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[Briony]

After a really hideous week, both physically and emotionally, I went to my doctor yesterday for some advice. I thought I'd share what she said as it seems to be contrary to the experience of some other ladies in peri menopause, like me, and may give you hope.

Firstly, she suggested that my current regime of 50mg Evorel and Utrogestan for 14 days is not powerful enough to override the fluctuations I'm experiencing. While I am definitely more 'my old self' on HRT (it took 4 months at  least to feel these benefits) I do have random days and weeks of quite extreme physical and emotional symptoms. I've therefore decided to take a risk and switch to Qlaira as a 'bridge' to returning to HRT at a later date. This is a new contraceptive pill which uses natural estrogen and only has two 'blank pill' days so it's more akin to HRT. It's apparently the pill closest to following the pattern of our natural hormone levels. It does include quite a complicated set of 'missed pill' rules, but providing you remember to take them, I guess this shouldn't be an issue.

Interestingly, she was happy for me to take this despite a family history of strokes at a young age and having suffered from migraines with aura in the past. Her reasoning was that each case needs to be considered individually, and for me, the benefits to my quality of life, she feels, outweigh the risks. (This concurs with what I heard a doctor on the radio saying last week: that under 50, if you are not producing enough estrogen, you have a 'deficiency' for which you body isn't designed, and therefore a higher and consistent dose of estrogen is required). It was great to speak to a doctor who was so open minded and reminded me why I am so glad I finally switched from my previous (old, male 'peri meopause doesn't need HRT') GP to a female 40 something with an interest in gynaecology. (I think I was previously in such a state that even switching GPs seemed too much of an ordeal, hence the reason I took so long to move!).

We also came up with an alternative plan if this doesn't work or the side effects are too great. Having explained that I am one of the more unusual people who prefers the progesterone phase of my HRT, she has agreed for me to try a conti regime even though I have regular periods. She suggested switching Femeston, if I go down this route, as so many of her peri menopausal patients in my situation have found this to be most effective. Again, I add this since I know there are a number of ladies on here who have questioned whether you can do this while still experiencing regular periods.

I can't deny that I am really anxious about starting Qlaira, especially as there are so few people who've taken it already to advise,  though these posts have been quite useful:

http://www.menopausematters.co.uk/forum/index.php'topic=24521.0

http://www.mumsnet.com/Talk/conception/a829455-Qlaira-contraceptive-pill-anyone-used-it-yet

I will keep you informed of how it goes, as I know there are others on here in the 'should I/shouldn't I' situation I was/am with Qlaira!

B xx

[hayjude]

This sounds very interesting. Thanks for sharing
Good luck and I look forward to hearing how it goes.
I am just all ears reading and learning so much at the moment.

[CACEY]

Hi Briony

Like you I have been struggling to find the right combination, after seeing another specialist last week, I am now about to stick on my first patch of Femseven conti, it will be interesting to see how this works in the peri stage.
I have been peri for the past five years, tried mirena & oestrogel, but after 12 weeks I kept crashing around my cycle. This continued for 18 months, so yesterday I had the mirena removed as the  Doctor explained that whilst the mirena was good, after the initial boost of progesterone it was not strong enough.. Hence the new regime. I will keep my fingers crossed for both of us.. Cacey x

[Morwenna]

Firstly, she suggested that my current regime of 50mg Evorel and Utrogestan for 14 days is not powerful enough to override the fluctuations I'm experiencing.

We also came up with an alternative plan if this doesn't work or the side effects are too great. Having explained that I am one of the more unusual people who prefers the progesterone phase of my HRT, she has agreed for me to try a conti regime even though I have regular periods. She suggested switching Femeston, if I go down this route, as so many of her peri menopausal patients in my situation have found this to be most effective. Again, I add this since I know there are a number of ladies on here who have questioned whether you can do this while still experiencing regular periods.

Briony I don't know anything about Qlaira but can advise that if your GP suspects Evorel 50 is not powerful enough to override your symptom fluctuations then Femoston Conti is not likely to be effective either as it is a 'low dose' preparation. I recently switched from Femoston 2/10 sequential to Femoston Conti 1/5 (owing to me reaching the age of 55) and after only four weeks on it I'm experiencing a return of hot flushes during the night, something I haven't suffered since I started HRT four years ago. Unfortunately Femoston Conti is only manufactured in a 1mg and 0.5mg oestrogen version for some reason so I imagine if the Qlaira doesn't suit, your GP would need to be looking at something in the higher dose range such as Elleste Duet. On another note however, as you mentioned, and while I'm no expert, I was led to believe that a continuous regime isn't appropriate for perimenopause due to the risk of Endometrial Hyperplasia? But maybe there are exceptions - did your GP discuss this at all?

[Briony]

Hi Morwenna, that's really useful to know. I think with the Evorel, it's not such much its strength, but the fact that it doesn't over ride my own hormones which seem to fluctuate crazily (so when they are high, I get too much). I will certainly mention the Femeston issue to her if I have to swap over. She did mention needing a scan if you go to a full conti regime? Looking at it sensibly, I think I would be best off doing days 1 to 26 on Utrogestan as I know this progesterone works and this would allow a bleed still (I really suffer when I stop the progesterone when I take it just for 14 days).

Early days with Qlaira. So far, I have had a banging headache but it started yesterday well before I took  the first tablet (day 1 of my period so suspect it's a hormonal headache).

