General
Description & Use
A combined oral contraceptive and a treatment for women who suffer
from acne or moderately increased growth of facial and body hair.
Also popular for M2F
transsexuals in gender reassignment as it combines
cyproterone acetate, progestin with ethynl estradiol.
Cyproterone acetate
Cyproterone acetate has weak progestational activity (e.g., it
acts like progesterone) and can be used to treat hot flushes.
As part of some combined oral contraceptive pills (Dianette in
UK and Diane-35®, Estelle and Ginette in other countries)
it decreases acne and hirsutism (male-pattern hair growth). Cyproterone
acetate (Androcur,
Cyprostat, Cyproteron, Procur, Cyprone, Cyprohexal, Ciproterona,
Cyproteronum, Neoproxil, Siterone) is an antiandrogen, i.e. it
suppresses the actions of testosterone (and its metabolite dihydrotestosterone)
on tissues. It acts by blocking androgen receptors which prevents
androgens from binding to them and suppresses luteinizing hormone
(which in turn reduces testosterone levels) Due to its anti-androgen
effect, it can also be used to treat hirsutism, and is a common
component in hormone therapy for male-to-female transgender people.
Medical
Information
With Diane-35®, you have the unique combined benefit of contraception
and anti-acne treatment. This two-in-one solutions package solves
two of your concerns at one go.
Diane-35®
is a contraceptive pill that doubles as a very effective acne
treatment. Diane-35® provides contraceptive protection as
reliable as other pills while it also relieves acne, greasy skin
and hairy skin. Essentially, Diane-35® works by regulating
your hormones: estrogen and progestogen (reproductive hormones)
and androgen (which can cause acne, by prompting excess oil production
in your skin).
How
does Diane-35 work as a contraceptive pill?
The
cyclical production of the female hormones and the maturation
of a follicle (egg) in the ovaries are controlled by a small organ
(size about 1 cm) connected to the brain, the pituitary gland.
Diane-35® meanwhile contains two female hormones, estrogen
and progestin. These are similar to the natural hormones women
produce in their ovaries. The
pituitary gland is not able to distinguish the hormones contained
in Diane-35® from those produced by the ovaries. It, therefore,
stops inducing the natural hormone production by the ovaries and
eventually the process of egg growth and release. This hormonal
feedback mechanism is based on the same principle which blocks
the maturation and release of further eggs during pregnancy.
How
does Diane-35 clear your skin?
Suitable treatment for acne in women, Diane-35® has a clearly
recognizable effect on the reduction of sebum production by blocking
the effect of androgen (male sex hormones) on your skin. Thus,
Diane-35® also reduces the formation of new spots and blackheads.
After about three months your acne clears. You may then choose
to stop using Diane-35® as an anti-acne treatment or to continue
using it as your contraceptive Pill of choice.
Diane-35®
is a 21Pill regimen that provides contraceptive protection starting
from the first day of your period, when the Pill should be taken.
Contraception remains effective on the 7-day Pill-free period.
As an advice, keep an extra pack of Diane-35® handy so you
won't run out of Pills when you want to start your new pack.
More
about the Pill
The
Pill is a contraceptive that is mainly used to prevent pregnancy.
A Pill like Diane-35® has also a very beneficial effect on
problem skin, and a lot of girls now take it to keep acne at bay.
So if acne is really spoiling your teenage years (which should
be a happy time) you could consider it. Your doctor will advise
you. The Pill is one of the most researched drugs in history and
is often quoted as one of the major inventions of the 20th century.
Side
effects of Cyproterone acetate
The most serious potential side effect is liver toxicity, and
patients should be monitored for changes in liver enzymes, especially
if taking a high dose (200-300 mg/day). Toxicity is dose-dependent
and the low doses used in birth control pills (2 mg) such as Diane-35®
not appear to represent a significant risk.
Suppression
of adrenal function and reduced response to ACTH have been reported.
Low cortisol levels may impair carbohydrate metabolism, and patients
with diabetes mellitus may require adjustments in insulin dosage.
Low aldosterone levels may lead to salt loss and hyperkalemia
(excess potassium). Patients taking cyproterone should have their
cortisol levels and electrolytes monitored, and if hyperkalemia
develops, reduce the consumption of food having a high potassium
content.
Used
alone, cyproterone acetate does not appear to have a significant
effect on blood clotting factors, however in combination with
ethinylestradiol (as in combined oral contraceptive pills) presents
an increased risk of deep vein thrombosis. There are conflicting
reports as to whether there is a significant difference in the
risk of thrombosis between oral contraceptives containing cyproterone
acetate versus other types of combined oral contraceptives.
Cyproterone
has been associated with depressive mood changes in some patients,
presumably due to androgen deprivation. However, others have reported
significant antidepressant effects. This may be due to its effect
on adrenal hormones, as similar antidepressant effects have been
observed with other adrenal suppressants, such as metyrapone.
Cyproterone acetate suppresses production of estrogen due to its
antigonadotrophic effect, and long-term use without estrogen replacement
may result in osteoporosis.
Side-effects
in men which directly result from its antiandrogenic action include
gynecomastia (breast growth), galactorrhea (milk outflow), and
erectile dysfunction.
