. 2019 Feb 28;8(3).<\/p>\n\n\n\n<p>231-Anti-diabetic potential of Panax notoginseng saponins (PNS): a review. Uzayisenga R, Ayeka PA, Wang Y.&nbsp;Phytother Res. 2014 Apr;28(4):510-6.<\/p>\n\n\n\n<p>232-Effect of synbiotic pomegranate juice on glycemic, sex hormone profile and anthropometric indices in PCOS: A randomized, triple blind, controlled trial.&nbsp;Esmaeilinezhad Z, Babajafari S, Sohrabi Z, Eskandari M, Amooee S, Barati-Boldaji R.&nbsp;Nutr Metab Cardiovasc Dis. 2019 Feb;29(2):201-208.<\/p>\n\n\n\n<p>233-&nbsp;Antidiabetic effect of Punica granatum flowers: effect on hyperlipidemia, pancreatic cells lipid peroxidation and antioxidant enzymes in experimental diabetes. P. Bagri, M. Ali, V. Aeri, M. Bhowmik, S. Sultana. Food Chem. Toxicol. 2008, 47, 50\u201354.<\/p>\n\n\n\n<p>234-Experimental study of Punica granatum flower polyphenol\u2019s effect on IL-6, TXB2\u2019s and PPAR-\u03b3 mRNA\u2019s expression in IR rats. Q. Dou, Y. Y. Wei, Y. Li, D. Yan, L. Adi, T. Yuan, Y. Kurexi, K. Parhat.&nbsp; Chin. Pharm. Bull. 2010, 26, 794\u2013 797.<\/p>\n\n\n\n<p>235-Comparison of potential preventive effects of pomegranate&nbsp; flower, peel and seed oil on ins\u00fclin resistance and inflammation in high-fat and high-sucrose diet-induced obesity mice model.&nbsp;Harzallah A, Hammami M, K\u0119pczy\u0144ska MA, Hislop DC, Arch JR, Cawthorne MA, Zaibi MS.&nbsp;Arch Physiol Biochem. 2016 ;122(2):75-87.<\/p>\n\n\n\n<p>236-Does grape seed oil improve inflammation and insulin resistance in overweight or obese women? Irandoost P, Ebrahimi-Mameghani M, Pirouzpanah S. Int&nbsp;J Food Sci Nutr. 2013;64(6):706\u2013710.<\/p>\n\n\n\n<p>237-Supplementation with viti vinifera L.&nbsp; skin extract improves&nbsp; ins\u00fclin resistanceand prevents hepa tic lipid accumulation and steatosis in high-fat diet-fed mice.&nbsp;Santos IB, de Bem GF, Cordeiro VSC, da Costa CA, de Carvalho LCRM, da Rocha APM, da Costa GF, Ognibene DT, de Moura RS, Resende AC.&nbsp;Nutr Res. 2017 Jul;43:69-81.<\/p>\n\n\n\n<p>238-Grape Sed Oil Compounds: Biological and Chemical Actions for Health. Garavaglia J, Markoski MM, Oliveira A, Marcadenti A. Nutr Metab Insights. 2016 Aug 16;9:59-64.<\/p>\n\n\n\n<p>239-Curcumin prevents high fat diet induced insulin resistance and obesity via attenuating lipogenesis in liver and inflammatory pathway in adipocytes.W. Shao, Z. Yu, Y. Chiang, Y. Yang, T. Chai, W. Foltz, H. Lu, I. G. Fantus, T. Jin. PLoS One 2012, 7, e28784.<\/p>\n\n\n\n<p>240-Curcumin improves insulin resistance in skeletal muscle of rats. L. X. Na, Y. L. Zhang, Y. Li, L. Y. Liu, R. Li, T. Kong, C. H. Sun. Nutr. Metab. Cardiovasc. Dis. 2011, 21, 526\u2013533.<\/p>\n\n\n\n<p>241-Curcumin extract for prevention of type 2 diabetes.&nbsp;Chuengsamarn S, Rattanamongkolgul S, Luechapudiporn R, Phisalaphong C, Jirawatnotai S.&nbsp;Diabetes Care. 2012 Nov;35(11):2121-7.<\/p>\n\n\n\n<p>242-Targeting curcusomes to inflammatory dendritic cells inhibits NF-\u03baB and improves insulin resistance in obese mice.&nbsp;Yekollu SK, Thomas R, O\u2019Sullivan B. Diabetes. 2011 Nov;60(11):2928-38.<\/p>\n\n\n\n<p>243-Effects of raw red onion consumption on metabolic features in overweight or obese women with polycystic ovary syndrome: a randomized controlled clinical trial.&nbsp;Ebrahimi-Mamaghani M, Saghafi-Asl M, Pirouzpanah S, Asghari-Jafarabadi M.&nbsp;J Obstet Gynaecol Res. 2014 Apr;40(4):1067-76.<\/p>\n\n\n\n<p>244-In vivo effects of dietary quercetin and quercetin-rich red nion extract on skeletal muscle mitochondria, metabolism, and ins\u00fclin sensitivity. Henagan TM, Cefalu WT, Ribnicky DM, Noland RC, Dunville K, Campbell WW, Stewart LK, Forney LA, Gettys TW, Chang JS, Morrison CD.&nbsp;Genes Nutr. 2015 Jan;10(1):451.