Replacing the Diane 35 pill and hair loss

Question from Aliette M.

I read your report on androgenetic hair loss because I've been suffering from this type of hair loss myself for many years. I used to take the Diane 35 pill, which limited the damage. In 2013, when it was withdrawn from the market, I had to change contraceptives and it seems to me that things have only got worse since then: continuous loss of density, thinning hair, very oily scalp. Can you give me some advice?

Clauderer's answer

Many women have found themselves in your situation. Diane 35 (or one of its generics*) was in fact a good drug for countering the harmful effects of androgens on scalps receptive to these hormones. Containing a sufficient quantity of oestrogen (0.035mg/day) and an actively anti-androgenic progestogen (cyproterone acetate), its formula could help some women to combat androgenetic alopecia or against hyperseborrhoea. But the ANSM (French National Agency for the Safety of Medicines) deemed the side effects of Diane 35 to be potentially too serious to allow it to remain on the market. In February 2013, the ANSM "suspended the Marketing Authorisations for Diane 35 and generics as a precautionary measure. Pharmaco-epidemiological data showed a 4-fold increase in the risk of venous thromboembolism in women taking Diane 35, compared with women taking neither Diane 35 nor oral contraception.". The only exceptions authorising the prescription of Diane 35 are cases of severe acne or hirsutism. For more information on this subject, please read the ANSM summary published on its website: Diane 35 and its generics - ANSM

As far as you are concerned, you need to see what type of contraceptive you have adopted. If you've switched from Diane 35 to a first- or second-generation contraceptive (which seems to be the case), it's not surprising that your hair has suffered and continues to suffer. 

Our first piece of advice is to check with your doctor whether it would be possible to replace your current pill with a contraceptive consisting of a 3rd or 4th generation progestin and an estrogen equal to 0.03mg/day. These types of pill can help to regulate your hair cycles better, as Diane 35 did. Only your doctor can decide whether you can take such a pill.

But that won't solve your problem entirely. Our second piece of advice is to have a hair diagnosis performed after which we will recommend a local anti-androgen treatment to act in parallel.

* Generics of Diane 35: Evapar, Minerva, Holgyème, Lumalia, Majorelle, Cyproterone-Ethinylestradiol

Jean-François Cabos

Jean-François Cabos is the creator of a unique hair care method based on the research he coordinated, which led to the publication of the book "Cheveux, Racines de Vie" with Hélène Clauderer by Robert Laffont (Collection "Réponses/ Santé").

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