What is Diane 35® Tablets?
Diane 35 Tablets is a combination of two hormonal medicines: Cyproterone and Ethinyl Estradiol which treats PCOS symptoms such as acne, excessive hair growth (hirsutism), and irregular periods. Cyproterone works by blocking the overproduction of androgens (male hormones) in the ovaries, thereby reducing unwanted hair growth and acne. Ethinyl Estradiol enhances the effect of Cyproterone by reducing the number of androgens in the blood. Together, they also regularize the menstrual cycle in PCOS.
Women with Polycystic ovarian syndrome (PCOS) have high levels of male hormones called androgens, which are responsible for irregular menstrual cycles (periods), excessive hair growth, and acne. Diane 35 Tablets is a combination medicine that helps in regulating the production of these androgens as well as periods in females. This also helps in treating excessive hair growth (hirsutism) and acne effectively. Take it as prescribed by the doctor. Do not skip any doses and follow your doctor’s instructions carefully to get maximum benefit.
In what disorders is Diane 35® found beneficial?
Below is a list of Indications for which Diane birth control pills has been found to be beneficial:
- Treatment Of Acne Vulgaris: Diane 35 when given over 3 to 4 months is found to lower pimple growth as well as their spread. Further benefits accrue by a progressive reduction in the oily skin predisposition. In summation it lowers the oily discharge from facial skin glands, thereby reducing blockage inflammation, which is core to the genesis of acne.
- Treatment Of Seborrhea: This refers to a state of increased greasiness of the skin. It is caused by oily sebum secreted from the sebaceous glands of the skin particularly the face and other hairy areas. Testosterone and other such male-type hormones also known as androgens are present in women in small amounts. These increase the tendency of skin to oily sebaceous discharge and its attending problems like pimples, scaling, boils, and resultant infections. Seborrheic discharge is very well controlled by continuous use of Diane 35.
- Treatment Of Idiopathic Hirsutism: Excessive hair growth is also a result of increased androgen action in female bodies. The underlying causes for the pronounced male hormonal action are varied and once found must be treated accordingly (e.g. an androgen producing tumor). However, there exists the entity of ‘Idiopathic Hirsutism’ wherein the affected woman’s body is for unknown or unexplained reasons simply more sensitive to androgenic hormonal effects. Such a sub-class of hirsute women benefits best from treatment Diane 35.
- Treatment Of Polycystic Ovarian Disorder: Commonly referred to as PCOD or PCOS, this syndrome is highlighted by longer menstrual cycles, multiple ovarian tiny cysts, a tendency to infertility and heightened testosterone activity with its attending tendency to excessive hair growth, dark skin pigmentation, and oily predisposition. Diane 35 serves multiple roles in the treatment of PCOS from regularizing the cycle to reducing acne, hirsutism and providing contraception to a select group of patients of PCOS who so desire it.
Additional Advantages of Diane 35 Birth Control Pills
When Diane 35 birth control pill is used to treat one or more of the disorders it is designed to treat from the ones listed above, other additional benefits accrue.
- Contraception: Suppression of ovulation, implantation, and sperm transport is the norm with combined contraceptive pills owing to the joint activity of the synthetic estrogen and progestin they contain. Cyproterone has progestin activity and together with the estrogen Ethinyl estradiol, the combination prevents pregnancy. The role of the use of Diane 35 as a contraceptive alone is controversial and considered off-label. A few countries around the world mainly the US FDA have banned its use for this purpose.
- Dysfunctional menstrual bleeding: Oligomenorrhoea or a longer menstrual cycle which often accompanies high androgen states such as PCOS or Hirsutism in women gets automatically regulated. Periods are more regular, pain-free, and lighter in bleeding.
- Cancer Prevention: Endometrial cancer (lining of the uterus or womb) and Ovarian cancer are prevented by prolonged usage of combined estrogen-progestin pills with benefits of cancer-free periods lasting many years after stopping treatment.
- Benign Disorders of women’s health: Pelvic infections and pain, benign ovarian cysts, benign fibrocystic breast disease.