<\/p>\n\n\n\n<p>245-Testosterone in Males as Enhanced by Onion (<em>Allium Cepa L.<\/em>).&nbsp;Banihani SA.&nbsp;Biomolecules. 2019 Feb 21;9(2).<\/p>\n\n\n\n<p>246-&nbsp;&nbsp;Onion peel extracts ameliorate hyperglycemia and insulin resistance in high fat diet\/streptozotocin-induced diabetic rats.&nbsp;Jung JY, Lim Y, Moon MS, Kim JY, Kwon O. Nutr Metab. 2011 Mar 28; 8(1):18.<\/p>\n\n\n\n<p>247-&nbsp;Piperine and Its Role in Chronic Diseases.G. Derosa, P. Maffioli, A. Sahebkar. Adv. Exp. Med. Biol. 2016, 928, 173\u2013 184.<\/p>\n\n\n\n<p>248-&nbsp;&nbsp;Piperine regulates glucose metabolism disorder in HepG2 cells of insulin resistance models via targeting upstream target of AMPK signaling pathway. C. Wan, Y. Wei, X. Li, L. Zhang, R. Yang, Z. Bao. China J. Chin. Mater. Med. 2017, 42, 542\u2013547.<\/p>\n\n\n\n<p>249-Activation of the mu-opiate receptor by Vitex agnus-castus methanol extracts: implication for its use in PMS.&nbsp;Webster DE, Lu J, Chen SN, Farnsworth NR, Wang ZJ.&nbsp;J Ethnopharmacol. 2006 Jun 30;106(2):216-21.<\/p>\n\n\n\n<p>250-Opioidergic mechanisms underlying the actions of Vitex agnus-castus L. Webster DE, He Y, Chen SN, Pauli GF, Farnsworth NR, Wang ZJ.&nbsp;Biochem Pharmacol. 2011 Jan 1;81(1):170-7.<\/p>\n\n\n\n<p>251-In vitro prolactin but not LH and FSH release is inhibited by compounds in extracts of Agnus castus: direct evidence for a dopaminergic principle by the dopamine receptor assay. Jarry H, Leonhardt S, Gorkow C, Wuttke W.&nbsp;Exp Clin Endocrinol. 1994;102(6):448-54.<\/p>\n\n\n\n<p>252-Pharmacological activities of Vitex agnus-castus extracts in vitro. Meier B, Berger D, Hoberg E, Sticher O, Schaffner W.&nbsp;Phytomedicine. 2000 Oct;7(5):373-81.<\/p>\n\n\n\n<p>253-Agnus castus extracts inhibit prolactin secretion of rat pituitary cells. Sliutz G, Speiser P, Schultz AM, Spona J, Zeillinger R.&nbsp;Horm Metab Res. 1993 May;25(5):253-5.<\/p>\n\n\n\n<p>254-Gynecological efficacy and chemical investigation of Vitex agnus-castus L. fruits growing in Egypt.&nbsp;Ibrahim NA, Shalaby AS, Farag RS, Elbaroty GS, Nofal SM, Hassan EM.&nbsp;Nat Prod Res. 2008 Apr 15;22(6):537-46.<\/p>\n\n\n\n<p>255-Mastodynon(R) bei weiblicher Sterilit\u00e4t. Gerhard I , Patek A, Monga B, Blank A, Gorkow C. &nbsp;Forsch Komplementarmed. 1998;5(6):272-278.<\/p>\n\n\n\n<p>256-The efficacy of the complex medication Phyto-Hypophyson L in female, hormone-related sterility. A randomized, placebo-controlled clinical double-blind study. Bergmann J, Luft B, Boehmann S, Runnebaum B, Gerhard I.&nbsp;Forsch Komplementarmed Klass Naturheilkd. 2000 Aug;7(4):190-9.<\/p>\n\n\n\n<p>257-Fructus agni casti and bromocriptine for treatment of hyperprolactinemia and mastalgia.&nbsp;Kilicdag EB, Tarim E, Bagis T, Erkanli S, Aslan E, Ozsahin K, Kuscu E.&nbsp;Int J Gynaecol Obstet. 2004 Jun;85(3):292-3.<\/p>\n\n\n\n<p>258-Comparing the Effects of Agnugol and Metformin on Oligomenorrhea in Patients with Polycystic Ovary Syndrome: A Randomized Clinical Trial. Shayan A, Masoumi SZ, Shobeiri F, Tohidi S, Khalili A.&nbsp;J Clin Diagn Res. 2016 Dec;10(12):QC13-QC16.<\/p>\n\n\n\n<p>259-Effects of extracts from Cimicifuga racemosa on gonadotropin release in menopausal women and ovariectomized rats.&nbsp;D\u00fcker EM, Kopanski L, Jarry H, Wuttke W. Planta Med. 1991. Oct;57(5):420-4.<\/p>\n\n\n\n<p>260-Evidence for selective estrogen receptor modulator activity in a black cohosh (Cimicifuga racemosa) extract: comparison with estradiol-17beta.&nbsp;Seidlova-Wuttke D, Hesse O, Jarry H, Christoffel V, Spengler B, Becker T, Wuttke W.&nbsp;Eur J Endocrinol. 2003 Oct;149(4):351-62.<\/p>\n\n\n\n<p>261-The effects of black cohosh on the regulation of estrogen receptor (ER\u03b1) and progesterone receptor (PR) in breast cancer cells.