{"id":8001,"date":"2025-09-27T20:08:24","date_gmt":"2025-09-27T20:08:24","guid":{"rendered":"https:\/\/polikistikover.net\/yeni\/?page_id=8001"},"modified":"2025-11-16T19:27:35","modified_gmt":"2025-11-16T19:27:35","slug":"polikistik-over-sendromunda-ciltte-yaglanma-artisi-ve-tedavisi","status":"publish","type":"page","link":"https:\/\/polikistikover.net\/yeni\/polikistik-over-sendromunda-ciltte-yaglanma-artisi-ve-tedavisi\/","title":{"rendered":"Polikistik Over Sendromu\u2019nda Ciltte Ya\u011flanma Art\u0131\u015f\u0131 ve Tedavisi"},"content":{"rendered":"\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(6,7,8,9,10,20).&nbsp;<\/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:#fadf0b\" class=\"has-inline-color\">1- <\/mark><\/strong>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(1,3). <\/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:#fadf07\" class=\"has-inline-color\">2-<\/mark><\/strong> Daha sonra gerilemeye ba\u015flar ve \u00e7o\u011funlukla &nbsp;20-25 ya\u015flar\u0131ndan sonra art\u0131k bir sorun olmaktan \u00e7\u0131kar.&nbsp;<\/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:#f9d60d\" class=\"has-inline-color\">3-<\/mark><\/strong> 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 menopoz sonras\u0131nda da devam etmektedir(2,4,5,14,15).<\/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:#f9de0b\" class=\"has-inline-color\">4-<\/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:#f1ff09\" class=\"has-inline-color\">5-<\/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;(2,16,17,18,19,21,22,23).<\/p>\n\n\n\n<figure class=\"wp-block-embed aligncenter is-type-video is-provider-youtube wp-block-embed-youtube 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\">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(5,24,25,26,27,28,29,30,31,32,33,37). <\/p>\n\n\n\n<p class=\"has-text-align-center wp-embed-aspect-16-9 wp-has-aspect-ratio\"><\/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, t\u00fcylenme art\u0131\u015f\u0131, adet d\u00fczensizli\u011fi ve sa\u00e7 d\u00f6k\u00fclmesinin de e\u015flik etti\u011fi sivilceler \u00e7o\u011funlukla polikistik over sendromu olan kad\u0131nlarda g\u00f6r\u00fclmektedir(4,34,35,36,38).<\/mark><\/strong><\/p>\n\n\n\n<figure class=\"wp-block-embed aligncenter is-type-video is-provider-youtube wp-block-embed-youtube 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-left wp-embed-aspect-16-9 wp-has-aspect-ratio\"><strong><mark style=\"background-color:#fa0d0d\" class=\"has-inline-color\">1-<\/mark><\/strong>Ciltte bulunan ya\u011f bezi h\u00fccrelerinde (sebocytes) ya\u011fl\u0131 bir madde (sebum) \u00fcretilmektedir(6).<\/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:#fa130b\" class=\"has-inline-color\">2-<\/mark><\/strong>Erkeklik hormonlar\u0131 (testosteron, dihidrotestosteron) ya\u011fl\u0131 maddeyi \u00fcreten h\u00fccrelerin&nbsp;(sebocytes) say\u0131s\u0131n\u0131 ve ya\u011fl\u0131 madde (sebum) \u00fcretimini artt\u0131rmaktad\u0131r (Seborrhea)(6,7,8,39,40).<\/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:#fa0404\" 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(7,8).<\/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:#fa0707\" 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(9,10).<\/p>\n\n\n\n<p class=\"has-text-align-center wp-embed-aspect-16-9 wp-has-aspect-ratio\">Erkeklik hormonlar\u0131n\u0131n (testosteron, dihidrotestosteron) b\u00fcy\u00fck bir k\u0131sm\u0131 b\u00f6brek \u00fcst\u00fc bezinde (Adrenal Gland) \u00fcretilen DHEA 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)41,42,43,44). <\/p>\n\n\n\n<p class=\"has-text-align-center wp-embed-aspect-16-9 wp-has-aspect-ratio\">Kan dola\u015f\u0131m\u0131nda bulunan testosteron miktar\u0131 sadece yumurtal\u0131k ve b\u00f6brek \u00fcst\u00fc bezinden direk olarak sal\u0131nan miktar\u0131 g\u00f6stermektedir. <\/p>\n\n\n\n<p class=\"has-text-align-center wp-embed-aspect-16-9 wp-has-aspect-ratio\">Kad\u0131nlarda testosteron hormonunun b\u00fcy\u00fck k\u0131sm\u0131n\u0131n&nbsp;\u00fcretildi\u011fi deri, ya\u011f dokusu, meme gibi organlardan ancak k\u00fc\u00e7\u00fck bir miktar (%10) testosteron kan dola\u015f\u0131m\u0131na girmektedir(45).