TY  - JOUR
T1  - İzotretinoinin Serum Hormonları ve Menstrüel Siklus Üzerine Etkileri
TT  - The Effects of Isotretinoin on Menstrual Cycle and Hormone Levels
AU  - Bener, Fidan
PY  - 2018
DA  - August
JF  - Ankara Eğitim ve Araştırma Hastanesi Tıp Dergisi
PB  - Sağlık Bakanlığı Ankara Eğitim ve Araştırma Hastanesi
WT  - DergiPark
SN  - 1304-6187
SP  - 145
EP  - 149
VL  - 51
IS  - 2
LA  - tr
AB  - Amaç: Akne vulgaris tanısıyla izotretinoin tedavisikullanan kadın hastaların serum hormon ve menstrüel sikluslarında ortaya çıkandeğişikliklerin araştırılması amaçlanmıştır.Gereç ve Yöntemler: Retrospektif olarak yapılan bu çalışmada, aknevulgaris nedeniyle izotretinoin tedavisi başlanmış, tedavi öncesi düzenlimenstrüel sikluslara sahip, laboratuvar parametreleri normal sınırlarda olan,herhangi bir sistemik hastalığı bulunmayan ve başka ilaç kullanmayan kadınhastaların verileri incelenmiştir.Bulgular: Çalışmaya dahil edilen 21 hastanın yaş ortalaması22±3.87 idi. Hastalara uygulanan izotretinoin kümülatif dozu 123.90±4.71 mg/kgidi. Tedavi sırasında hastaların %19.1’inde dehidroepiandrosteron sülfat(DHEAS), %23.8’inde serbest testosteron (sT), %33.3’ünde total testosteron (tT)serum seviyelerinin referans aralığının üzerine çıktığı tespit edildi. OrtalamaDHEAS ve sT düzeylerinde tedavi öncesine kıyasla istatistiksel olarak anlamlıolmayan artış saptandı (p>0.05). Tedavi boyunca normal sınırlar arasındaortalama tiroid stimüle edici hormon (TSH) değerlerinde istatistiksel olarakanlamlı (p<0.05) ve ortalama serbest T3 (sT3) düzeylerinde anlamlı olmayan (p>0.05)progresif azalma tespit edildi. Prolaktin, 17-hidroksiprogesteron, tT, folikülstimüle edici hormon, lüteinize edici hormon ve serbest T4 ortalamadeğerlerinde anlamlı bir fark bulunmadı (p>0.05). Hastaların %23.8'indemenstrüel düzensizlik olduğu saptandı. Bir hastada polimenore, bir hastadahipomenore, üç hastada oligomenore ve oligomenore gelişen hastaların birinde desiklus ortası kanama ortaya çıktığı tespit edildi. Menstrüel düzensizlikgelişen hastaların hormon değerlerinde herhangi bir değişiklik olmadığıbelirlendi.Sonuç: Bu çalışma izotretinoinin androjen metaboliması,tiroid hormonları ve menstrüel sikluslar üzerinde etkili olduğunugöstermektedir. Bu nedenle uzun süreli tedavilerde hiperandrojenizm vehipotiroidi açısından takip önerilmektedir. Anormal uterin kanamaların hormonalkaynaklı olmadığı düşünülmektedir. Bu etkilerin hangi mekanizmalarla ortayaçıktığının kanıtlanabilmesi için ileri seviyede araştırmalara gerek vardır.
KW  - Akne vulgaris
KW  - izotretinoin
KW  - serum hormonları
KW  - menstrüel siklus
N2  - Introductıon: This study aimed atexamining the effects of isotretinoin treatment on menstrual cycle and serumhormones in women with acne vulgaris.Materials and methods: In this retrospective study, the data of femalepatients who have been treated with isotretinoin for acne vulgaris, had regularmenstrual cycles before treatment, had normal laboratory parameters, had no anysystemic disease and did not take any medicine have been examined.Results: The mean age of the 21 women included in the study was 22±3.87. Thecumulative dose of isotretinoin administered to the patient was 123.90±4.71mg/kg. During the treatment, in 19.1% of the patients dehydroepiandrosteronesulfate (DHEAS), in 23.8% of free testosterone (fT) and in33.3% of total testosterone (tT) were reported to be higher than the referencerange of serum levels. There was a statistically insignificant increase in meanDHEAS and fT levels (p>0.05) compared to before treatment. During thetreatment, a statistically significant in mean thyroid stimulating hormone(TSH) values (p<0.05) and a insignificant in mean free T3 (fT3) values(p>0.05) was determined progressive decrease between normal limits. Therewas no significant difference in mean values of 17-hydroxyprogesterone, tT,prolactin, follicle stimulating hormone, luteinizing hormone and free T4(p>0.05). We found that 23.8% of the patients had menstrual irregularity. Inone patient polymenorrhea was observed and hypomenorrhea in another one. Also,oligomenorrhea was observed in three patient, with one of them hemorrhage inthe middle of her cycle. It has been determined that there is no change in thehormone levels of patients with menstrual irregularity.Conclusion: In this study show that isotretinoin has an effecton androgen metabolism, on thyroid hormones and on menstrual cycles. For thisreason, we recommend follow-up in terms of hyperandrogenism and hypothyroidismin long-term treatment. As a result of the data, it can be said that abnormaluterine bleeding is not hormonal origin. Further studies are needed to provewhat kind of mechanism cause these effects.
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UR  - https://dergipark.org.tr/tr/pub/aeahtd/issue//450670
L1  - https://dergipark.org.tr/tr/download/article-file/587819
ER  -