Dianette is a tablet taken by women who have severe acne or excess hair growth. It contains cyproterone acetate and ethinylestradiol, and also functions as an effective contraceptive pill – provided it is taken correctly.
Who can take Dianette?
Typically, Dianette is prescribed to women with severe acne that has not cleared up with the use of antibiotics or other treatments. It can also be prescribed to women who are suffering from abnormal excess hair growth.
It is important to note that doctors can be hesitant to prescribe Dianette, largely because it is associated with a higher risk of blood clots and certain types of cancer. For this reason, your doctor will never prescribe you Dianette if you only need it for contraception.
While it is safe for the majority of women to use Dianette in the short term, there are certain groups of people who must not take Dianette, including men. Other groups include women who:
- are pregnant or breastfeeding
- have a personal history or family history of blood clots
- have a high risk of getting blood clots
- have had a heart attack or stroke, or suffer from from other heart problems such as angina
- are overweight and smoke
- smoke more than 40 cigarettes a day
- suffer from high blood pressure
- are over 35
- have severe diabetes
- have migraines
- have breast cancer or a family history of breast cancer in a first degree relative (mother or sister)
- have unexplained vaginal bleeding
- have liver disease or jaundice
- have an intolerance to any of the ingredients of Dianette (these ingredients are listed in the Patient Information Leaflet)
How does Dianette work?
Dianette contains cyproterone acetate, which is an anti-androgen. Androgens are male hormones produced by both men and women. In men, androgens are vital for the development of the sex organs (the best known androgen is testosterone). Androgens also play a necessary role in the female body, stimulating the growth of body hair and the production of oestrogen.
When a woman’s body produces too many androgens or is overly sensitive to the effects of androgens, however, it can lead to problems such as hirsutism (excess hair growth), severe acne, oily skin, hair loss on the head and amenorrhoea (having no periods).
Androgens stimulate skin growth, including the growth of the sebaceous glands that produce an oily substance called sebum. Sebum is used to waterproof and lubricate the skin, but if too much of it is produced the sebaceous glands can become blocked and infected, leading to acne.
Androgens such as testosterone are responsible for hair growth on the body, which can lead to hirsutism in women whose bodies produce too many androgens, or who have a hypersensitivity to them.
The cyproterone acetate in Dianette helps improve acne and hirsutism by blocking the receptors in the body that androgens normally act upon. It also reduces the amount of androgens produced by the ovaries. The effect is that the action of the sebaceous glands is unaffected by androgens, meaning they do not overproduce sebum or stimulate excess hair growth.
Dianette also contains ethinylestradiol, a form of oestrogen, while cyproterone functions as a form of progesterone. This means that Dianette also works as a combined contraceptive pill when taken correctly. As with most other combined pills, Dianette must be taken at the same time every day for 3 weeks. At this point you have a week’s break, during which time you have a monthly bleed (similar to your normal periods).
If taken in this manner, Dianette will provide over 99% protection against pregnancy. If pills are missed, however, you may be at risk of pregnancy and you should use barrier methods during sex to be safe. For more information on what to do if you miss a pill, talk to your GP or pharmacist, or consult your Patient Information Leaflet.
What are the side effects and risks associated with Dianette?
- Nausea and vomiting
- Abdominal pain
- Breast tenderness
- Raised blood pressure
- Weight changes
- Water retention
- Vaginal thrush
- Changes in your menstrual cycle (lighter periods or breakthrough bleeding)
- Reduced sex drive
- Changes in your skin
- Disturbed liver function
One of the biggest risks associated with taking Dianette is an increased chance of blood clots (thrombosis). In 1-2% of cases a blood clot is fatal. It is important to be aware of the symptoms so you can seek medical help if you think you might have a blood clot.
- Symptoms include:
- a sudden cough
- severe pain or swelling in the legs
- severe pain the chest (which may spread to the left arm)
- a severe headache
- loss of vision
- slurred speech
- dizziness or fainting
- severe abdominal pain
How long should I take Dianette for?
It can take a few months for the full effects of Dianette to be seen. You should take Dianette for about 3 months after you have seen an improvement in your acne or hirsutism.
Dianette is not recommended for use solely as a contraceptive pill, as it is associated with a higher risk of blood clots than other combined pills. After you have stopped taking Dianette, you can change to another contraceptive pill that has a lower incidence of side effects.
Are there other treatments for acne and hirsutism?
Yes, particularly acne. There are multiple treatments for mild acne that are available without prescription in a pharmacy. For more severe acne, there are prescription treatments available such as creams containing vitamin A (topical retinoids), antibiotics or isotretinoin tablets (such as Roaccutane). If you aren’t sure what kind of treatment you need, you can carry out our free acne assessment and get advice from our doctors.
Excess hair, meanwhile, can be managed with over-the-counter hair removal products, or electrolysis or laser hair removal. For excess facial hair growth, there is a prescription cream called eflornithine (branded as Vaniqa). Eflornithine is applied to the face twice a day and works by reducing hair growth – however, it needs to be used on a permanent basis as once you stop using it, your facial hair will return.
There are also other contraceptive pills which can help with acne, and do not carry the same risks associated with Dianette, such as Microgynon 30 or Marvelon.