“Well, it looks like you have a hormonal imbalance”
The family doctor was sitting across from my mother and me. I was aged 18 with a very sudden face full of acne, some weird facial hair, and a 15kg weight gain. We were going through the results of a series of tests about what the hell had happened.
The doctor held up some indecipherable number readings and said something like:
This indicates you have much higher levels of androgens [male hormones] than average, and that combined with the acne and extra hair indicates a likely condition polycystic ovarian syndrome. The usual treatment is an oral contraceptive pill that blocks the androgens to address the hormonal imbalance.
And so he introduced me to Diane-35 ED. Or ‘Diane depression’ as she later became known.
I thought Diane was here to save me.
And at first, she did!
The acne cleared up within a month; the weight settled back somewhat and the stubborn chin hairs that had begun seemed to not be gaining any buddies.
But then things got a little toxic.
She started making me feel bad.
I began crying daily and painfully.
Anxiety was at it’s peak- culminating in trembly shaky fearful sensations for very little reason.
An intense clinginess became the norm. I’d freak out if my boyfriend was even a little late, imagining he’d had an accident or… I don’t even know. It wasn’t rational and I knew it, but I couldn’t stop.
I hated being alone but hated being around people too.
Hopelessness descended. I couldn’t make any decisions, feeling paralysed, scared and dark. I was living with a Diane depression but I didn’t know it yet.
Eventually we started looking into therapeutic options and clinical interventions for depression, I just couldn’t get a grip.
And then I finally went back to the family doctor.
“Well, you could stop taking Diane. That might be affecting you”
You mean I could just break up with Diane? Could she really be the cause of all this? Just a tiny little pill that had sorted out my ‘ugly’ problems? But you never mentioned that was even possible…
Within a couple of months my personality came back.
And, importantly, my ability to cope with the ups and downs of life- my resilience- went back to the way it was.
I stopped crying for no reason. There was a sense of being capable again even though nothing had ‘actually’ changed.
There was hope, a future I could imagine began to unfurl, and I could take steps towards it. Life felt kinda fun again, like it should be.
Six years later, for contraception and in an attempt to curb the hair growth PCOS (Poly Cystic Ovary Syndrome) can cause, I attempted to reignite the old flame with Diane. I thought that maybe my life had been such a mess back then, and I’d blamed the pill for causing problems when in actual fact it was just me.
It was definitely Diane. That nasty beast had me going crazy within 6 months again.
But this time I was aware of the symptoms and was able to break up quickly.
It’s amazing how hard it is to tell when you’re in a relationship with Diane, Brenda, Yasmin or Estelle that she’s bad for you. The yucky feelings creep up on you, and more than likely you blame yourself before connecting the dots.
A little like PMS- even when it comes around every single month it’s still surprising. It feels so real.
That’s because hormones and their effect on how we feel ARE real, so why do we pretend otherwise?
- Why- in 2018, when a woman rings a women’s health clinic asking for a review of the pill she is taking- would she be told it’s ‘unlikely’ that the pill is affecting her mental health?
- Why- when we KNOW from reports by thousands of women who have taken hormonal contraception that around 20% report concerning mood changes; when transgender folks who have hormone therapy describe a myriad of changes to their feelings, behaviour and personality beyond lifestyle and gender identity (experts there, hello!!); and when it’s simply a fact that many women going through menopause report related mental health issues- are we still so blasé about prescribing hormonal contraception for a number of interventions?
Is this societal misogyny at work?
I can’t help but think that it is.
We are still supposed to think of the Pill as a ‘miracle’ that gave women control over their sexuality, their bodies. And in some ways that is true… but it’s concerning that for many of us it’s actually become a trap. The immediate go-to for contraception in a monogamous relationship. Professionals ignoring side-effects and even reports of pain.
It’s more important that I, as a woman, have clear skin and a hairless body than be free from a Diane depression.
Interestingly, similar statistics have been sited in a small trial of a male hormonal contraceptive: 17% of the participants reported emotional changes such as depression and mood swings, and 2% additionally described these side effects as ‘severe’ (as this amazing informative comic by The Nib documents).
And you guessed it: the trials were stopped immediately when these side effects were reported.
It’s not only mental health you should be concerned about when hooking up with Brenda’s and Diane’s. Numerous studies indicate links with dangerous blood clotting: that it should only be prescribed for short-term treatment of PCOS-like symptoms if at all, and not as a contraceptive. There has been a loud call for it to be banned in Australia kicked off by Labor MP Julian Hill after his daughter nearly died due to clotting.
In fact, it has already been banned in France after a report revealed 125 women ‘suffered undesirable or life-threatening side effects’ linked to Diane and her generics.
But it still got the green light here in Australia.
Here in Australia, a young woman with mild acne can still be prescribed Diane without so much as a casual warning of possible side-effects, let alone a thorough investigation into her family history or physical and mental health.
Hormones are strange creatures. Certainly, in my experience, they’re not to be toyed with.
Diane had the potential to actually ruin my life.
If I’d stayed in that toxic relationship I can’t imagine how things would have gone.
I’m very lucky to have had wonderful people around me.They were quick to follow my lead when I started to wonder if it was her and not me making things toxic.
