Methods
What is the Diane pill used for?
Quick answer
Diane-35 (cyproterone acetate 2 mg + ethinylestradiol 35 mcg) is used mainly for moderate to severe acne and excess hair growth linked to androgens, usually after creams and antibiotics have not worked.[src] It also prevents pregnancy, so it is never taken together with another hormonal contraceptive. It eases PCOS symptoms but does not treat PCOS itself.
The four things Diane-35 does
Diane-35 pairs ethinylestradiol, the usual pill estrogen, with cyproterone acetate (An anti-androgen progestin in Diane-35, Althea and Cybelle.), a progestin that also blocks androgens (male-type hormones) at the skin and hair follicles. That gives it a wider job list than most pills:
- Acne linked to hormones. The European Medicines Agency kept Diane-35 on the market in 2013 for women with moderate to severe androgen-related acne, ideally after topical treatment and oral antibiotics have failed.[src]
- Excess hair (hirsutism). Hair on the chin, upper lip, chest or belly that comes from androgens is the second licensed use.[src]
- Contraception. It prevents pregnancy like other combined pills, which is why you do not add Trust or any other pill on top. Doubling up adds estrogen and raises the clot risk.[src]
- A regular withdrawal bleed. For people with irregular cycles, including many with PCOS, it gives a predictable bleed every 4 weeks. That bleed is a withdrawal bleed (The bleed during the inactive or break days of a pill pack. It is not a true period.), not a sign the cycle has been "fixed".
What Diane-35 is not for
- Contraception alone, as a first choice. EMA framed it as a treatment for skin and hair that also contracepts, not the go-to pill for someone with clear skin.[src] Its risk of clots in the veins is about 1.5 to 2 times that of levonorgestrel pills such as Trust (levonorgestrel + ethinylestradiol).[src]
- Mild acne. Creams and other skin treatments usually come first. A dermatologist can help here.
- Treating PCOS. It can calm acne and hair growth and regulate bleeding, but it does not change the condition underneath. Filipinas in r/PCOSPhilippines describe acne coming back after stopping.[src] That is experience, not evidence, but it matches what EMA says about acne returning.
- People who should avoid estrogen. Smokers 35 and over, anyone with migraine with aura, a past blood clot or high blood pressure should ask about other options.[src]
How long people take it
Acne usually takes several cycles to improve, and a breakout in the first pack is common.[src] Because it is a treatment for skin and hair, it makes sense to review it with your doctor once the skin has settled and ask whether you still need it. [TODO: source: label or guideline wording on how long to continue cyproterone acetate + ethinylestradiol after acne clears] Plan the exit with your doctor before you start: what skin routine you will use, and which contraceptive you will switch to if you stop.
Cost and same-formula brands
A 21-tablet pack of Diane-35 costs from ₱695.75.[src] Althea (from ₱537) and Cybelle (from ₱525) have the same active ingredients and doses.[src] All need a prescription. See pills for acne for how Diane-35 compares with drospirenone pills like Yaz.
Three legal routes
Get a prescription
Diane-35 needs a prescription in the Philippines. Pick the route that suits you. For adults 18 and over.
Free at a health center
Barangay health centers, RHUs, DOH hospitals and Likhaan. Subject to supply.
See an OB-GYN in person
Clinic visit, prescription in hand. Bring it to any licensed pharmacy.
Online consult
A licensed doctor by video or chat. From ₱700 on some platforms.
Online consult options
For adults 18 and over. Fees are set by each provider and can change.
Frequently asked questions
Para saan ang Diane pills?
Pangunahing para sa katamtaman hanggang malalang acne at sobrang buhok na dulot ng hormones. Contraceptive din ito, kaya hindi ito sinasabay sa ibang pills. Kumonsulta sa doktor bago magsimula.
Can Diane-35 be used only for acne if I am not sexually active?
Yes, many people take it for skin. It still works as a contraceptive and carries the same clot cautions as other combined pills, so a doctor should check your health history first.
Does Diane-35 help with PCOS?
It can help PCOS symptoms such as acne, excess hair and irregular bleeding, but it does not treat PCOS itself. Symptoms often return after stopping.
This guide is for information. Talk to a doctor before starting, stopping or switching birth control.
Sources
- Benefits of Diane 35 and its generics outweigh risks in certain patient groups, European Medicines Agency
- Combined pill: who can and cannot take it, NHS
- Oral contraceptives category, Watsons PH
- Prescription Pharmacy: Contraceptive Agents, Rose Pharmacy
- Diane 35 or Yaz?, r/PCOSPhilippines