Transitioning from Qlaira

[YouokHun]

Two years ago after struggling with horrible mood swings, flushing skin (though no hot flushes as such) dry skin, formication, insomnia, rage and generally feeling dreadful, I went to a private clinic (Nick Panay’s clinic but didn’t see him) and was prescribed Qlaira. I was 49 at the time. This made some difference, my skin improved, my mood stabilised so that I don’t feel rage anymore and haven’t had suicidal thoughts. I still sleep very badly and still haven’t got my general self confidence back but generally the horrible troughs in mood haven’t been so bad.

It’s now nearly two years since I started taking Qlaira and I’ve noticed in the last six months I’m getting severe headaches when the hormone levels drop and I’m on day 25-28 of the pill pack. My periods are much heavier too, not unmanageable but requiring heavy flow pads and getting worse each time. I remember that the person I saw (GP with specific training in menopause matters) said I shouldn’t take the pills ‘past 52’ so I am worried about continuing. My problem is that I just can’t afford to go back as it’s £250 just to step through the door. I need to return to my GP but they really didn’t help me last time and were insistent that I needed CBT and antidepressants - I am a CBT therapist and I knew I wasn’t depressed! My question is - if I go back to the GP (possibly find a different one in the practice) will they likely swop me to gels and patches and if so does anyone have any experience of swopping treatments? I’m terrified of feeling like I did before Qlaira but I also feel Qlaira isn’t really right anymore, but I’m also terrified of not coping with a change to HRT and not being able to cope: hold down my job/manage teenagers/elderly parents etc etc. I guess I’m also concerned that the GPs will not be receptive to helping me (despite NICE guidelines on HRT) or that what they prescribe is a one size fits all ... I don’t know what I’m asking really!

The majority of gps have absolutely no idea about hrt for Meno.
I have decided that I will try to get informed by my own. I think that if Qlaira doesn’t suit you any more, try another type of hrt.
Everyone has a different opinion about hrt!
My last gyn said that patches are preferable than pills but I don’t like the idea and I said that I will stay with the hrt that makes me feel good and that is the main criterion for me!
Just try to find the type that suits you better!

If you live in London, you can be referred to the meno clinic at the C&W run by Panay ( as NHS patient.)

Is this an option?

If you see a consultant privately, you won't need to pay £250 every time. (I don't.) You would have a review every 6 months or so and it would not be the same fee for a shorter appt.
(Mine is a lot less than £250.)

However, your GP ought to be more up to speed. Can you change Gps?

If not, you need to be assertive. Do your own research and decide what you want to try- and ask for it!

The reason to come off Qlaira will be the higher yet small risk of blood clots in older women, due to it being pill form HRT and a higher level than with HRT.

Ideally now, women are being put on transdermal HRT as a first choice rather than pills to avoid risk of blood clots.

That narrows down your choice to gel or a patch. If you use gel or an estrogen-only patch, you will need to use progestogens too- usually utrogestan which is natural progestogen.

I suggest you go to your GP and ask for these explaining you have now reached the age limit for Qlaira.

If they refuse, ask for a referral to an NHS meno clinic or meno consultant on the basis your GP isn't offering support. That should shut them up as they won't want to fund it.

You might also like to print off the NICE guidelines about meno treatment being tailored to the individual and a JOINT decision process with her dr.

Sorry- I know Qlaira is not HRT- meant to say CCP

Emerald thanks for your response. I guess I’m scared of fiddling around trying to find the right thing with only the guidance of a GP who is either anti or not particularly informed and disappearing down a black hole of psychological symptoms and not coping with life. I don’t really know whether Qlaira suits me or not; I’m putting up with somesymptons but not getting others; kind of bumping along the bottom, but I do know they don’t want women to take it for long because of higher chance of clots etc. I’m not sure I’ve actually felt good, energised and positive for years, I don’t remember what it’s like to feel self confident like I used to.

Jingling thanks very much, you’ve added helpful things while I’ve been slowly typing and you’re right, I need to be more assertive and I know this really. I will book an appointment and ask for the gel which sounds a more flexible option. I think today is a particularly wobbly day for me so it all seems like a mountain to climb!