&nbsp;Szmyd M, Lloyd V, Hallman K, Aleck K, Mladenovik V, McKee C, Morse M, Bedgood T, Dinda S. Breast Cancer (Dove Med Press). 2018 Jan 18;10:1-11.<\/p>\n\n\n\n<p>262-Antidiabetic effects of the Cimicifuga racemosa extract Ze 450 in vitro and in vivo in ob\/ob mice.&nbsp;Moser C, Vickers SP, Brammer R, Cheetham SC, Drewe J.&nbsp;Phytomedicine. 2014 Sep 25;21(11):1382-9.<\/p>\n\n\n\n<p>263-Studies on the endocrine effects of the contents of Cimicifuga racemosa. Jarry H, Harnischfeger G.&nbsp;Planta Med. 1985 Feb;51(1):46-9.<\/p>\n\n\n\n<p>264-Adding the phytoestrogen Cimicifugae Racemosae to clomiphene induction cycles with timed intercourse in polycystic ovary syndrome improves cycle outcomes and pregnancy rates \u2013 a randomized trial. Shahin AY, Mohammed SA.&nbsp;Gynecol Endocrinol. 2014 Jul;30(7):505-10.<\/p>\n\n\n\n<p>265-Role of phyto-oestrogens in ovulation induction in women with polycystic ovarian syndrome. Kamel HH.&nbsp;Eur J Obstet Gynecol Reprod Biol. 2013 May;168(1):60-3.<\/p>\n\n\n\n<p>266-Economical and environmentally-friendly approaches for usage of onion (Allium cepa L.) waste. Sharma K, Mahato N, Nile SH, Lee ET, Lee YR.&nbsp;Food Funct. 2016 Aug 10;7(8):3354-69.<\/p>\n\n\n\n<p>267-Toxicity of aromatic disulphides. I. Generation of superoxide radical and hydrogen peroxide by aromatic disulphides in vitro. Munday R.&nbsp;J Appl Toxicol. 1985Dec;5(6):402-8.<\/p>\n\n\n\n<p>268-Toxicity of thiols and disulphides: involvement of free-radical species.&nbsp;Munday R.&nbsp;Free Radic Biol Med. 1989 ;7(6):659-73.<\/p>\n\n\n\n<p>269-Toxic anemias and Heinz bodies. Fertman MH, Fertman MB. Medicine (Baltimore). 1955 May;34(2):131-92.<\/p>\n\n\n\n<p>270-Erthrocyte glucose-6-phosphate dehydrogenase deficiency-a pharmacogenetic prototype.&nbsp;Keller DF.&nbsp;CRC Crit Rev Clin Lab Sci. 1970 May;1(2):247-302.<\/p>\n\n\n\n<p>271-&nbsp;Glucose -6-phospate dehydrogenase deficiency in \u00c7ukurova Province, Turkey.&nbsp;Ako\u011flu T, Ozer FL, Ci\u011f S, K\u016dmi M, Erdo\u011fan A, Anil H.&nbsp;Int J Epidemiol. 1981 Mar;10(1):27-9.<\/p>\n\n\n\n<p>272-Epidemiology of acne vulgaris. Bhate K, Williams HC.&nbsp;Br J Dermatol. 2013&nbsp;Mar;168(3):474-85.<\/p>\n\n\n\n<p>273-Postadolescent acne in females. Holzmann R, Shakery K.Skin Pharmacol Physiol. 2014;27 Suppl 1:3-8.<\/p>\n\n\n\n<p>274-The prevalence of acne in Mainland China: a systematic review and meta-analysis. Li D, Chen Q, Liu Y, Liu T, Tang W, Li S.&nbsp;BMJ Open. 2017 Apr 20;7(4):e015354.<\/p>\n\n\n\n<p>275-Polycystic ovary syndrome: a review for dermatologists: Part I. Diagnosis and manifestations. Housman E&nbsp;, Reynolds RV.&nbsp;J Am Acad Dermatol. 2014&nbsp;Nov;71(5):847.e1-847.e10; quiz 857-8.<\/p>\n\n\n\n<p>276-Evidence-based approach to cutaneous hyperandrogenism in women. Schmidt TH, Shinkai K.&nbsp;J Am Acad Dermatol. 2015 Oct;73(4):672-90<\/p>\n\n\n\n<p>277-Pathophysiology of acne. Degitz K, Placzek M, Borelli C, Plewig G.&nbsp;J Dtsch Dermatol Ges. 2007&nbsp;Apr;5(4):316-23.<\/p>\n\n\n\n<p>278-Regulation of human sebaceous glands. Thiboutot D.&nbsp;J Invest Dermatol. 2004&nbsp;&nbsp;Jul;123(1):1-12.<\/p>\n\n\n\n<p>279-The sebocyte culture: a model to study the pathophysiology of the sebaceous gland in sebostasis, seborrhoea and acne.&nbsp;Zouboulis CC, Schagen S, Alestas T. Arch Dermatol Res. 2008 Sep;300(8):397-413.<\/p>\n\n\n\n<p>280-Generation of free fatty acids from phospholipids regulates stratum corneum acidification and integrity. Fluhr JW, Kao J, Jain M, Ahn SK, Feingold KR, Elias PM. J Invest Dermatol. 2001&nbsp;&nbsp;Jul;117(1):44-51.<\/p>\n\n\n\n<p>281-Stratum corneum defensive functions: an integrated view. Elias PM. J Invest Dermatol.2005&nbsp;Aug;125(2):183-200.