<\/p>\n\n\n\n<p class=\"has-text-align-center wp-embed-aspect-16-9 wp-has-aspect-ratio\">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;(41,46,47,48,49). <\/p>\n\n\n\n<p class=\"has-text-align-center wp-embed-aspect-16-9 wp-has-aspect-ratio\">Dihidrotestosteron hormonunun etkili olabilmesi i\u00e7in ilk olarak erkeklik hormonu al\u0131c\u0131s\u0131na (androgen receptor) tutunmas\u0131 gerekmektedir(39,40,52). <\/p>\n\n\n\n<p class=\"has-text-align-center wp-embed-aspect-16-9 wp-has-aspect-ratio\">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(63,64,65). <\/p>\n\n\n\n<p class=\"has-text-align-center wp-embed-aspect-16-9 wp-has-aspect-ratio\">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(61,62). Bu genetik de\u011fi\u015fiklikler erkeklik hormonu al\u0131c\u0131lar\u0131n\u0131n etkinli\u011fini (transcritional activity) artt\u0131rarak sivilce olu\u015fumuna neden olmaktad\u0131r(61,62).<\/p>\n\n\n\n<p class=\"has-text-align-center wp-embed-aspect-16-9 wp-has-aspect-ratio\">5-&nbsp;\u03b1 reduktaz (reductase) enziminin 2 formu (isozyme) vard\u0131r(50,51).&nbsp;<\/p>\n\n\n\n<p class=\"has-text-align-center wp-embed-aspect-16-9 wp-has-aspect-ratio\">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(48,50,51).<\/p>\n\n\n\n<p class=\"has-text-align-center wp-embed-aspect-16-9 wp-has-aspect-ratio\"> 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) &nbsp;\u00e7al\u0131\u015fmaktad\u0131r(52). <\/p>\n\n\n\n<p class=\"has-text-align-center wp-embed-aspect-16-9 wp-has-aspect-ratio\">Bu nedenle sivilce \u00e7\u0131kma e\u011filimi olan b\u00f6lgelerde dihidrotestosteron daha fazla miktarda \u00fcretilmektedir(52). <\/p>\n\n\n\n<p class=\"has-text-align-center wp-embed-aspect-16-9 wp-has-aspect-ratio\">5-&nbsp;\u03b1 reduktaz (reductase) enziminin etkinli\u011finde (activity) b\u00fcy\u00fck oranda anneden k\u0131z\u0131na genetik&nbsp;ge\u00e7i\u015f bulunmaktad\u0131r(53).&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(58,59,60).<\/p>\n\n\n\n<p class=\"has-text-align-center wp-embed-aspect-16-9 wp-has-aspect-ratio\">Dihidrotestosteron hormonunun da testosteron hormonu gibi b\u00fcy\u00fck \u00e7o\u011funlu\u011fu (%90) kan dola\u015f\u0131m\u0131na girmemektedir. <\/p>\n\n\n\n<p class=\"has-text-align-center wp-embed-aspect-16-9 wp-has-aspect-ratio\">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;(47,54).&nbsp;<\/p>\n\n\n\n<p class=\"has-text-align-center wp-embed-aspect-16-9 wp-has-aspect-ratio\">Deride (cilt) \u00fcretilen&nbsp;dihidrotestosteron (DHT)&nbsp;hormonunun b\u00fcy\u00fck \u00e7o\u011funlu\u011fu deri h\u00fccresini 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(54,55,56,57). <\/p>\n\n\n\n<p class=\"has-text-align-center wp-embed-aspect-16-9 wp-has-aspect-ratio\">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(54, 55,56,57).<\/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\">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=\"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\">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=\"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\">Di\u011fer bir nedeni de bu kad\u0131nlarda&nbsp;dihidrotestosteron hormonunu \u00fcreten 5-&nbsp;\u03b1 reduktaz (reductase) enziminin etkinli\u011finin (activity) artm\u0131\u015f olmas\u0131d\u0131r.&nbsp;<\/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\">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\u0131 da unutmamal\u0131y\u0131z.