What are Diane pills (Diane-35)?
Diane-35 is a medication containing cyproterone acetate and ethinyl estradiol, primarily prescribed for women of child-bearing age to treat severe skin conditions like acne and excessive hair growth (hirsutism) when other treatments have been ineffective. Cyproterone acetate blocks male sex hormones. Diane-35 also acts as a hormonal contraceptive. Its hormonal components mean it has potential side effects and risks that patients should be aware of.
Common side effects of Diane pills
Common side effects of Diane-35 often occur as the body adjusts to hormonal changes and are usually mild and temporary, typically resolving within a few months. Persistent or bothersome effects warrant medical attention.
Gastrointestinal issues
- Nausea and vomiting
- Abdominal cramps and bloating
Physical changes
- Weight changes
- Breast pain or swelling
- Headaches
- Spotting between periods
- Changes in appetite
Mood and libido
- Mood changes, including depression
- Changes in sexual desire
- Nervousness
Skin and hair
- Brown spots on skin (melasma)
- Hair loss or excess hair growth
Serious and rare side effects
Some side effects are serious and require immediate medical attention, most notably an increased risk of blood clots.
Blood clots (Thromboembolism)
Diane-35 is linked to an increased risk of venous and arterial blood clots. This includes Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE), with the risk being highest in the first year of use. Arterial clots can lead to heart attack or stroke.
Other serious conditions
Rarely, liver tumors, meningioma (a brain tumor, linked to high cyproterone acetate doses), and cardiovascular issues like heart attack or stroke can occur. Severe depression and increased blood pressure are also possible serious effects.
Comparison: Diane-35 vs. other hormonal treatments
The choice between Diane-35 and other hormonal treatments for conditions like acne depends on individual health factors. Other options, like Yasmin or Ortho Tri-Cyclen, also treat acne but have different hormone combinations and risk profiles, particularly regarding blood clots.
| Feature | Diane-35 | Yasmin (drospirenone/ethinyl estradiol) | Ortho Tri-Cyclen (norgestimate/ethinyl estradiol) |
|---|---|---|---|
| Primary Use | Severe acne, hirsutism. Also acts as a contraceptive. | Contraception, PMDD, and acne treatment. | Contraception and acne treatment. |
| Key Hormones | Cyproterone acetate and ethinyl estradiol. | Drospirenone and ethinyl estradiol. | Norgestimate and ethinyl estradiol. |
| Blood Clot Risk (VTE) | Higher risk than some COCs, including levonorgestrel-containing pills. | Risk similar or slightly higher than Diane-35, but less than for some other COCs. | Risk can vary depending on formulation, generally lower than Diane-35 and Yasmin. |
| Side Effects | Common: Weight gain, mood changes, nausea, breast tenderness. | Common: Nausea, headache, breast tenderness, mood swings. | Common: Nausea, weight changes, mood swings, headache. |
| Effectiveness for Acne | High efficacy for severe androgen-related acne and hirsutism. | Effective, possibly less potent for severe androgen-related acne than Diane-35. | Effective, especially for mild to moderate acne. |
Important warnings and contraindications
Diane-35 is not suitable for all women due to its risks. Contraindications include a history of blood clots, heart attack, or stroke, severe diabetes with vessel damage, high blood pressure, known or suspected cancer, abnormal vaginal bleeding, pregnancy or breastfeeding, and being a heavy smoker over 35. Careful evaluation of thromboembolism risk is necessary, along with regular check-ups. Report any signs of blood clots immediately.
How to manage common side effects
Minor side effects may be managed with lifestyle adjustments, though persistent or severe issues require a doctor's attention.
Nausea and stomach upset
Taking the pill with food or eating smaller, frequent meals can help.
Headaches
Over-the-counter pain relief like paracetamol may be used.
Mood changes
Maintaining a healthy lifestyle with exercise and a balanced diet, and considering stress management techniques can help. Contact your doctor if depression symptoms worsen.
Weight fluctuations
A balanced diet and regular exercise are recommended.
For comprehensive information, including drug interactions, refer to the official package leaflet. An example is available from Medsafe.
Conclusion
Diane pills are effective for severe androgen-related skin conditions but carry known side effects and risks. Patients must be aware of common issues like weight changes and mood fluctuations, and the serious, albeit rare, risks of blood clots and liver problems. Treatment decisions should involve careful consultation with a healthcare professional to assess individual risks and monitor for adverse effects. As Diane-35 is also a contraceptive, it should not be combined with other hormonal birth control.
