Using Diane Oral Contraceptives for Acne: Dosage and Menstrual Concerns

Oral contraceptive - Dianne

Hello, doctor.
I would like to ask about the recommendation to take the oral contraceptive pill Diane for acne treatment for a duration of 3 months.
I finished the second month of Diane 21 on July 31 and started a new pack on August 3 without waiting the full 7 days.
During the break, I did not get my period.
Should I continue taking the medication? Will this cause irregular menstruation? Lastly, after stopping the medication, how long will it take for my period to return? How long should I wait before seeking medical attention if my period does not come? Thank you!

Shan Shan, 20~29 year old female. Ask Date: 2020/08/03

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, after stopping the birth control pill, menstruation typically occurs within a week.
You should start taking the pill again on the fifth day of your period.
Continue taking the current pack until it's finished, and then resume the next pack when your period starts again.
Wishing you good health!

Reply Date: 2020/08/03

More Info

When considering the use of Diane oral contraceptives (which typically contain ethinylestradiol and cyproterone acetate) for acne treatment, it is essential to understand both the intended effects and potential implications for menstrual cycles. Diane is often prescribed not only for contraception but also for managing hormonal acne due to its anti-androgenic properties, which can help reduce sebum production and improve skin condition.

In your case, you mentioned that you completed the second month of Diane on July 31 and started a new pack on August 3 without waiting for a withdrawal bleed. This practice is known as "continuous cycling" or "extended use" of birth control pills, which some healthcare providers may recommend for specific conditions, including acne. However, it is crucial to note that this approach can lead to irregularities in your menstrual cycle, particularly if your body is not accustomed to this regimen.

Regarding your concern about whether to continue taking the pills after not having a withdrawal bleed, it is generally safe to continue taking Diane as prescribed. The absence of a menstrual period during the placebo week (the week when you would typically not take active pills) can occur for various reasons, including hormonal fluctuations and the effects of the contraceptive itself. Many women experience lighter periods or even skip them altogether while on hormonal contraceptives. However, if you have any concerns about potential pregnancy or unusual symptoms, it is advisable to take a pregnancy test and consult your healthcare provider.

As for the timing of your menstrual cycle after stopping the pills, it can vary significantly from person to person. Some women may experience a return to their normal menstrual cycle within a few weeks after discontinuation, while others may take several months for their cycles to regulate. If you have not had a period for more than three months after stopping the medication, it would be prudent to consult with your healthcare provider to rule out any underlying issues.

In summary, continuing Diane as prescribed is generally acceptable, especially for acne management. However, be aware that this may lead to changes in your menstrual cycle. If you have concerns about your cycle or experience any unusual symptoms, do not hesitate to reach out to your healthcare provider for personalized advice. They can help you navigate any potential side effects and determine the best course of action for your health and well-being.

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