<\/p>\n\n\n\n<p>282-Cutaneous hyperandrogenism: role of antiandrogen therapy in acne, hirsutism, and androgenetic alopecia. Krausz A, Friedman AJ. J Drugs Dermatol. 2013 Nov;12(11):1297-300.<\/p>\n\n\n\n<p>283-The role of androgen and androgen receptor in skin-related disorders. Lai JJ, Chang P, Lai KP, Chen L, Chang C.&nbsp;Arch Dermatol Res. 2012&nbsp;Sep;304(7):499-510.<\/p>\n\n\n\n<p>284-Role of hormones in pilosebaceous unit development. Deplewski D, Rosenfield RL. Endocr Rev. 2000&nbsp;Aug;21(4):363-92.<\/p>\n\n\n\n<p>285-A global perspective on the epidemiology of acne. Tan JK, Bhate K. Br J Dermatol. 2015&nbsp;Jul;172 Suppl 1:3-12.<\/p>\n\n\n\n<p>286-Treatment of adult female acne: a new challenge. Dreno B.&nbsp;J Eur Acad Dermatol Venereol. 2015&nbsp;Jun;29 Suppl 5:14-9.<\/p>\n\n\n\n<p>287-The prevalence of acne in adults 20 years and older. Collier CN, Harper JC, Cafardi JA, Cantrell WC, Wang W, Foster KW, Elewski BE.&nbsp;J Am Acad Dermatol. 2008&nbsp;&nbsp;Jan;58(1):56-9.<\/p>\n\n\n\n<p>288-Persistent acne in women : implications for the patient and for therapy. Williams C, Layton AM. Am J Clin Dermatol.&nbsp;2006;7(5):281-90.<\/p>\n\n\n\n<p>289-Post-adolescent acne: a review of clinical features. Goulden V, Clark SM, Cunliffe WJ.&nbsp;Br J Dermatol. 1997&nbsp;Jan;136(1):66-70.<\/p>\n\n\n\n<p>290-The familial risk of adult acne: a comparison between first-degree relatives of affected and unaffected individuals. Goulden V, McGeown CH, Cunliffe WJ.&nbsp;Br J Dermatol.1999&nbsp;Aug;141(2):297-300.<\/p>\n\n\n\n<p>291-Pathogenesis of acne. Toyoda M, Morohashi M.&nbsp;Med Electron Microsc. 2001&nbsp;Mar;34(1):29-40.<\/p>\n\n\n\n<p>292-Prevalence of facial acne vulgaris in late adolescence and in adults. Cunliffe WJ, Gould DJ.&nbsp;Br Med J. 1979&nbsp;Apr 28;1(6171):1109-10.<\/p>\n\n\n\n<p>293-An epidemiological study of acne in female adults: results of a survey conducted in France. Poli F, Dreno B, Verschoore M.&nbsp;J Eur Acad Dermatol Venereol. 2001&nbsp;Nov;15(6):541-5.<\/p>\n\n\n\n<p>294-Persistent acne in adult women. Shaw JC, White LE.&nbsp;Arch Dermatol. 2001&nbsp;Sep;137(9):1252-3.<\/p>\n\n\n\n<p>295-Correlation between endocrinological parameters and acne severity in adult women. Borgia F, Cannav\u00f2 S, Guarneri F, Cannav\u00f2 SP, Vaccaro M, Guarneri B.&nbsp;Acta Derm Venereol. 2004;84(3):201-4.<\/p>\n\n\n\n<p>296-Hormonal profiles and prevalence of polycystic ovary syndrome in women with acne. Timpatanapong P, Rojanasakul A.&nbsp;J Dermatol. 1997&nbsp;Apr;24(4):223-9.<\/p>\n\n\n\n<p>297-The relationship of mild hirsutism or acne in women to androgens. Reingold SB, Rosenfield RL&nbsp;Arch Dermatol. 1987&nbsp;Feb;123(2):209-12.<\/p>\n\n\n\n<p>298-Testosterone, dehydroepiandrosterone, and dehydroepiandrosterone sulfate in hyperandrogenic women. Steinberger E, Smith KD, Rodriguez-Rigau LJ.&nbsp;J Clin Endocrinol Metab. 1984&nbsp;Sep;59(3):471-7.<\/p>\n\n\n\n<p>299-Assessment of androgens in women with adult-onset acne. Seirafi H, Farnaghi F, Vasheghani-Farahani A, Alirezaie NS, Esfahanian F, Firooz A, Ghodsi SZ.&nbsp;Int J Dermatol. 2007&nbsp;Nov;46(11):1188-91.<\/p>\n\n\n\n<p>300-Predictors of severity of acne vulgaris in young adolescent girls: results of a five-year longitudinal study. Lucky AW, Biro FM, Simbartl LA, Morrison JA, Sorg NW.&nbsp;J Pediatr. 1997&nbsp;Jan;130(1):30-9.<\/p>\n\n\n\n<p>301-Hyperandrogenemia in patients presenting with acne. Slayden SM, Moran C, Sams WM Jr, Boots LR, Azziz R.&nbsp;Fertil Steril. 2001&nbsp;May;75(5):889-92.<\/p>\n\n\n\n<p>302-Reduced sex hormone binding globulin and derived free testosterone levels in women with severe acne. Lawrence DM, Katz M, Robinson TW, Newman MC, McGarrigle HH, Shaw M, Lachelin GC.&nbsp;Clin Endocrinol (Oxf). 1981&nbsp;Jul;15(1):87-91.