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[ANGEL66]

Hi Everyone

I'm in a bit of a quandry and hoping someone on here might be able to help.  I had major surgery to remove a dermoid cyst which was twisted round my right ovary a few years ago.  6 hours of surgery later I had one ovary left and had problems ever since with perimenopausal symptoms.  Heavy, irregular bleeding.  Stained clothes and even stained a chair at work.  So embarrassing, particular as I work in an office with a load of men. When I discovered the Qlaira pill it was the answer to my prayers.  Light regular cycles, no flooding and able to relax without any accidents.  The problem now is I'm 50 this year and going to have to find an alternative which is proving difficult.  I currently have a prescription which takes me to my 50th birthday and then that's it.  Really dreading going back to flooding and heavy unexpected bleeds again.  A Mirena coil was suggested to me a long time ago but never had children and don't really fancy one of those.  I still need contraception so wondering about Mini-Pill.  Can this be taken as the progresterone part of HRT?  Does anybody know please?  Can anybody make any suggestions to keep the unexpected flooding and bleeds away?  Any help/suggestions would be much appreciated.  Dreading the time when I can no longer take Qlaira. 

Many Thanks. 

ANGEL

[Dancinggirl]

As far as I'm aware there is no reason why you should stop taking the Qlaira if it is helping - I believe many use this through their peri stage as it works better for them in the peri meno stage. I would really query why you should stop this so young!!!!  DG x

[Tinkerbellj]

I agree anything I read suggests u have no need to stop it! I am considering starting for peri I am 47 if it works and gives u a good quality of life stay with it xx good luck

[ANGEL66]

Thanks Dancinggirl and Tinkerbellj for your kind words of support.  This is a really big worry to me as my quality of life has been really good on Qlaira and I really don't look forward to going back to the way I was before, heavy unexpected cycles and flooding.  I went to see my (lady) GP yesterday and she mentioned that they had tried to get Qlaira licensed so women could take it up to age 55 but at the moment it is only licensed in the U.K. up to age 50.  As I am 50 this year, she gave me a prescription for my usual 6 month supply and said this would be my last one.  I am pretty healthy, not overweight and never smoked.  Really not sure what to do.  I usually get a blood pressure check every 6 months when I go to get my prescription re-filled and never had any problem.  Never felt better.  Qlaira really seems to agree with me.  That's why I'm at my wits end now and dreading the time when I come to the end of my current prescription.

[dahliagirl]

I was sort of dumped in your situation when I had to stop taking the pill at 49 because they changed the rules about migraine with aura.

I was offered the Mirena option, which I did not want (which is why I had stayed on the pill so long) and I tried pop without success (huge sore boobs, problems with private bits, and 3 days added onto transit time (constipation problems))  This doesn't give  you the oestrogen option.  Mostly they give you cerezette, or a cheaper generic version, which is higher in progestogen and it has been talked about as possibly being enough to provide the progestogen part of hrt, but it is not licensed as such.

I used condoms for 18mths, then started on hrt, so do not know when to stop using them.  I sort of wish I had been brave enough to try the Mirena option, but it would only have lasted another year from now, as you need to replace them 4 yearly for hrt.  In no-mans land, really.

[Tinkerbellj]

Can they not just  use it for hrt? Try a different gp? Not that I an cynical or anything but it is an expensive pill relatively speaking surely its your decision to take or not if u have no other contraindications.  If not then ask for bio identical oestrogen gel and separate estrogen and see what the reaction is. Doesn't help with contraception sadly. Seems so unfair when u get something that suits and they pull the rug from under u xx

[Tinkerbellj]

Can they not just  use it for hrt? Try a different gp? Not that I an cynical or anything but it is an expensive pill relatively speaking surely its your decision to take or not if u have no other contraindications.  If not then ask for bio identical oestrogen gel and separate estrogen and see what the reaction is. Doesn't help with contraception sadly. Seems so unfair when u get something that suits and they pull the rug from under u xx

[Dancinggirl]

ANGEL66
Firstly I would ask your GP for a referral to a meno clinic or gynae to see if they can allow you to continue with the Qlaira - there are many who seem to use this well into even post meno!!!!.  If you still can't then i wouldn't panic as you can just switch to HRT - The Mirena option could be good for you at your age and you then just add oestrogen as gel or patch alongside and this could take you over the next 5-10 years or even longer.  There are of course other HRT preparations - pills etc.  Femoston is often tolerated well by many women - do look under TREAMENTS above for info on the different HRT types. It is trial and error to find the right HRT for you but I'm sure you could fine something that will keep you flush free and maintain your quality of life. 
DG x

[ANGEL66]

Sorry to hear that Dahliagirl.  That's how I feel at the moment - in no man's land.  I didn't want Mirena either as never had children and even the doctor herself said it could be more painful to insert.  One of my friends had a Mirena and she's had a child and still had constant bleeding and endless problems with it.  I think there is some kind of test they can do Dahliagirl to see if you are through menopause and no longer fertile.  So maybe worth asking your GP. 

