Alternatives to dianette/yasmin

Hey everyone, so finally after a battle I've been diagnosed. I'm awaiting blood test to check my hormone levels (after telling my doctor I needed one!!) only advice she gave me is I need to lose weight to manage it. She assumed I already knew I had it! Anyways, I always had thought I had it but never had it confirmed as the hospital lost my tests results and had self treated on Yasmin. For me it was perfect, cleared up my skin and reduced my facial hair. However, last year the doctor changed me to Lucette and after 2 weeks on that I had a migraine. So now they have stopped me being on the pill. I'm waiting to see the gynaecologist but wondered how people are getting on with alternatives? I'm not looking to get pregnant so need this for contraception but worried that alternatives will make things worse :( 

19 Replies

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  • Hiya,  I was on dianette for years, then came off to start a family and 15 years later have returned to the consultants for help treating my facial hair.  I learnt a lot about the contraceptive pill recently which might be of interest to you.

    Dianette is a type of 'combined' contraceptive pill, which pumps oestrogen and progesterone into you.  The effect is that you get shots of these hormones to counteract the very active male hormones us PCOS sufferers have in abundance, and makes an egg impossible to be fertilised.

    I have tried, recently, a variety of 'pop' contraceptive pills which are different to combined ones.  POP pills are progesterone only pills, the extra progesterone makes your womb lining healthy but uninhabitable for fertile eggs.  In short they only do the 'contraceptive' part of the job and not necessarily help you combat acne or facial hair symptoms.

    If you are looking for just contraception, you may like to ask the GP if they would let you try a POP pill (I used to suffer from migraines and breast swelling and they still tried me on them) but the other thing I have been offered is the coil.  Lots of PCOS sufferers swear by the Minerva coil.  Have a look at some of the threads.

    If you are looking for something to treat the acne and facial hair AND contraception.  Maybe it's time to separate medication?  I can swear by VANIQA cream for facial hair (must be prescribed, and at great cost to the NHS so you'll have to fight for it) and Metformin manages my insulin-retention which has a direct effect on my testosterone levels (which are responsible for your facial hair and acne).

    Finally, have you tried playing with your diet to manage your symptoms?  I swear by a low-sugar, gluten-free lifestyle which has directly affected some of my PCOS symptoms (weight and hair).

    Sorry for the long reply! xxx

  • No thank you for the long reply! It really is helpful to hear what other people are doing. I've just been diagnosed and all the Dr said to me was that I need to lose weight. I'm not massively overweight (12/14) but could do with losing some. Ive had to ask her to get blood tests done to check my hormone levels and asked to be referred to the gyno re contraception as I don't want to take anything that's going to make things worse and she wont put me back on Yasmin due to the one migraine. I am starting to explore diet options. Do you have any good links for diets to follow? I'm quite apt re high protein diets and managing carbs (I've stopped whey protein after it made acne worse and now exploring other protein sources). It's like a minefield! 

  • That's pretty unhelpful!  Sure losing weight helps some of your symptoms but it won't make the PCOS go away.  Where in the world are you?  If you're in London I thoroughly recommend getting a referal to my UCLH PCOS clinic, gynae's can help but it's so lovely to be understood finally that I will never give up this clinic!

    I began, 7 yrs ago, with a gluten-free diet and lost a lot of weight that way.  I found even if I cheated (I love bread) every once in a while it didn't pile on the pounds straight away so I could make it a lifestyle change and not succumb to yo-yo dieting.  It's expensive but I think worth it, the pasta tastes no different but the bread really does so that's why I cheat occasionally!  And it's such a trend now that eating out is much easier too.

    My latest however is 'no added sugar' diet and I'm seeing more amazing results.  Although less immediate weight loss there has been a direct affect on my facial hair.  Again I do cheat occasionally but it's harder to jump back on the wagon again after a cheat so I usually reserve it only for birthday cake etc!  All this means is I read labels constantly, if there is added sweetner or sugar I don't buy it.  There are a whole host of names they hide sugar behind dextrose, glucose etc so it takes some learning but google's a magical thing! It took about 3 weeks to get that sweet tooth gone and then I found I hardly crave chocolate or other desserts.  They've become 'treats' as they always should have been, rather than cravings.

    At my last consultant appointment we talked about the direct correlation between weight and hair (for me), do you know the link?