<\/p>\n\n\n\n<p>303-Androgen excess in women with acne. Scholl GM, Wu CH, Leyden J.&nbsp;Obstet Gynecol. 1984&nbsp;Nov;64(5):683-8.<\/p>\n\n\n\n<p>304-Serum androsterone conjugates differentiate between acne and hirsutism in hyperandrogenic women. Carmina E, Stanczyk FZ, Matteri RK, Lobo RA.&nbsp;Fertil Steril. 1991&nbsp;May;55(5):872-6.<\/p>\n\n\n\n<p>305-Cutaneous Findings and Systemic Associations in Women With Polycystic Ovary Syndrome. Schmidt TH, Khanijow K, Cedars MI, Huddleston H, Pasch L, Wang ET, Lee J, Zane LT, Shinkai K.&nbsp;JAMA Dermatol. 2016&nbsp;Apr;152(4):391-8.<\/p>\n\n\n\n<p>306-Clinical characteristics, metabolic features, and phenotype of Chinese women with polycystic ovary syndrome: a large-scale case-control study. Zhang HY, Guo CX, Zhu FF, Qu PP, Lin WJ, Xiong J. Arch Gynecol Obstet. 2013 Mar;287(3):525-31.<\/p>\n\n\n\n<p>307-Androgen excess in cystic acne. Marynick SP, Chakmakjian ZH, McCaffree DL, Herndon JH Jr.&nbsp;N Engl J Med. 1983&nbsp;&nbsp;Apr 28;308(17):981-6.<\/p>\n\n\n\n<p>308-Androgen excess in women with acne alone compared with women with acne and\/or hirsutism. Vexiau P&nbsp;, Husson C, Chivot M, Brerault JL, Fiet J, Julien R, Villette JM, Hardy N, Cathelineau G.&nbsp;J Invest Dermatol. 1990&nbsp;Mar;94(3):279-83.<\/p>\n\n\n\n<p>309-Control of human sebocyte proliferation in vitro by testosterone and 5-alpha-dihydrotestosterone is dependent on the localization of the sebaceous glands. Akamatsu H, Zouboulis CC, Orfanos CE.&nbsp;J Invest Dermatol. 1992&nbsp;Oct;99(4):509-11.<\/p>\n\n\n\n<p>310-Spironolactone directly inhibits proliferation of cultured human facial sebocytes and acts antagonistically to testosterone and 5 alpha-dihydrotestosterone in vitro. Akamatsu H, Zouboulis CC, Orfanos CE.&nbsp;J Invest Dermatol. 1993&nbsp;May;100(5):660-2.<\/p>\n\n\n\n<p>311-Immunohistochemical distribution of aromatase and 3B-hydroxysteroid dehydrogenase in human hair follicle and sebaceous gland. Sawaya ME, Penneys NS. J Cutan Pathol. 1992 Aug;19(4):309-14.<\/p>\n\n\n\n<p>312-Oxidative activity of the type 2 isozyme of 17beta-hydroxysteroid dehydrogenase (17beta-HSD) predominates in human sebaceous glands. Thiboutot D, Martin P, Volikos L, Gilliland K.&nbsp;J Invest Dermatol. 1998 Sep;111(3):390-5.<\/p>\n\n\n\n<p>313-Characterization, expression, and immunohistochemical localization of 5 alpha-reductase in human skin.&nbsp;Luu-The V, Sugimoto Y, Puy L, Labrie Y, Lopez Solache I, Singh M, Labrie F.&nbsp;J Invest Dermatol. 1994&nbsp;Feb;102(2):221-6.<\/p>\n\n\n\n<p>314-Steroid 5 alpha-reductase: two genes\/two enzymes. Russel DW, Wilson JD.&nbsp;Annu Rev Biochem. 1994;63:25-61.<\/p>\n\n\n\n<p>315-Activity of the type 1 5 alpha-reductase exhibits regional differences in isolated sebaceous glands and whole skin. Thiboutot D, Harris G, Iles V, Cimis G, Gilliland K, Hagari S.&nbsp;J Invest Dermatol. 1995&nbsp;Aug;105(2):209-14.<\/p>\n\n\n\n<p>316-Quantitating genetic and nongenetic factors that determine plasma sex steroid variation in normal male twins. Meikle AW, Bishop DT, Stringham JD, West DW.&nbsp;Metabolism. 1986&nbsp;Dec;35(12):1090-5.<\/p>\n\n\n\n<p>317-Origin of plasma androstanediol glucuronide in men. Moghissi E, Ablan F, Horton R.&nbsp;J Clin Endocrinol Metab. 1984&nbsp;Sep;59(3):417-21.<\/p>\n\n\n\n<p>318-Androgen glucuronides, instead of testosterone, as the new markers of androgenic activity in women. Labrie F, B\u00e9langer A, B\u00e9langer P, B\u00e9rub\u00e9 R, Martel C, Cusan L, Gomez J, Candas B, Castiel I, Chaussade V, Deloche C, Leclaire J.&nbsp;J Steroid Biochem Mol Biol. 2006&nbsp;Jun;99(4-5):182-8.<\/p>\n\n\n\n<p>319-Inactivation of androgens by UDP-glucuronosyltransferase enzymes in humans.&nbsp;B\u00e9langer A, Pelletier G, Labrie F, Barbier O, Chouinard S.