- Endometriosis: Cyproterone alone has been used in higher doses to treat this syndrome which is associated with painful periods. Continuous combined hormonal pill therapy is useful in endometriosis. The presence of Cyproterone in such a combination is valuable in ameliorating the disease progression in endometriosis.
- Chronic Pelvic Pain: Painful groins and pubes, regardless of menses, for more than three to six months is a debilitating condition of multiple etiologies. Diane 35 works effectively to provide relief in this disorder since it advantageously has Cyproterone as its progestin ingredient.
Availability And Presentation
Diane 35 and Diane 35 ED are two versions of the same combination marketed by Bayer Pharmaceuticals International / Zydus Cadila. The ED variant has 28 tablets in total which include 21 active pills and additional 7 placebo tablets. The blister pack of Diane 35 on the other hand has only 21 active pills.
These 21 active or hormone-containing tablets are beige in color. The 7 neutral or blank tablets are white in color. Diane 35 ED is used to mimic a 28-day normal menstrual cycle as some women prefer to take birth control pills for 28 days fulfilling a psychological aim of having consumed a tablet to prevent conception.
Diane-35 Birth Control Pill Contents
Diane 35 birth control pill contains Ethinyl estradiol 0.035mg plus Cyproterone Acetate 2mg. The former is the most common synthetic estrogen found in contraceptive pills while the latter is a special kind of progestin that has anti-androgenic or anti-male hormonal influences.
How does Diane 35 work?
The mechanism of action of Diane 35 is the following. When given exogenously, Diane 35 combination contraceptive pill floods the blood and body with synthetic estrogen and progestin, Ethinyl estradiol, and cyproterone acetate in the case of Diane 35. These hormones in turn suppress the secretion of FSH and LH the brain made gonadotrophic hormones that act on and control the Ovary. Thus the natural rhythm and levels of FSH and LH are suppressed.
Natural ovulation is inhibited and endometrial (uterine lining) receptivity to any conception (implantation) is prevented. Moreover, congelation of the secretions at the entry of the womb sieves and delays sperm transport. Cyproterone in addition to its central FSH/LH inhibitory action in the hormonal feedback loop also acts directly to block the male hormone testosterone’s receptors on end organ sites such as in the skin, hair follicles, and sebaceous glands. This increases the repertoire of Diane 35 to treat hyper or excessive androgenic disorders as discussed above.
Diane 35 Birth Control Pill Instructions, Prescription, And Dosage
Diane 35 birth control pill is effective after 7 days of starting the first pack. The detailed instructions and dosage for birth control follow:
- Diane 35 contraceptive pill is started preferably on the first day of menses and the 21 active pills are to be taken daily without missing any in between.
- On completing the 21 active tablets the user will get a period that is usually lighter and pain-free anywhere between 3 to 4 days after completion. Such a medically induced bleeding or artificial period is called the ‘withdrawal bleed’ and it mimics the natural period in that it occurs around day 28 of the cycle but it is not a natural period and ovulation has not occurred.
- If already on some other contraceptive pill, Diane 35 is ideally started the day after completing the last active pill from the previous pack or at least on the day after completing the placebo from the previous pack.
- Following the use of a vaginal contraceptive ring, Diane 35 is started on the day the ring is removed. As far as switching from Progesterone only contraceptives are concerned namely the ‘Minipill’ or an implant or an ‘Intra Uterine Device/System’, Diane 35 can be started at any time but with the rider that an additional barrier (condom/diaphragm) method of protection is to be used for the first 7 days after starting.
Diane 35 Missed Pill Instructions
You might be curious about what to do in case of missed pills? These instructions are applicable only in the event of having missed one or more of the 21 beige active tablets and do not apply to any placebo tablets (found in Diane 35 ED)
- On missing one pill of Diane 35, try to take it as soon you remember preferably within 12 hours, even if this means having to take two pills at the same time on the next day. Continue the remainder pills as usual.