  • I'm in London would you believe! I had spotting which is why the gyne referral has happened as well and why I had the ultrasound in the first place which is exactly what o had a few years ago but they lost the ultrasound and I was back on my pill then so I didn't push it as symptoms were sorted by that. I'm older and wiser now. I may have to explore that option. Mine is mild and isn't as bad as some other people I've read about plus although I'm 30 im not trying for kids so I think she's kinda only looking at that side of things if I had said I was. I have no idea what my link is! I am part med which means naturally I'll be hairer anyways (which is what the Dr said to me) but I also said to get that's it's got worse again since being off my pill! Again most as bad as some people I have seen but it's been getting worse over past year since been off pill and fear it will continue to get worse! How did you get a referral to them at uclh? I rarely eat bread anyways as I feel carbs don't agree with me too much. I been training at the gym and most gym diets encourage s certain amount of carbs but struggling re how I do have enough carbs to train bs every where I'm reading about carbs not being helpful for pcos! 

  • Ha!  I've only just realised we're responding to each other in two different threads!  I have responded to your other message where I say my weight is linked to my insulin resistence which makes me store fat which produces  overactive testosterone levels!

    I'm also mediteranean! Which means I can get away with a lot (rather than seeing it as a flaw ;) I don't manage the hair on my arms for example but cannot stand the hair on my face.  I'm a realist.  I know the body does things for a reason and I don't stifle it too much, but something definately doens't work in mine and I need to avoid diabetes in later life (although I'm not worried about my weight, my grandmothers both had diabetes late in life).

    I suddenly found myself sufferring with my moods late 2014 and the GPs were quick to diagnose mild depression (I however think that's incorrect), after following a few treatment courses (not meds) I asked to explore the idea that the moods were linked to my hormone levels and my GP suggested this clinic.  It was pot luck that I got a GP willing to explore it with me.  What I had in my arsenal was years of blood tests and various appointments for managing my PCOS so she could see I took the management seriously.  My advice?  Just bloomin' ask to be referred every time you have an app ;) Also, I can give you the number of the clinic, if you like, and you can ask their advice on how to get reffered.  They are so nice and accommodating.

  • Totally thought I had replied to you🙈 been a busy month. How did you know you have insulin resistance? I've had my bloods done and seeing the doctor tom actually to go through the results. Given I got told to just lose weight (like I haven't been trying for like my whole life!) im not holding out much hope but I'm going to ask for a copy of my results so I can explore them online and the results. I will ask about the uclh as I just don't want to do things that will make things worse. Yeah hair on my arms etc don't bother me but the hair on my face really does and it's just getting worse since I came off Yasmin. That kept everything at bay 😔

  • It came up in the bloods, so ask that specific question and good luck. Let me know how it goes if you like x

  • Thanks. He said that I don't have diabetes but he couldn't print out my results so he's gonna leave them for me at the surgery.

    He said my tester one was 1.5 abd wasn't concerned about this and I had to ask specifically about this one. my progesterone was 15 which was the one he was concerned about. I'm not sure against what reference they were as he was unable to print them out. Basically said it doesn't look like I'm ovulating but said nothing to be done until I want to start trying for children which in not in that place now. He said no point re specialisrs unless trying for children.

  • That sounds quite unhelpful from him unfortunately but maybe you felt it was an informative appointment?

    Insulin retention is a common symptom of PCOS and does not mean you have diabetes. It does however mean you have to be careful of getting diabetes. I am unsure however how that shows up in blood work, I've always just discussed it as insulin retention with my GP/Consultant.

    Your testosterone levels, as I understand them, are quite low, sometimes I refer to this table pcosjournal.com/hormone-lev...

    Maybe you can correlate your results with that table. Good luck.

  • Sorry one more thing.... If your progesterone is low it is not just babies you have to be concerned about. If you wanna push the point, ask him about cervical cancer and osteoporosis. You need to keep your womb lining healthy and periods or progesterone are needed for that.

  • You are so helpful with all of this!! I really appreciate it. I feel like being armed with the right imformation means I can get this sorted once and for all.

    That list seems to show results for from day 3. I was told to have my bloods done on day 21. He wasn't very helpful and I've not been well this week with a bug (as well as getting dumped by a guy been seeing a few weeks as he decided although I was attractive he's doesn't feel like ripping my clothes of, which to him equates to no butterflies. I dont really blame him as I feel so fat of late and horrid!) so didn't feel like arguing it and how can I when when tells me its all normal if that makes sense with nothing to compare it to? That's why I've asked for a copy then I can go and research it all myself.

    Diabetes runs in my family as well as cervical cancer actually so they are the two things that concentrate me.I do have a period every month it just various re dates as to when it is. I've been tracking it on clue app for the past year and it goes from 28 days to 40 days and think averages out to 33 days cycle. I'm not sure how the diabetes gets tested on the blood work so waiting for the paperwork so I can go through it myself.

  • If you're having a regular (albeit all over the place) period then you're womb lining is healthy enough, in this area. My consultant told me you need to have a minimum of 3 or 4 a year to guard against more serious illnesses. So that's one less worry for you.

    Blood tests are incredibly hard to understand, I wish you luck. Armed with the tests I always go to the GP and ask them to point out to me what is what and then write on my test notes to remember for next time.