&nbsp;Trends Endocrinol Metab. 2003&nbsp;Dec;14(10):473-9.<\/p>\n\n\n\n<p>320-Inactivation by UDP-glucuronosyltransferase enzymes: the end of androgen signaling. Chouinard S, Yueh MF, Tukey RH, Giton F, Fiet J, Pelletier G, Barbier O, B\u00e9langer A.&nbsp;J Steroid Biochem Mol Biol. 2008&nbsp;Apr;109(3-5):247-53.<\/p>\n\n\n\n<p>321-Androgenic correlates of genetic variation in the gene encoding 5alpha-reductase type 1. Ellis JA, Panagiotopoulos S, Akdeniz A, Jerums G, Harrap SB. J Hum Genet. 2005;50(10):534-7.<\/p>\n\n\n\n<p>322-Variants in the 5alpha-reductase type 1 and type 2 genes are associated with polycystic ovary syndrome and the severity of hirsutism in affected women. Goodarzi MO, Shah NA, Antoine HJ, Pall M, Guo X, Azziz R.&nbsp;J Clin Endocrinol Metab. 2006&nbsp;Oct;91(10):4085-91.<\/p>\n\n\n\n<p>323-Association of genetic variants in the two isoforms of 5\u03b1-reductase, SRD5A1 and SRD5A2, in lean patients with polycystic ovary syndrome. Graupp M, Wehr E, Schweighofer N, Pieber TR, Obermayer-Pietsch B.&nbsp;Eur J Obstet Gynecol Reprod Biol. 2011&nbsp;&nbsp;Aug;157(2):175-9.<\/p>\n\n\n\n<p>324-Androgen receptor polymorphisms (CAG repeat lenghts) in androgenetic alopecia, hirsutism, and acne. Sawaya ME, Shalita AR. J Cutan Med Surg. 1998&nbsp;Jul;3(1):9-15.<\/p>\n\n\n\n<p>325-Androgen receptor gene CAG repeat polymorphism&nbsp;in the development of ovarian hyperandrogenism.&nbsp;Ib\u00e1\u00f1ez L, Ong KK, Mongan N, J\u00e4\u00e4skel\u00e4inen J, Marcos MV, Hughes IA, De Zegher F, Dunger DB.&nbsp;J Clin Endocrinol Metab. 2003 Jul;88(7):3333-8.<\/p>\n\n\n\n<p>326-Epidemiology of isotretinoin&nbsp;exposure during pregnancy. Dai WS, LaBraico JM, Stern RS.&nbsp;J Am Acad Dermatol. 1992 Apr;26(4):599-606.<\/p>\n\n\n\n<p>327-Reprod Biomed Online. 2013 Aug;27(2):184-91. Decreased ovarian reserve in female Sprague-Dawley rats induced by isotretinoin (retinoic acid) exposure.<\/p>\n\n\n\n<p>About this FactMed analysis covering adverse side effect reports of ACCUTANE patients who developed PREMATURE MENOPAUSE.<br>Percentage of ACCUTANE patients where PREMATURE MENOPAUSE is a reported side effect: 0.0037%<br>FDA reports of any drug causing PREMATURE MENOPAUSE : 322<br>Average percentage for all medicated patients where PREMATURE MENOPAUSE is reported as a complication: 0.0020%<\/p>\n\n\n\n<p>328-Isotretinoin,pregnancies, abortions and birth defects: a population-based perspective.&nbsp;B\u00e9rard A, Azoulay L, Koren G, Blais L, Perreault S, Oraichi D.&nbsp;Br J Clin Pharmacol. 2007&nbsp;Feb;63(2):196-205.<\/p>\n\n\n\n<p>329-Diagnosis and treatment of acne. Feldman S, Careccia RE, Barham KL, Hancox J.&nbsp;Am Fam Physician. 2004&nbsp;May 1;69(9):2123-30.<\/p>\n\n\n\n<p>330-Guidelines for optimal use of isotretinoin in acne. Layton AM, Cunliffe WJ.&nbsp;J Am Acad Dermatol. 1992&nbsp;Dec;27(6 Pt 2):S2-7.<\/p>\n\n\n\n<p>331-The relapses of cystic acne after isotretinoin treatment are age-related: a long-term follow-up study. Harms M, Masouy\u00e9 I, Radeff B.&nbsp;Dermatologica. 1986;172(3):148-53.<\/p>\n\n\n\n<p>332-Oral isotretinoin. How can we treat difficult acne patients? Leyden JJ.&nbsp;Dermatology. 1997&nbsp;;195 Suppl 1:29-33; discussion 38-40.<\/p>\n\n\n\n<p>333-The role of isotretinoin in acne therapy: why not as first-line therapy? facts and controversies. Rigopoulos D, Larios G, Katsambas AD.&nbsp;Clin Dermatol. 2010&nbsp;Jan-Feb;28(1):24-30.<\/p>\n\n\n\n<p>334-Association of Isotretinoin With Depression and Suicide: A Review of Current Literature.&nbsp;Oliveira JM, Sobreira G, Velosa J, Telles Correia D, Filipe P.&nbsp;J Cutan Med Surg. 2018 Jan\/Feb;22(1):58-64.