Qlaira to HRT ... or ADs?

[Rufus27]

After finally finding something that worked for my peri symptoms (extreme PMS, estrogen fluctuations, headaches, anxiety, tingling skin) my GP has said that at 49 I need to come off it. I’m gutted as it works so well - my body seems to prefer the nearly constant combination of progesterone and estrogen which Qlaira supplies.

I’m dreading coming off it and not sure what to try next? I dabbled with patches and Utrogestan in my early 40s, but didn’t like the days in the month when I stopped the Utrogestan. Is there a tablet form of HRT similar to the progesterone in Qlaira? If the anxiety / mood swings is the symptom I’m most worried about returning, would I be better off with ADs?

Any advice or experience appreciated.

Hi, I’ve just had to come off Qlaira for the same reason and have chosen to take a mini pill for the progesterone and an oestrogen tablet separately. I’ve only been taking this combo for a few days so can’t tell you how it’s going yet but it’s an option for you hopefully. Talk to your GP

Hi Rufus and Cherie

I stumbled upon these posts while in my own form of peri hell - I've been taking Zoely contraceptive pill for 3 months to try and suppress my crazy fluctuations but I don't think it has fully worked as I'm still experiencing horrific cyclical insomnia and night sweats. I am swapping to Qlaira tomorrow and really hoping that I get some relief. Can I ask - why has your GP said you need to stop at 49? Is that just for Qlaira for any BCP? I know women in their 50s happily on BCPs. Seems crazy that something that has given you such relief is being taken away from you

It is general medical practice to stop a combined hormone bcp after 50 because of risks of blood clots. A mini pill (for birth control) is preferred option. Or a coil. Then HRT can be used additionally

Thanks Cherrypie, I wasn't aware of that. Can I ask which POP and estrogen tablet you've opted for? I really hope it works as well for you as Qlaira did x

Cerelle with Femoston 1/10

Thanks all. Apologies I’ve not responded sooner - hadn’t received notifications (and assumed I was Billy no mates!).

@GILL999 How’s it going with Qlaira? It took me about two months for it to control the fluctuations.

@Cherrypie32 That’s really useful to know as my GP said I’d have to take a mini pill for contraception, plus separate Utrogestan and estrogen HRT. Or is the Femeston a combined HRT with progesterone and estrogen? How are you getting on with this combo?

Rufus, my quick google tells me that Femoston is indeed a combined progesterone and estrogen, the listed hormones are these under slightly different names. I refused to have a coil fitted so this was what my doctor offered. I came off Qlaira for about 4/5 weeks before I started this and felt tired and had very bad headaches which I think was lack of oestrogen. I’m feeling much better on something again and so far so good.

@GILL999 @Cherrypie32

Just a quick update. I spoke with one of the partners at our GP practice with an interest in women’s health today. She said there’s absolutely no need to stop Qlaira at 50 because the estrogen in it is natural and the risk therefore much lower than with conventional BCPs. She was v apologetic the other GP had said I needed to come off it. Her recommendation was to take it until 55 and then swap to a continuous HRT.

@rufus27 that is such good news - really pleased for you! At least it takes some of the immediate pressure off and you can plan the swap to HRT a while beforehand. You must be so relieved!

I swapped from Zoely to Yasmin a month ago as I found Zoely wasn't controlling my own hormonal fluctuations but have so far been experiencing the same thing on Yasmin so not sure what to do now. Can I ask how quickly you felt Qlaira worked for your perimenopausal fluctuations? I spoke to Dr Caroline Marfleet (loca gynae) who said the next options would either be HRT, or Qlaira, which she's had a lot of success with. But as the estrogen is the same as in Zoely, I wasn't sure if that would be the case for me... or if I'm just not giving it long enough (I was on Zoely for 3 months before switching to Yasmin)

Sorry just to add - i opted for Yasmin over Qlaira a few weeks ago as I was told (on another forum) the strength of the more natural estrogen in Zoely in Qlaira is often not strong enough to suppress your own hormones, compared to the synthetic estrogen in traditional Pills. But so far my experience on Yasmin hasn't been any different with the original symptoms. I have read about people seeming to have success with Qlaira though x

@GILL999 I opted for Qlaira over Zoely eight years ago because my doctor thought the progesterone would suit me better. I had dabbled with HRT before that, but it was a nightmare as it wasn’t controlling my own system, so at times my estrogen was ridiculously high and I felt horrible.