&nbsp;<\/mark><\/strong><\/p>\n\n\n\n<p class=\"has-text-align-center wp-embed-aspect-16-9 wp-has-aspect-ratio\"><strong>Tedavi;<\/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-blue-color\">A vitamini&nbsp;(Retinoik asit)&nbsp;benzeri&nbsp;maddeler&nbsp;i\u00e7eren ila\u00e7lar<\/mark><\/strong>;<\/p>\n\n\n\n<p class=\"has-text-align-center wp-embed-aspect-16-9 wp-has-aspect-ratio\">Polikistik over sendromu olan kad\u0131nlarda altta yatan sorunu&nbsp;tedavi etmemektedir(69,70,71,72,73).<\/p>\n\n\n\n<p class=\"has-text-align-center wp-embed-aspect-16-9 wp-has-aspect-ratio\"> 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(74).<\/p>\n\n\n\n<p class=\"has-text-align-center wp-embed-aspect-16-9 wp-has-aspect-ratio\"> 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(69,70,71,72,73). <\/p>\n\n\n\n<p class=\"has-text-align-center wp-embed-aspect-16-9 wp-has-aspect-ratio\">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&nbsp;erken menopoz\u2018 a&nbsp;neden olabilen bu ila\u00e7lar\u0131n&nbsp;genellikle tekrar tekrar, d\u00fczensiz bir \u015fekilde kullan\u0131lmas\u0131na neden olmaktad\u0131r(66,67,68).<\/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\">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 tedavisinden \u00f6nce kullan\u0131lmas\u0131 do\u011fru de\u011fildir.<\/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-blue-color\">Do\u011fum kontrol haplar\u0131;<\/mark><\/strong><\/p>\n\n\n\n<p class=\"has-text-align-center wp-embed-aspect-16-9 wp-has-aspect-ratio\">Uzun etkili ve kal\u0131c\u0131 bir tedavi etkinli\u011finin olmamas\u0131na ve&nbsp;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 emboli) 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(75,76,77,78,79,80,81,82).<\/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 sivilce tedavisinde&nbsp;do\u011fum kontrol hap\u0131 kullan\u0131lmas\u0131&nbsp;do\u011fru de\u011fildir.<\/mark><\/strong><\/p>\n\n\n\n<figure class=\"wp-block-embed aligncenter is-type-video is-provider-youtube wp-block-embed-youtube 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\"><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&nbsp;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=\"has-text-align-left wp-embed-aspect-16-9 wp-has-aspect-ratio\"><strong><mark style=\"background-color:#72fe09\" 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(83,84). \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(83,84).<\/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:#71f40e\" 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&nbsp; al\u0131c\u0131lara tutunmas\u0131n\u0131n engellenmesi (androgen receptor antagonist) di\u011fer&nbsp;bir tedavi se\u00e7ene\u011fidir(85,86,87,88).<\/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:#60f709\" 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(46,47,48,52).&nbsp;5-&nbsp;\u03b1 reduktaz (reductase)enziminin bu etkisinin engellenmesi (5-&nbsp;\u03b1 &nbsp;reductase inhibitor) de bir tedavi se\u00e7ene\u011fidir(46,47,48,52,89).<\/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:#4cf70f\" class=\"has-inline-color\">4-<\/mark><\/strong>Polikistik over ameliyat\u0131&nbsp;miktar\u0131 ve etkinli\u011fi artm\u0131\u015f olan erkeklik hormonlar\u0131n\u0131n (testosteron, dihidrotestosteron) etkinli\u011finin ve miktar\u0131n\u0131n azalt\u0131lmas\u0131 ve ins\u00fclin duyarl\u0131l\u0131\u011f\u0131n\u0131n artmas\u0131 sonucunda SHBG miktar\u0131n\u0131 artt\u0131rarak etki g\u00f6steren bir tedavi se\u00e7ene\u011fidir(90,91,92).<\/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:#63fe0b\" class=\"has-inline-color\">5-<\/mark><\/strong>D\u00fczenli olarak yap\u0131lan spor (y\u00fcr\u00fcy\u00fc\u015f ve y\u00fczme gibi) kilodan ba\u011f\u0131ms\u0131z olarak yani ki\u015fi fazla kilolu olsa dahi v\u00fccutta bulunan ya\u011f dokusunun yerini kas dokusunun almas\u0131n\u0131 sa\u011flar.