<\/p>\n\n\n\n<p>335-Risk of venous&nbsp;thromboembolism&nbsp;in&nbsp;women&nbsp;with&nbsp;polycystic ovary syndrome: a population-based matched cohort analysis. Bird ST, Hartzema AG, Brophy JM, Etminan M, Delaney JA. CMAJ. 2013 Feb 5;185(2):E115-20.<\/p>\n\n\n\n<p>336-Combined hormonal contraception and the risk of venous&nbsp;thromboembolism: a guideline. Practice Committee of the American Society for Reproductive Medicine. Fertil Steril. 2017 Jan;107(1):43-51.<\/p>\n\n\n\n<p>337-Different&nbsp;combined oral contraceptives&nbsp;and the&nbsp;risk of&nbsp;venous thrombosis:systematic review&nbsp;and&nbsp;network meta-analysis. Stegeman BH, de Bastos M, Rosendaal FR, van Hylckama Vlieg A, Helmerhorst FM, Stijnen T, Dekkers OM. BMJ.&nbsp; 2013 Sep 12;347:f5298.<\/p>\n\n\n\n<p>338-Pills-related&nbsp;severe&nbsp;adverse&nbsp;events: A&nbsp;case&nbsp;report&nbsp;in&nbsp;Taiwan. Chen CH, Chin HY et al. Taiwan J Obstet Gynecol . 2016 Aug;55(4):588-90.<\/p>\n\n\n\n<p>339-Oral contraceptives and breast cancer risk among younger women. Brinton LA, Daling JR, Liff JM et al. J Nath Cancer Inst. 1995&nbsp;Jun 7;87(11):827-35.<\/p>\n\n\n\n<p>340-Contemporary Hormonal Contraception and the Risk of Breast Cancer. M\u00f8rch LS, Skovlund CW, Hannaford PC, Iversen L, Fielding S, Lidegaard \u00d8. N Engl J Med. 2017 Dec 7;377(23):2228-2239.<\/p>\n\n\n\n<p>341-Breast cancer and hormonal contraceptives: collaborative reanalysis of individual data on 53 297 women with breast cancer and 100 239 women without breast cancer from 54 epidemiological studies.Collaborative Group on Hormonal Factors in Breast Cancer.Lancet. 1996 Jun 22;347(9017):1713-27.<\/p>\n\n\n\n<p>342-Breast cancer among young U.S. women in relation to oral contraceptive use. White E, Malone KE, Weiss NS, Daling JR.&nbsp;J Natl Cancer Inst. 1994&nbsp;Apr 6;86(7):505-14.<\/p>\n\n\n\n<p>343-Clinical review: Insulin sensitizers for the treatment of hirsutism: a systematic review and metaanalyses of randomized controlled trials.&nbsp;Cosma M, Swiglo BA, Flynn DN, Kurtz DM, Labella ML, Mullan RJ, Elamin MB, Erwin PJ, Montori VM.&nbsp;J Clin Endocrinol Metab. 2008 Apr;93(4):1135-42.<\/p>\n\n\n\n<p>344-&nbsp;Treatment Options for Hirsutism: A Systematic Review and Network Meta- Analysis . Barrionuevo P, Nabhan M, Altayar O, Wang Z, Erwin PJ, Asi N, Martin KA, Murad MH.&nbsp;J Clin Endocrinol Metab. 2018 Apr 1;103(4):1258-1264.<\/p>\n\n\n\n<p>345-The endocrine effects of spironolactone used as an antiandrogen. Young RL, Goldzieher JW, Elkind-Hirsch K.&nbsp;Fertil Steril. 1987&nbsp;Aug;48(2):223-8.<\/p>\n\n\n\n<p>346-Oral Spironolactone for Acne Vulgaris in Adult Females: A Hybrid Systematic Review. Layton AM, Eady EA, Whitehouse H, Del Rosso JQ, Fedorowicz Z, van Zuuren EJ.&nbsp;Am J Clin Dermatol. 2017&nbsp;Apr;18(2):169-191.<\/p>\n\n\n\n<p>347-Guidelines of care for the management of acne vulgaris. &nbsp;Zaenglein AL, Pathy AL, Schlosser BJ, Alikhan A, Baldwin HE, Berson DS, Bowe WP, Graber EM, Harper JC, Kang S,Keri JE, Leyden JJ, Reynolds RV, Silverberg NB, Stein Gold LF, Tollefson MM, Weiss JS, Dolan NC, Sagan AA,Stern M, Boyer KM, Bhushan R.&nbsp;J Am Acad Dermatol. 2016&nbsp;May;74(5):945-73.e33.<\/p>\n\n\n\n<p>348-Practical management of acne for clinicians: An international consensus from the Global Alliance to Improve Outcomes in Acne. Thiboutot DM, Dr\u00e9no B, Abanmi A, Alexis AF, Araviiskaia E, Barona Cabal MI, Bettoli V, Casintahan F, Chow S, da Costa A, El Ouazzani T, Goh CL, Gollnick HPM, Gomez M, Hayashi N, Herane MI, Honeyman J, Kang S, Kemeny L,Kubba R, Lambert J, Layton AM, Leyden JJ, L\u00f3pez-Estebaranz JL, Noppakun N, Ochsendorf F, Oprica C, Orozco B, Perez M, Piquero-Martin J, See JA, Suh DH, Tan J, Lozada VT, Troielli P, Xiang LF.&nbsp;J Am Acad Dermatol. 2018&nbsp;&nbsp;Feb;78(2 Suppl 1):S1-S23.e1.<\/p>\n\n\n\n<p>349-Anti- acne&nbsp;drugs in phase 1 and 2 clinical trials.