    I'm sorry to hear about your love-life. Don't ever blame yourself though, even if you feel fat and unlovable, the right sort of person will overlook that or help you work on it. He wasn't the right sort of person this time.

    Loving yourself in your lowest PCOS state (fat, hairy and emotional!) is a very big challenge. Sometimes I am right on top of that and sometimes it all slips away! I too am on a downhill right now. I just gotta get more headspace and I can love my body again. It's about loving it, whatever it's size and condition, and stopping saying 'I have a realistic, ideal weight'. Ideal is the size you are right now. Because that is who we are, and if we don't love who we are, how the hell can anyone else?

    xxxx

  • Contraceptive combination tablets like microgynon, Yasmin, dianette, ovranette, and loestrin. Have oestrogen and preogesterone as someone else has already said.

    Doctors won't leave you on new age combination pills like Yasmin for a long period as they can cause DVT & contribute to diabetes (insulin resistance).

    I found Yasmin to be the best one I took as the rest made me suicidal...

    Dianette/microgynon have the same chemical hormones in. Ovranette/Yasmin have the same in too! My lovely doctor told me this when I said I didn't get on with some of them...

    I'm on a POP( progesterone only) as I have recently been diagnosed with endometriosis as well...

    I've had PCOS since I was about 17 and was officially diagnosed at 21.

    I hope this helps. Xxx

  • My daughter has pcos and type 1 diabetes. She is on Yasmin. Is that a good move if it can make u insulin resistant?? X

  • Hey this is really late so I hope you have found the right pill for you! I was on dianette for years (since I was 16) but had to change to yasmine because of high bp and again from yasmin to mercilon (for the same thing). I've actually completely come off the bcp (and metformin) for about 3 years and rely on natural + condom and it was the best decision of my life. Things that I didn't realise was missing in my life (like a super high libido) actually appeared and overall I'm so much happier.

    Having said that, you're looking for a bcp and I can't recommend mercilon enough. It's one of the lowest dose combi pill available so technically lower side effects. I've recommended it to lots of friends and everyone who took it loved it. Of the 3 pills I've been on, mercilon definitely worked the best for me (though I took it in combo with metformin so they might have worked with each other too).

    I now work with a fantastic chinese doctor who helps me manage my pcos with herbs and acupuncture. 3 years, 30 odd periods (I have a long 33 day cycle) and a much improved glucose/insulin profile later, I can't recommend looking into alternative and chinese medicine enough. I can't believe I was crazy enough to completely stop the pill and metformin on a leap of faith (I saw her for back pain initially and she freaked out over the metformin, she has a point- what happens when you get diabetes later?) but I've actually since seen a specialist who is claiming "misdiagnosis" (for 18 years??).

    Diet wise, I try as much as possible to stick to a high fat, low carb diet- Real meal revolution was an eye opener and I feel less bloated (even though you are eating really heavy stuff?) and a bit more energetic on it. It's the WORST when they tell you "just to lose some weight" because it is so hard to do that with pcos. At least on a LCHF diet you are not challenging your body to deal with the insulin thing (it depends if you are insulin resistant though, not everyone is).

    Super good luck with your PCOS journey. I feel super lucky that mine is finally managed and I can concentrate on harnessing/ beating hypothyroidism, but it really got me down for years. Give me a shout if you need anything!

    P.S. If you're getting lots of migraine 5htp really helped me (and the doctor can also prescribe sumatriptan which you take when you get them).

  • Hey viv, thanks for your reply. I was on Yasmin for years but I had one migraine and the doctor stopped it. I had self medicated with it for years as I always suspected I had it but wasn't formally diagnosed for various reasons of the hospital losing test results etc and me not pushing it as had my Yasmin. Now the doctor won't put me back on yasmin and I'm looking for something for contraception and to manage the symptoms but most that do the latter are the combined pill but she said I can't have it. I've never had a migraine before that or since then which was over a year ago. It was one that I had and that's it. Yeah I've always sort of followed a lchf diet but weight still doesn't move :( I'm 13 stone and 5'4 and the heaviest I've ever been in my life. I'm going through my bloods tomorrow and will ask if they show insulin resistance. What has the herbalist been doing with you? I just don't want to do anything that makes things worse re weight, spots and hair on face!

  • Wow. 1 migraine and they stopped it? Some people are thorough. I guess it depends on how bad that episode was? Did they say it's ok for a mini pill? I mean, the only thing I could suggest is that because mercilon is a low dose combi pill it might be worth asking for it because of reduced risks? I mean, I'm not sure in your situation as they said no already- I've always had migraines and I still had a combi pill but it might be because they put me on metformin and you had to take it with a bcp (it makes bad babies).