Tinkerbellj  all the other GPs there are men.  I wondered about the option of mini pill and oestrogel but again doctor told me there could be problems with irregular bleeding.  I did explain my situation to her.  That's problem when doctor retires.  A new doctor doesn't know your history.  I do feel like rug has been pulled from under me.  Not good.  I think it is one of the more expensive pills.  Even wondering about seeing if I can buy it online but I know I should probably really go through doctor.  That's how desperate I am not to go back to the way I was. 

Dancinggirl unfortunately there aren't any meno clinics round here.  I live in Blackpool/Fylde area.  Might ask to be referred to a gynae though.  Hadn't thought of that and didn't know they could give you prescriptions. Only ever been to gynae when I had my big op and problems after and there was no mention of any hormone treatments.  I was just offered Mirena which I don't want as never had children and would be painful to insert.  Not sure if mini pill/oestrogel option would work.  Don't even know if you can have mini pill as progesterone part of hrt.  Also didn't know people took Qlaira post-meno as I'm 50 this year and was told you could only take it up to age 50 even though I'm pretty fit and healthy and a non-smoker.  GP told me they had done trials recently to get Qlaira approved for use up to age 55 but apparently they didn't get it passed through.  Just feeling a bit out on a limb at the moment.

Thanks everyone for your help and advice.  It's much appreciated :-) x

[Dancinggirl]

ANGEL66
If you look under TREAtMENTS above you will see the HRT options - there are various progesterone options that can be used with oestrogen gel or patches.
You may find at this stage you won't get the erratic and problematic bleeds you used to have - this may have been due to fluctuating hormones which could have settled now. I wouldn't panic at this stage.  When you get to the end of this latest prescription it could be a good idea to take a break from this anyway to see where you are in your menopause journey - you could find the periods have stopped and you feel OK. Blood tests can then be done after 4-6 weeks to look at FSH and oestrogen levels and then appropriate treatment can be put into place.   If you find flushes etc emerge you can then try HRT - there are various options so I wouldn't despair at the moment. I think the important thing to focus on right now is to make sure your diet and exercise regime is good and don't expect the worst. If you do get heavy bleeds again then they can just give you progesterone to help reduce and control this. I still wouldn't rule out the Mirena as it works very well for the majority of women - one tends to only hear about the women who have had problems. You could have it inserted with an anaesthetic if need be and the post fitting bleed tends to stop within a few weeks and is usually very light. 
I'm sure there will be a way forward for you.  DG x

[Hurdity]

Hi ANGEL66

Re using mini-pill as the progestogen part of hRT - it is likely that the dose is not high enough I don't think but I seem to recall some women being on it as well - but it could be they were on it as well as combi HRT to give some extra progestogen to control bleeding?

I am not familiar with the different mini-pills and what they contain but you could look them up ( the mini-pills) and then look at the HRT preparations listed here to see if any contain the same progestogen and then compare the dose:
http://www.menopausematters.co.uk/perimeno.php

One example I do know if is Micronor which contains norethisterone - a progestogen also used in HRT. However Micronor has only 0.35 mg in it whereas the lowest dose of norethisterone in HRT is 1 mg which is almost 3 x as much. Do you see what I mean?

In your position I would go for the Mirena as Dancinggirl suggests - at least try it if you can tolerate synthetic progestogens in the pill.

Hurdity x

[dahliagirl]

While a POP can be used concomitantly with hormone replacement therapy (HRT) to provide
effective contraception, FSRH guidelines53 do not advise that a POP can be relied on as the
progestogen component of HRT. Currently the LNG-IUS is the only contraceptive available in
the UK that is licensed for endometrial protection.

From this:  http://www.fsrh.org/pdfs/CEUGuidanceProgestogenOnlyPills.pdf

There is also an over 40s contraception one - I think it is linked to from this site. http://www.fsrh.org/pdfs/ContraceptionOver40July10.pdf