It is unfortunate if you ARE a woman thinking about taking The Pill that you can’t take medical advice at it’s surface. You need to do your own research.
It is essential for your mental and physical health that you do so.
- Be thorough, use reliable sources, but don’t write off anecdotal evidence (let’s remember women’s knowledge and experiences of pain can be treated with casual disdain on a regular basis by all sorts of professionals)
- Talk about it if you have a cis-gendered male partner and you are seeking contraception. If he doesn’t want to use condoms then he doesn’t respect you, is that good enough? No. Dump him. And while you’re at it, dump all male lovers who refuse condoms, seeing as condoms are one of the only and easiest methods to prevent STI’s (you should be using them if you’re having sex with different blokes, even if you are also using The Pill or Implanon or an IUD etc.This is triple-true if you are having anal sex). Then take the time to find the right thing for you. Visit a Sexual Health Clinic (they are located in cities AND smaller towns across Australia) and have a proper conversation with an understanding professional
- Use your critical thinking brain at all times
- Pay attention to your body and keep track of your bodily sensations, moods, sleep, and emotions with a diary. Getting to know your unique patterns will help reveal when and what kind of treatment you might need
- Ask trusted loved ones to give you compassionate feedback if they notice any significant changes in you if you’re trialling Diane 35ED
- Don’t be afraid to push for a review of any medication you take with a doctor. You are employing them. You are a service seeker and they are a service provider. Be polite but firm about your needs and don’t stand for any patronising behaviour! Find someone new if you don’t like how you are being treated or you suspect the advice is bad
- Try and find a GP you like who has expertise in women’s health and who will listen to you with curiosity and respect
- Give a Naturopath a try!!!! I wish I had (as you will see in my update below)
- See a counsellor who specialises in working with women. Your self-image can take a beating when PCOS rears up and it’s marvellous to work with someone who helps you gain confidence in yourself no matter what you look like in the eyes of society
- If you live in Australia and have a diagnosis of PCOS you can get 5 free sessions with a dietician. Use them but don’t see a bog-standard dietician the doc send you to. Find one who is HAES (Health At Every Size) registered and has solid knowledge of PCOS. Alongside un-training your unhealthy beliefs about yourself and food, you will be given a simple and self-loving plan based on your TEST RESULTS (not based on fatphobia). I’d strongly recommend this even if you don’t have PCOS and just want to address unhealthy beliefs and behaviours around food. A side-effect will be better skin, higher self-image, and good strong healthy habits that will last a lifetime
- Gather true loving allies and listen when they’re worried about you. Let them build you up when things like acne, hair issues, weight and fertility struggles get you down. I wish we didn’t need them, but we obviously do, because let me tell you: Diane, Brenda and Yasmin are one helluva vicious trio if they decide to turn against you.
Please do share your experiences in the comments below.
It’s May 2021 and as I’ve mentioned in the comments below, I’ve personally had some excellent success in managing the symptoms of my PCOS since I read this book 1.5 years ago. I want to stress I do not receive money for affiliate links, I just genuinely found this book incredibly helpful and want to share it with my PCOSisters.
It’s called ‘8 Steps to Reverse Your PCOS‘ by Dr Fiona Mcculloch, a world-leading naturopath who has and specialises in PCOS. The book offers a very thorough biological, medical and naturopathic examination of and treatments for PCOS. It is not attached to any branded products.
I did not take all the advice, but I did start taking some supplements (Myo-inositol being the most important one, as well as transresveratol, fish oil and vitamin D). Myo-inositol increases insulin sensitivity, decreases hyperandrogenism and improves the menstrual cycle, all of which mean that my body is working better when I take it.
I can report after a solid trial period that I now sleep better than I have in my whole life. My skin is clearer, I’m calmer and less anxious. I have a regular-ish cycle (around 28 days) which means predictable moods and I would assume improved ovulation, and my hydradenititis suppurativa has vanished.
Given my success with a fairly lazy adherence to the advice, I’d imagine if you followed Dr Fiona’s recommendations more vigilantly you could have the same positive impact on mood and sleep but also improve acne, excess hair or hair loss and fertility.
I would also strongly recommend seeing a Naturopath who specialises in women’s health, especially if your PCOS concerns are time-sensitive (eg: you’re trying to get pregnant) and it’s vital to have a professional manage your health.
Getting the proper treatment for PCOS can change your life. I’m only sorry it’s taken me 20 years of useless medical interventions to give naturopathic advice a go.
As mentioned above, I do not know Dr Fiona McCullogh and do not receive any payment or affiliated advantages for recommending her. I am independent and this information is based on my lived experience only. But Dr F, if you’re reading this, THANK YOU.
Narrative therapy is all about deconstructing accepted ‘norms’ and helping you find your own way through the long grass. I’m interested in helping women escape the kinds of rubbish Diane depression put me through (and any other suffering you’ve been subjected to or are experiencing).
Get in touch with me directly here if you want to ask any questions, or sign up for the free blog here if you liked this post and want a free mini-workbook on re-authoring painful problems. When you sign up for for the blog you’ll also get an invite to join an intimate honest Facebook group for ‘Dedicated Imperfectionist’ women-folk, we’d love to have you with us.