    It's really difficult to show insulin resistant as most nhs gp will only go as far as a regular glucose test which does nothing. It will only reflect what is happening to your blood sugar at that particular point in time of the test (i.e. if you had something sugary it would be worse, if not better) and they won't order you a dynamic one (where you drink a pint of sugary water and they measure how your body process it in 3 hours). I'm lucky that my dad is a ob-gyn so he ordered those tests for me, even if he doesn't treat me. Try push for one, especially if you feel a bit funny after eating sugary food (hey I said that to my doctor last time and I didn't even get a regular blood glucose test). I'm only slightly lighter than you are at 78 kg, but for me I know I don't follow my diet at all, and I drink probably more than I should (apparently we shouldn't have no more than 1-2 units a day but erm, I find it extremely difficult when I'm out for dinner!). I've gained 4kg in the last 12 months but I suspect it's more the thyroid than the ovaries. Damn these pesky hormone things!

    For skin- I've had really bad skin all my life until about a year ago when I was visiting my sister and I used her dermalogica sensitive skin stuff- over the weekend my skin got a bit better so I bought some and now it's completely cleared up- if you've been using a lot of strong products for spots it might be that your skin has been overtreated and using a good sensitive skin product will help calm it down and allow it to heal properly- worth a try if it's such an easy solution.

    And regarding the herbalist- sadly, I have NO CLUE. She is a full fledge traditional chinese doctor with a western medical degree and she just do what chinese doctor do (I'm chinese so I'm quite whatever about it). She does my pulse and looks at my tongue and tsk at me about how much I drink and from that she adjusts my herbal formulae once in a while (like every 3-4 months), writes the herbal script and orders it online for me and bottles of herbal powder arrives in the post. All I'm in charge of is taking it. I have one that helps nourish and rebuild the body after the period and one that helps bring it on. And the only drink I'm really allowed to drink is a whisky (or similar) a night a couple of nights before my period to "stir the blood" and get everything going- this really works, and I've heard from other people about it too. As far as I understand, it's a lot about nourishing your kidney yin and lower burners in the body...

    I ovulated yesterday on schedule, so fist pumps, it is manageable, as with all conditions, a bit scary and there are all these choices out there and it just depends on what works for you.

    I hope all this meandering thoughts help and that you have a sucessful trip to the doc tomorrow!

  • Yeah 1 migraine. I only went as 2 weeks before they changed my pill from Yasmin to the cheaper version ( Lucette I think it's called) and that's when it started. I didn't have flashing lights or whatever but just felt really sick and not with it. I asked just to be put back in the Yasmin specifically as used that for about 6 years or so and no issues what so ever on it and blood pressure was all ok. Not had one before or since then. There is family history of strokes so I can understand that caution and have said if I get another I would stop it completely but she's still saying no and to ask the gyno when I eventually see them and see if they would agree for me to go on. She said about the mini pill but I said I didn't want to a be limited to 3 hour window ( I know cerezerte now means a 12 hour window) and wanted to control as and when I come on like if I go on holiday etc as well as control my symptoms hence I wanted to go back on Yasmin. She suggested implant might be better but couldn't really tell me how they will impact on the Pcos. I had to ask for the blood test as all I got told was to lose weight ( I'm actually 12 stone not 13 i wrote!) which I didn't feel was very helpful being honest. I actually gym a fair amount and only carry weight realistically on my stomach. I get the impression that she doesn't really know very much about it. My appointment is now Tom as they got the time wrong so I may ask her about the marvelon pill too. I suspect she jag just say wait until you see the gyno. No it helps to get different peoples views on things as its a bit of a minefield!

  • Urgh. That weight loss thing is my personal bug bear. You can be at the ideal bmi of 20 (which is what I've been told we should be at with pcos) have very little muscle tone and definition and be "healthy" while being a bit heavier but much fitter is perceived as "unhealthy".

    Also, I know another girl that have pcos who have been on 1000kcal diets, kill herself at the gym and not lose anything. She lost weight on metformin and was "healthy" but turned out the reason was that she was allergic to metformin! How does that work?

    It's taken a long long time but finally it twigged that the most important thing is to feel healthy and strong. Sure, I'd love (and it's my aim) to lose another 20kg but I'm not going to make my life miserable doing it or beat myself up about it. I know I'm stronger and healthier than when I weighed 15kg less and that's what important.

    And finally, as consolation, apparently the weigh loss thing only becomes super important when it comes to having babies. And I know lots of people who have pcos, slightly overweight and have babies, so evidently even that is not the end of the world. (But one did get gestational diabetes, so I guess...!)

    P'S I was given cerezette too but I refused to take it. It just sounds too faffy and the idea of random spotting just really didn't convince me, but that's just my opinion.

    Hope you got the yasmin!