Thanks again for responding, B x

[Millykin]

Briony sorry i can't remember did you try Femoston 1/10 sequi? I think you did. We both found we crashed after prog tablets? Like we needed more prog. Did you ever try 2/10? I ask because I have moved to 2/10 and am in middle of prog part and wondered if you still felt the dip after it? I had a week of 1/10 oestrogen then started 2/10 so had a week of extra oestrogen now in middle of prog. I did notice because I had higher dose of oestragen that I felt a little better but dreading finishing the prog part in case the dip hits. Can you just update me on the above question thanks, sorry if it's a mumble using my mobile just now such small writing lol x

[Briony]

Hi Millykin
No I haven't tried Femeston before, only patches and Utrogestan. The reason she suggested swapping was because taking Utro for 26 days, plus patches, would be more faffing than a single pill. Like you, I hate the crash when the progesterone stops. It really affects me, usually 3 or 4 days after stopping it - even my nails and hair are noticeably affected. Often get a headache too.  Qlaira has more days with progesterone (see below) so it'll be interesting to see how this goes. Am still a bit anxious (actually, really anxious). but determined to at least give it a try! xxxx

Each wallet (28 film-coated tablets) contains in the following order:
2 dark yellow tablets each containing 3 mg estradiol valerate
5 medium red tablets each containing 2 mg estradiol valerate and 2 mg dienogest
17 light yellow tablets each containing 2 mg estradiol valerate and 3 mg dienogest
2 dark red tablets each containing 1 mg estradiol valerate
2 white tablets do not contain active substances

[Millykin]

WOW that's a right wee mixture going on there! But I think that's what goes on in our body anyway. I have read some good reviews about it so give it a good try and hopefuly it will work. Your new GP sounds clued up so that's good, someone willing to listen and advise different things. I just hope with me taking higher dose oetrogen I keep feeling better. Keep us updated on your progress, will also be interesting to see if different doses on certain days helps. X

[Morwenna]

I feel better for taking progesterone continuously too. If it weren't for the night flushes I'd give Femoston Conti the thumbs up but maybe they'll settle down given time. I see what you mean now Briony about your fluctuating symptoms being caused by your body's own erratic hormone levels - maybe your GP is thinking Qlaira will balance them out more effectively than HRT being as presumably it's made to mirror our pre-menopausal peaks and troughs? It looks as if it will be more suitable than a continuous regime for perimenopause anyway. Keep us updated!

[Briony]

I see what you mean now Briony about your fluctuating symptoms being caused by your body's own erratic hormone levels - maybe your GP is thinking Qlaira will balance them out more effectively than HRT being as presumably it's made to mirror our pre-menopausal peaks and troughs? It looks as if it will be more suitable than a continuous regime for perimenopause anyway. Keep us updated!

Yes, that was her thinking, as the Qlaira will suppress my own hormones totally which means the only fluctuations I will get will be from the Qliara which mimics our  'natural' ones. .... Well, that's the theory anyway. I am still a bit apprehensive about swapping, but hey, I get apprehensive about just about everything these day (!) x

[Briony]

Update: for the first week I  felt fantastic, especially in terms of my emotions (which are usually a mess as I head towards the end of my period). No nausea nor headaches, either - both of which I had anticipated (ever the optimist, me).

Just as I was about to start singing words of encouragement on here, things started to alter. Not only have I had two days of  intermittent crushing fatigue (can never decide if this is a low or high estrogen symptom) but worse than that, I have developed the most annoying itching. At first I thought it was inset bites as there were clear 'marks' on my legs. However, this evening every part of my body is itching, especially my arms and face.

I don't want to take an anti histamine as they make me crazily sleepy, but Hydrocortisone is hardly helping. Do you reckon it's related to the Qlaira, even after 8 days? Should I stop or persevere?

So annoyed as I had high hopes for this! x 

[Millykin]

Hi Briony
I was getting quite chuffed for you there until I read on. Is the itchiness on the list of side effects?
I know when I upped my dose of Femoston after the first 7 days I started itching at night time really bad, legs and stomach but I took Antihystamine. Maybe you should phone GP or ask pharmisist if it is normal and will settle. X

[peegeetip]

From day 8 onwards the prog component rises.
But you could just be getting used to the raised levels of estrogen this Pill will give.

My view, stick with it as it will take at least 3 - 6 months to balance you out again.

 

1 – 2
   

Dark yellow tablets (3.0 mg EV)

3 - 7
   

Medium red tablets (2.0 mg EV + 2.0 mg DNG)

8 – 17
   

Light yellow tablets (2.0 mg EV + 3.0 mg DNG)

18 – 24
   

Light yellow tablets

(2.0 mg EV + 3.0 mg DNG)

25 – 26
   

Dark red tablets

(1.0 mg EV)
   

27-28
   

White tablets (Placebos)
   

[Briony]

Thanks to you both. You're right, the itching started on Day 8. It's slightly better today so I am going to try and ride it out. I so want this to work and know from experience you need to be patient (thanks Peegeetip  ) . Will keep you updated xx

[Briony]

Itching has finally calmed down. So glad I listened to you and hung in there! Still getting random fatigue, but mentally, feeling much better than previously. Fingers crossed! From what I have seen so far, I would definitely recommend giving this a go if your problem is fluctuation hormone levels rather than permanently low ones x