Qlaira initially gave me sore breasts and lots of spotting. This took three months to settle down. I do still get a bleed at times other than the end of the pill pack, but it’s always light and doesn’t bother me.

A friend of mine tried Yasmin but the progesterone in it didn’t suit her and so she switched to Qlaira and had better results.

The estrogen in Z and Q is identical to (nearly all) HRT estrogen so it’s more natural and lower risk. It seems to be the progesterone that makes a difference to whether it works for a person or not, both with BCP and HRT. Have you looked at the Avon Pill Ladder? It’s quite a good chart of the various progesterones in BCP and their potential side effects.

heeoe.hee.nhs.uk/sites/default/files/combined_hormonal_contraception.ppt

gpnotebook.com/simplepage.cfm?ID=x20130725203135685340

Thanks @rufus27 this is really so helpful. Yes I've looked at all the pill ladders and spent hours trying to work everything out! Zoely didn't seem to be controlling my fluctuations (I gave it 3 months) so at that point I switched to Yasmin after being told that because the estrogen in Zoely and Qlaira is more natural it is also less potent and still "tops up" your own hormones, much like HRT. However I'm now a month in to Yasmin and STILL having my original symptoms (cyclical night sweats and middle-of-the-night insomnia). As well as a whole host of other classic side effects - weight gain (half a stone) and chronic constipation which I think is due to the water retention aspect. I'm really trying to establish whether I need to give Yasmin longer or whether I should consider switching to Qlaira.

A gynae I spoke to said she's had lots of success with Qlaira for perimenopausal women - I'm not sure if that would be something to do with the phased approach over Zoely or whether i would be likely to just experience the same as I did with Zoely.

Can I ask how long you felt it took your fluctuations to calm down on Qlaira?

Thanks again, it's really useful hearing from people who have been through the same thing x

@GILL999

I think it was about 2-3 months before I noticed a difference. My GP did suggest having some estrogen gel as a ‘top up’ if needed, but I never got around to it. Qlaira has slightly more estrogen than Zoely I believe - Zoely has 1.5mg daily, whereas Qlaira ranges from 1-3 mg, but mainly has 2mg.

I remember being very focused on the amount of estrogen in various pills and whether it was natural or synthetic, when in fact I think it was finding the right progesterone that has helped most. I tried Marvelon - which is meant to have a well tolerated progesterone- and became an ogre overnight. (It also left me constipated and bloated!) whereas the progesterone in Qlaira seems to suit me more than anything else I’ve tried.

I did experiment with a really high dose of HRT patch (high enough to prevent ovulation) as I know Prof John Studd had good results with this, but I didn’t like the 10 day block of progesterone I had to have with it. I’m better with continuity!
This website is quite interesting www.studd.co.uk/depression.php

@Rufus27 thanks for taking the time to write this, it's really helpful. I've decided to give it a go and switch from Yasmin to Qlaira tomorrow (I already have a pack). I'm a little worried about the side effects of dropping from the stronger estrogen in Yasmin to the natural less potent estrogen in Qlaira but I'll just have to ride that out - I'm definitely not feeling great on Yasmin and overall the original symptoms are no better either. I also have an estrogen gel on stand by so if I really can't hack the higher prog days on Qlaira then I could always top up. Wish me luck... a bit nervous!!

@GILL999 I really do empathise. I remember being in an almost identical situation.

The ‘what will it throw at me next’ on going miserableness off peri menopause means that something as seemingly trivial as switching tablets can feel like a real ordeal.

To make it worse, I’ve found that sometimes the symptoms of too much estrogen can be very similar to too little so it’s hard to know what you need! Then there’s the ‘is this a side effect or a sign it’s not working?’ dilemma!

Fingers crossed for you. Try to give it a few months if you can, and don’t be afraid to ‘top up’ as this is a much more natural estrogen.