&nbsp;Ya\u011f dokusunun azalmas\u0131&nbsp;hem erkeklik hormonlar\u0131n\u0131n \u00fcretimini azaltarak, hem de SHBG miktar\u0131n\u0131 artt\u0131rarak etki g\u00f6steren yard\u0131mc\u0131 bir tedavi se\u00e7ene\u011fidir.<\/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:#46f707\" class=\"has-inline-color\">6-<\/mark><\/strong>Fazla miktarda t\u00fcketilen karbonhidratlar proteinlerden farkl\u0131 olarak&nbsp;yumurtal\u0131k ve b\u00f6brek \u00fcst\u00fc bezi gibi erkeklik hormonlar\u0131n\u0131n \u00fcretildi\u011fi b\u00f6lgelerden biri olan&nbsp;ya\u011f dokusu&nbsp;olarak depolanmaktad\u0131r. Bu nedenlerle karbonhidrat miktar\u0131 d\u00fc\u015f\u00fck, buna kar\u015f\u0131l\u0131k protein miktar\u0131 fazla olan besinleri t\u00fcketilmesi hem erkeklik hormonlar\u0131n\u0131n \u00fcretimini d\u00fc\u015f\u00fcrerek, hem de SHBG miktar\u0131n\u0131 artt\u0131rarak etki g\u00f6steren yard\u0131mc\u0131 bir tedavi se\u00e7ene\u011fidir.<\/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\">Yukar\u0131da anlatt\u0131\u011f\u0131m tedavi se\u00e7eneklerinden hangisinin uygulanaca\u011f\u0131 ki\u015fiden ki\u015fiye g\u00f6re de\u011fi\u015fmektedir. <\/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\">\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 wp-embed-aspect-16-9 wp-has-aspect-ratio\"><strong>Kaynaklar<\/strong><\/p>\n\n\n\n<p class=\"has-text-align-left wp-embed-aspect-16-9 wp-has-aspect-ratio\">1-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 class=\"has-text-align-left wp-embed-aspect-16-9 wp-has-aspect-ratio\">2-Postadolescent acne in females. Holzmann R, Shakery K.Skin Pharmacol Physiol. 2014;27 Suppl 1:3-8.<\/p>\n\n\n\n<p class=\"has-text-align-left wp-embed-aspect-16-9 wp-has-aspect-ratio\">3-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 class=\"has-text-align-left wp-embed-aspect-16-9 wp-has-aspect-ratio\">4-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 class=\"has-text-align-left wp-embed-aspect-16-9 wp-has-aspect-ratio\">5-Evidence-based approach to cutaneous hyperandrogenism in women. Schmidt TH, Shinkai K.&nbsp;J Am Acad Dermatol. 2015&nbsp;&nbsp;Oct;73(4):672-90<\/p>\n\n\n\n<p class=\"has-text-align-left wp-embed-aspect-16-9 wp-has-aspect-ratio\">6-Pathophysiology of acne. Degitz K,&nbsp; Placzek M, Borelli C, Plewig G.&nbsp;J Dtsch Dermatol Ges. 2007&nbsp;Apr;5(4):316-23.<\/p>\n\n\n\n<p class=\"has-text-align-left wp-embed-aspect-16-9 wp-has-aspect-ratio\">7-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 class=\"has-text-align-left wp-embed-aspect-16-9 wp-has-aspect-ratio\">8-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 class=\"has-text-align-left wp-embed-aspect-16-9 wp-has-aspect-ratio\">9-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 class=\"has-text-align-left wp-embed-aspect-16-9 wp-has-aspect-ratio\">10-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 class=\"has-text-align-left wp-embed-aspect-16-9 wp-has-aspect-ratio\">11-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 class=\"has-text-align-left wp-embed-aspect-16-9 wp-has-aspect-ratio\">12-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 class=\"has-text-align-left wp-embed-aspect-16-9 wp-has-aspect-ratio\">13-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 class=\"has-text-align-left wp-embed-aspect-16-9 wp-has-aspect-ratio\">14-A global perspective on the epidemiology of acne. Tan JK &nbsp;, Bhate K. Br J Dermatol. 2015&nbsp;Jul;172 Suppl 1:3-12.