What is Diane 35?

Diane 35 (Also known as Dianette) is essentially an ethinyl oestradiol oral contraceptive pill with the antiandrogen cyproterone acetate used for the treatment of hirsutism and acne. In most respects all the advice for any combined oral contraceptive pill pertains. Diane 35 is used for treatment of hirsutism and acne and is not generally recommended otherwise for birth control.

What side effects could I have whilst taking Diane 35?

The vast majority of patients taking Diane 35 feel very well but, as with any medicine that has benefits, some minor side effects are occasionally reported. These include:

  • altered body weight (some gain a few pounds and others lose a little).
  • nausea (feeling sick) and vomiting.
  • mastalgia (breast tenderness).
  • headaches (Diane 35 should be stopped if they become severe).
  • altered libido (sex drive - Q15.5) with many women noticing an increase and others a reduction.
  • depression.
  • reduced or absent menstrual flow (Q15.4 ;24.17A).

These side effects usually settle within two or three months.

What is the effect of birth pills on body weight?

All of us are intermittently gaining or losing weight.

Inevitably some patients find that they gain weight around the time of starting Diane 35 but others observe a weight loss.

In a personal computer search of the medical literature from 1966 to date I found exactly fifty papers (articles in medical journals) where weight change in relation to Diane 35 had been studied.

  • Thirty-six papers indicated no change, eleven found an increase varying from 0.3kg to 2.4Kg.
  • Three papers found weight loss with the combined oral contraceptive pill for women who were overweight or who had polycystic ovaries.

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Will Diane 35 increase my vaginal discharge?

Cervical ectopy (erosion - cervical erosion) appears to be more common in women taking the combined oral contraceptive pill although the newer lower dose pill seem to cause this less frequently. Cervical ectopy only requires treatment if there are persistent significant symptoms after excluding other problems such as infection. Contrary to popular belief, there is no evidence that Diane 35 increases the incidence of candida (thrush).

Does Diane 35 increase my chance of pelvic infections?

There is no increase in the incidence of Candida infection in pill users. The incidence is the same as in women with intrauterine devices and those using no contraception. Bacterial infections that gain entry to the pelvis through the cervix are less common in pill users as the progestogen makes the cervical mucus thick. However, there is no protection against viruses or chlamydia.

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What is the relationship between Diane 35 and fibroids?

Surprisingly, studies show that the combined oral contraceptive pill reduces the chance of fibroid development. It is a surprise because both oestrogen and progesterone are factors in fibroid development so fibroids shrink after the menopause (HRT-Add-Back). The current presumption is that the total of these hormones provided by the combined oral contraceptive pill in a month must be less than the natural hormone output by the ovaries.


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Will Diane 35 increase my blood pressure?

For the majority of women, the blood pressure increases on the combined oral contraceptive pill by an average of 1mm Hg (a tiny amount). An increase of 5-10mm Hg may be of clinical importance but 1mm really does not matter. This is an example of a statistical (mathematical) proven increase that has no consequence from the medical point of view.

The international recommendation is that the combined oral contraceptive pill should not be started or continued if your blood pressure is 160/100 or higher. High blood pressure can be a factor in heart disease and strokes and as a few women (about 1%) may develop clinically significant raised blood pressure, checks should be carried out periodically. Your blood pressure should be measured before you start Diane 35 and three months later. If your blood pressure is normal it should be reviewed at six months intervals and after two years it can be reviewed annually.


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