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Diane 35 (Other Brands:  Cyestra, Cleo)


Diane 35 is a birth control pill that is especially effective in treating acne. Acne occurs because male hormones stimulate oil production and cell growth in your skin.  Diane reduces the production of male hormones and blocks their effect, thereby improving acne.  Studies have shown that Diane 35 can decrease acne by more than half in over 80% of women after six months of use.  In every other way, including possible side effects, Diane 35 is similar to most other birth control pills.


Who should take Diane 35?


Women with acne who are planning to take a birth control pill anyway.


Women whose acne is not well controlled by other methods and are not planning to conceive.



Who should not take Diane 35?


Women who are or may be pregnant.


Women who have or may have breast cancer.


Women who are prone to blood clots or are at high risk for heart attacks or strokes - this includes women with high levels of fat or cholesterol in the blood or are over age 35 and smoke.


Women who have some types of kidney and liver disease.


Women who have unexplained vaginal bleeding.


Women who have SLE (lupus).



Who should be careful about taking Diane 35?


Women with close relatives who had heart attacks or strokes at a young age (under age 55 for men and under age 65 for women).


Women who have migraine headaches.


Women with high blood pressure or diabetes.



Side Effects of Birth Control Pills


The most common side effects of birth control pills, experienced by approximately 10% of users, are nausea, vomiting, breast tension, bloating (gas), spotting, headache and weight gain.  These are usually mild and resolve within 3 months.


Blood clots are the most common serious side effect of birth control pills.  They most commonly occur in the legs and can cause swelling, tenderness and pain in the legs.  In healthy women not on the birth control pill, the risk of these blood clots, called deep vein thromboses, or DVT’s, is less than 3 in 10,000.  In women taking the regular birth control pill, this risk increases to slightly less than 6 in 10,000.  There is some controversy about the exact risk with Diane 35.  Some studies have found a higher risk with Diane 35 than with the regular birth control pill.  Other studies have found no difference in risk between Diane and the regular birth control pill.  The risk is probably around 9 in 10,000.  To put things in perspective, the risk of DVT’s in pregnancy is about 12 in 10,000.  The risk if you are obese, or if you smoke is between 5 and 10 in 10,000.  Often, the blood clot is in the superficial veins and does not present a major problem, but sometimes the blood clot can be deeper.  Deeper blood clots need to be treated with blood thinners because they can sometimes come loose and lodge in the lung causing a serious condition called a pulmonary embolism.  Pulmonary embolism and other serious complications, including death, can occur in 1-2% of DVT’s.  Any woman who develops a blood clot should discontinue the birth control pill.


In women who have high blood pressure, elevated fats or cholesterol in the blood or who smoke heavily, the birth control pill can increase the risk of heart attack or stroke.  In women who do not have these risk factors, there is little or no increase in risk.


It is now believed that the Pill does not increase the risk of breast cancer.  However, the hormones in the Pill may stimulate a breast cancer that has already developed to grow faster.  For that reason, women at high risk of breast cancer should not take it.


Birth control pills may increase the risk of obstruction of the bile ducts in your liver.  This is rare, but people who have had certain types of obstructive jaundice in the past should not take the pill.


Birth control pills do not cause liver cancer.  A benign growth called a liver adenoma is slightly more common (but still very rare) in women taking the pill.  This growth can sometimes bleed so women on the pill should see their physician if they have pain under their ribcage.


After 40 years of experience with the birth control pill, there is now solid evidence that it has no long-term side effects.  After you have stopped taking the pill, your risk of any of these problems is the same as someone who has never taken the pill.



Benefits of the Birth Control Pill


Aside from reducing acne and preventing the risks of pregnancy or abortion, the pill can reduce your lifetime risk of ovarian and endometrial cancer by up to 15%.  This means that by age 55, a woman is less likely to be diagnosed with any type of cancer if she has used the pill than if she has not.


The pill decreases the incidence of benign masses in your breast and uterus.


The pill decreases the incidence of ovarian cysts.


The pill decreases the risk of pelvic inflammatory disease, which can cause infertility or ectopic pregnancies later in life.  The pill does not prevent sexually transmitted diseases so you should still use condoms.


The pill helps reduce the incidence of painful periods, irregular or heavy bleeding and subsequent iron deficiency anemia.




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