<\/p>\n\n\n\n<p class=\"has-text-align-left wp-embed-aspect-16-9 wp-has-aspect-ratio\">15-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 class=\"has-text-align-left wp-embed-aspect-16-9 wp-has-aspect-ratio\">16-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 class=\"has-text-align-left wp-embed-aspect-16-9 wp-has-aspect-ratio\">17-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 class=\"has-text-align-left wp-embed-aspect-16-9 wp-has-aspect-ratio\">18-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 class=\"has-text-align-left wp-embed-aspect-16-9 wp-has-aspect-ratio\">19-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 class=\"has-text-align-left wp-embed-aspect-16-9 wp-has-aspect-ratio\">20-Pathogenesis of acne. Toyoda M, Morohashi M.&nbsp;Med Electron Microsc. 2001&nbsp;Mar;34(1):29-40.<\/p>\n\n\n\n<p class=\"has-text-align-left wp-embed-aspect-16-9 wp-has-aspect-ratio\">21-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 class=\"has-text-align-left wp-embed-aspect-16-9 wp-has-aspect-ratio\">22-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 class=\"has-text-align-left wp-embed-aspect-16-9 wp-has-aspect-ratio\">23-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 class=\"has-text-align-left wp-embed-aspect-16-9 wp-has-aspect-ratio\">24-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 class=\"has-text-align-left wp-embed-aspect-16-9 wp-has-aspect-ratio\">25-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 class=\"has-text-align-left wp-embed-aspect-16-9 wp-has-aspect-ratio\">26-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 class=\"has-text-align-left wp-embed-aspect-16-9 wp-has-aspect-ratio\">27-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 class=\"has-text-align-left wp-embed-aspect-16-9 wp-has-aspect-ratio\">28-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 class=\"has-text-align-left wp-embed-aspect-16-9 wp-has-aspect-ratio\">29-Predictors of severity of acne vulgaris in young adolescent girls: results of a five-year longitudinal study. Lucky AW&nbsp;, Biro FM, Simbartl LA, Morrison JA, Sorg NW.&nbsp;J Pediatr. 1997&nbsp;Jan;130(1):30-9.<\/p>\n\n\n\n<p class=\"has-text-align-left wp-embed-aspect-16-9 wp-has-aspect-ratio\">30-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 class=\"has-text-align-left wp-embed-aspect-16-9 wp-has-aspect-ratio\">31-Reduced sex hormone binding globulin and derived free testosterone levels in women with severe acne. 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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 class=\"has-text-align-left wp-embed-aspect-16-9 wp-has-aspect-ratio\">89-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 class=\"has-text-align-left wp-embed-aspect-16-9 wp-has-aspect-ratio\">90-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 class=\"has-text-align-left wp-embed-aspect-16-9 wp-has-aspect-ratio\">91-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 class=\"has-text-align-left wp-embed-aspect-16-9 wp-has-aspect-ratio\">92-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","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(6,7,8,9,10,20).&nbsp; 1- 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(1,3). 2- Daha sonra gerilemeye ba\u015flar ve \u00e7o\u011funlukla &nbsp;20-25 ya\u015flar\u0131ndan sonra art\u0131k bir sorun olmaktan \u00e7\u0131kar.&nbsp; 3- [&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-8001","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/polikistikover.net\/yeni\/wp-json\/wp\/v2\/pages\/8001","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=8001"}],"version-history":[{"count":25,"href":"https:\/\/polikistikover.net\/yeni\/wp-json\/wp\/v2\/pages\/8001\/revisions"}],"predecessor-version":[{"id":12882,"href":"https:\/\/polikistikover.net\/yeni\/wp-json\/wp\/v2\/pages\/8001\/revisions\/12882"}],"wp:attachment":[{"href":"https:\/\/polikistikover.net\/yeni\/wp-json\/wp\/v2\/media?parent=8001"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}