- On missing two consecutive pills, anytime in the first two weeks, take two pills the day you remember and two more on the day after. Continue the rest of the pack as usual. But additional protection in the form of barrier contraception
(condom/diaphragm) is vital for seven days starting from the day after the missed pill episode occurred. If two consecutive pills are missed anytime in the third week, then the current pack is to be discarded, and a new fresh pack is to be started, with 7 days of additional barrier contraceptive protection.
- Missing three or more consecutive pills at any time warrants the discontinuation of the current defaulter pack and a fresh new pack is to be started, with the security of additional barrier contraceptive protection for 7 days.
- Withdrawal bleeding should occur on completion of the fresh pack. Rarely the withdrawal may not happen. In any case, where pills are missed it is advisable and reassuring to check for pregnancy at the end of that cycle regardless of the withdrawal bleed.
- Vomiting for up to 4 hours from the time of pill intake is to be considered as a missed pill because the absorption of the tablet cannot be guaranteed in such cases.
Side Effects of Diane 35 Pills
The possible side effects of Diane 35 pills are given below:
- Insignificant effects pertaining to the gastrointestinal system include Nausea, Vomiting, Diarrhea, Bloating, and Acidity/Gastritis.
- Mental disturbances in the form of altered sex drive, irritability, altered mood, and depression are not uncommon. Headaches and Migraines are also known to occur.
- Skin lesions include allergic rash or red nodules.
- Weight changes either gain or loss, fluid retention, and breast pains are reported.
Diane 35 Contraindications And Precautions
Diane 35 birth control pill should not be used in these situations:
- Circulatory Disorders: Diane 35 is not to be used by women over 35 who smoke. Smokers, women with blood clotting history or disorders, high blood pressure, heart disease, diabetes with vascular involvement, immobilized for long periods, obese, and those with high fat or lipid content in the blood are not eligible candidates for Diane 35 therapy. This is simply because Contraceptive hormones are known to increase the risk for blood clot formation especially in the deep veins of the lower limbs and other veins of the body. Cyproterone has been found to aggravate this risk.
- Cancer Risks: Increased risks for breast cancer are known but this reduces gradually after 10 of stopping. It is controversial whether contraceptives are responsible directly for the increased risk of Cervical (Mouth of the Uterus or Womb) cancer in its users. Benign and rarely malignant Liver tumors have been reported with resultant pain and bleeding in the abdomen.
- Gastro-Intestinal Risks: Increased propensity for gall bladder stones, stasis of its secretions with an increased tendency to gall bladder infections, and inflammation of the pancreas. Its role in the alteration of the blood fat milieu with a predisposition to increased cholesterol and lipid deposition or atherosclerosis is doubtful.
- Chronic Diseases: Diane 35 is contraindicated in those women with long-standing Liver (abnormal liver function tests), Kidney (altered renal parameters), and Adrenal Disorders.
- Gynecologic Issues: Menopause is an obvious contraindication as is undiagnosed vaginal bleeding, undiagnosed or suspected pregnancy, and breastfeeding.
- Sexually Transmitted Infections and HIV: Diane 35 does not protect against these and is not a panacea for sexual problems. Barrier contraceptives are the gold standard here.
Diane 35 Interactions
The following medications reduce the efficacy of Diane 35: Barbiturates, primidone, carbamazepine, rifampicin, oxcarbazepine, topiramate, felbamate, griseofulvin, products containing St John’s Wort, ritonavir, and nevirapine.
Therefore, when on any of these drugs, women are advised to use security barrier contraception for the entire duration of therapy and for an additional 28 days after cessation of treatment with these medicines. Labs results that may be influenced by Diane 35 include Liver function tests, Thyroid Profiles, Renal functions, Diabetes/Blood Glucose parameters, Blood Lipid Fractions, and Coagulation studies.
Buy Diane 35 Birth Control Pills Online OTC For Really Cheap
You can buy Diane 35 birth control pills online from OKDERMO.com. Diane 35 birth control pills are supplied in a blister pack of 21 tablets. The cost of Diane 35 is only $31 per blister with 21 tablets.