&nbsp;Zouboulis CC, Dessinioti C, Tsatsou F, Gollnick HPM.&nbsp;Expert Opin Investig Drugs. 2017 Jul;26(7):813-823.<\/p>\n\n\n\n<p>350-Long term follow-up of &nbsp;patients with polycystic ovarian syndrome&nbsp;after laparoscopic ovarian drilling: clinical outcome. Amer SA, Gopalan V, Li TC, Ledger WL, Cooke ID. Hum Reprod. 2002 Aug;17(8):2035-42.<\/p>\n\n\n\n<p>351-Effects of laparoscopic ovarian drilling&nbsp;on adrenal steroids in polycystic ovary syndrome patients with and without hyperinsulinemia.&nbsp;Saleh A, Morris D, Tan SL, Tulandi T.&nbsp;Fertil Steril. 2001 Mar;75(3):501-4.<\/p>\n\n\n\n<p>352-Success of laparoscopic ovarian&nbsp;wedge resection is related to obesity, lipid profile, and insulin&nbsp;levels.&nbsp;Duleba AJ, Banaszewska B, Spaczynski RZ, Pawelczyk L.&nbsp;Fertil Steril. 2003 Apr;79(4):1008-14.<\/p>\n\n\n\n<p>353-Spironolactone and risk of incident breast cancer in women older than 55 years: retrospective, matched cohort study. Mackenzie IS, Macdonald TM, Thompson A, Morant S, Wei L.&nbsp;BMJ. 2012&nbsp;Jul 13;345:e4447.<\/p>\n\n\n\n<p>354-Spironolactone use and risk of incident cancers: a retrospective, matched cohort study. Mackenzie IS, Morant SV, Wei L, Thompson AM, MacDonald TM.&nbsp;Br J Clin Pharmacol. 2017&nbsp;Mar;83(3):653-663.<\/p>\n\n\n\n<p>355-Spironolactone use and the risk of breast and gynecologic cancers. Biggar RJ, Andersen EW, Wohlfahrt J, Melbye M.&nbsp;Cancer Epidemiol. 2013&nbsp;Dec;37(6):870-5.<\/p>\n\n\n\n<p>356-Adverse Effects and Safety of 5-alpha Reductase Inhibitors (Finasteride, Dutasteride): A Systematic Review. Hirshburg JM, Kelsey PA, Therrien CA, Gavino AC, Reichenberg JS.&nbsp;J Clin Aesthet Dermatol. 2016&nbsp;Jul;9(7):56-62.<\/p>\n\n\n\n<p>357-Functional integrity of granulosa cells from polycystic&nbsp;ovaries. Almahbobi&nbsp;&nbsp;G, Anderiesz C, Hutchinson P, McFarlane JR, Wood C, Trounson AO.&nbsp;Clin Endocrinol (Oxf)<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/8762734#\">.<\/a>&nbsp;1996 May;44(5):571-80.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Sivilce (Akne vulgaris) deride ya\u011f bezleri ve k\u0131l k\u00f6klerinin birlikte bulundu\u011fu yap\u0131n\u0131n (pilosebaceous unit) &nbsp;iltihab\u0131d\u0131r&nbsp;(277,278,279,280,281,282,291). &nbsp;Ergenlik \u00e7a\u011f\u0131nda (adolesan d\u00f6nem)&nbsp;gen\u00e7 k\u0131zlarda erkeklik hormonlar\u0131n\u0131n \u00fcretiminin artmas\u0131na ba\u011fl\u0131 olarak 12 ya\u015f civar\u0131nda g\u00f6r\u00fclmeye ba\u015flar ve giderek \u015fiddetlenerek 15-17 ya\u015flar\u0131nda zirveye ula\u015f\u0131r(272,274). Daha sonra gerilemeye ba\u015flar ve \u00e7o\u011funlukla &nbsp;20-25 ya\u015flar\u0131ndan sonra art\u0131k bir sorun olmaktan \u00e7\u0131kar.&nbsp;Fakat, &nbsp;kad\u0131nlar\u0131n bir k\u0131sm\u0131nda [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-5743","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/polikistikover.net\/yeni\/wp-json\/wp\/v2\/pages\/5743","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/polikistikover.net\/yeni\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/polikistikover.net\/yeni\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/polikistikover.net\/yeni\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/polikistikover.net\/yeni\/wp-json\/wp\/v2\/comments?post=5743"}],"version-history":[{"count":141,"href":"https:\/\/polikistikover.net\/yeni\/wp-json\/wp\/v2\/pages\/5743\/revisions"}],"predecessor-version":[{"id":13374,"href":"https:\/\/polikistikover.net\/yeni\/wp-json\/wp\/v2\/pages\/5743\/revisions\/13374"}],"wp:attachment":[{"href":"https:\/\/polikistikover.net\/yeni\/wp-json\/wp\/v2\/media?parent=5743"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}