Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Briony on February 17, 2015, 11:59:28 AM
-
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
-
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.
-
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
-
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?
-
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
-
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
-
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
-
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
-
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! :)
-
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
-
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
-
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
-
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)
-
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
-
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
-
Good to hear, hope things keep improving you'll be back to yourself in no time x
-
Hi Bryoni
I've been reading your thread,very interested to know how you are getting on with the qlaira ? As I'm considering hrt and seeing what my optons are ATM. Has it been successful?
Tricia x
-
HI Tricia
Psychologically, I am definitely feeling better with this higher dose of hormone. It's funny, I was anxious about moving up from a 50 mg patch (equivalent to 10 tablet I believe) yet taking 20 and 30 of estrogen doesn't seem to be affecting me as I thought it would - no sickness etc. Only slight issue is my hair shredding. I think this is the progesterone doing it. Others have advised me to hang in there if I can so that's what I intend to do.
What sort of HRT are you considering? x
-
Hi there
I visited doc today to begin hrt as I'm 52 and so feel its needed now for an array of symptoms .had a meltdown last week that threw me as didn't have a period for 8 months an thought yayyy no more periods then bammmm I got one with avengence and bad anxiety. Tears anger you name I had it . so that's what led me to seek out hrt .
The doc has prescribed everol conti I'm having to wait until tomorrow to collect from pharmacy as it needed to be ordered so fingers crossed I hope it works for me . like yourself I feel OK with progestone as I was on mini pill years ago which was progestrone only and got along fine I'm just hoping I'm OK with estrogen with the everol patches.
X
-
I really liked the Evorel 50 patches (no progesterone in them as I took that separately). They do take time to work - months rather than weeks for me. The conti has one of the less well tolerated progesterones in it, so if you do get problems, consider switching to a bio identical progesterone like Utrogestan (v popular on here) x
-
Hi B
I noticed that the everol conti has the same progestrone used in micronor mini pill which isnorethisterone and I was OK on that but it's lower dose in the everol .
X
-
Now onto month two of Qlaira and feeling so much better psychologically. Theoretically on day three of period but only had a tiny drip of a bleed - and no pmt so far. Am beginning to realise that what I thought were high estrogen symptoms were in fact still symptoms of low estrogen - just different variants, if that makes sense?!! Now I am on a substantially higher dose, most of my physical symptoms have calmed down and I feel calmer mentally. Has taken a good three weeks for this to become obvious. So far, I can only say I wish I'd tried Qlaira earlier. The hormones are higher than HRT but still very low compared to most COPs. I seem to be better now my own hormones are suppressed rather than randomly fluctuating. If you're contemplating it - but nervous- hope this might give you some confidence .
Just hope I haven't spoken too soon! X
-
Wonderful that its helped you.
I'm sure it will be a help to others knowing they have a "free" alternative in Peri :)
I'd mentioned this approach before on posts because some ladies were not able to get HRT and also the cost of 2 prescriptions.
I just wish I'd done what your doing in my peri years and been better for it.
Look forward to hearing more progress :)
:-*
-
Several months in, so thought I'd ad an update. Yesterday, someone asked at work randomly told me I was 'more like my old self'. I guess this sums up how, overall, I am feeling. It hasn't been plain sailing - it took three months for things to settle and I still get a few mild side effects (spotting being the main one, plus itching limbs for one day a month - day 8 for some reason!) but this is a small price for getting some quality of life back. The anxiety has noticeably decreased, I have a little more confidence and I do feel in control again. There is the odd day of 'that feeling' - you know the sorts of days I mean - but it seems to just disappear, unlike a year or two ago now when I'd have weeks of that scary, 'what's happening to me?!!' feeling. GP thinks the continued spotting is a sign that I actually need a stronger pill - though I really don't want to switch yet as I like the fact this has bio identical estrogen and is a lower dose, compared to regular pills. (Plus I like the fact that with only two non estrogen days, you don't have such a 'dip'/headaches, like I had with the normal pill years ago).
I know this won't work for everyone and hope I don't sound like I am 'pushing' Qlaira. I just want to share my experience as I know how hard it was for me deciding whether to take it - there seemed to be no one who knew about it and that worried me (have since found out the price and the newness of it deters some GPs - it's better known in America where it has a different name (Natazia). All I would say is if you're at the younger end of the menopause range and feel you need something more controlling than HRT, yet don't want a traditional pill, then it's a consideration.
-
I have been reading this thread with interest, as I have tried 2 different HRT's (prempak and Cycloprognova) and on both I have suffered with headaches and nausea and just feeling dreadful, wondering whether to go back to the GP and ask if I can try this....
-
The more I read your posts Briony, the more I am tempted to go back to my G and ask for Qlaria.
I am into my 8th week of HRT and I have just checked back through my Mood Diary, and I have still had far more bad days than good days.
Granted, it's very likely that my body wasn't absorbing any oestrogen this last week due to my (stupid) spray tan and then my patch fell off. So I have been feeling very low and some anxiety since last Sunday.
But I have been wearing a new patch since Thursday afternoon and I STILL feel very low today, and can't be bothered to do anything. I feel hopeless and desperately miserable inside, though am putting a brave face on it for the sake of my family.
Yes, I know that this will lift at some point over the next few days, it always does. But I will have lost YET MORE days of my life to this horrible low mood/anxiety. I dread to think how many days I have lost over the last 18 months :(
I want something that will lift my mood considerably and then RELIABLY keep it lifted. I don't mind getting the occasional 'off' day. But I am still getting long runs of 5-6 days at a time where I feel just awful, very low and despairing and with ridiculous anxieties about silly stuff such as it getting dark outside.
These mood swings are killing me by degrees. I can't plan anything. I can't look forward to anything.
-
I empathise with you both.
Looking back, I am annoyed with myself that I wasn't more proactive earlier on - but you get to to the point where everything, including even visiting the GP, is an effort (especially when you don't know how you'll be feeling in an hour, let alone a week!). I knew I had to do something when I realised I was avoiding 'real life' (anything beyond simply existing) and waking up already wishing it was bed time. Not how a 40 year old is meant to be, especially one who, up to that point, had been so enthusiastic about life. I even got to the point of being scared to go shopping (not quite sure what I was actually scared of!) and started ordering clothes online.
I would hate to mislead you in saying everything is back to normal. I think, realistically, that will never happen. However, the balance has now shifted so that the bad days no longer dominate/dictate my life. The spotting is a pain, but it's only very light, and if it means I need a stronger pill eventually, then so be it. I must add that Qlaira took a good three months (plus) for me to feel like this, so if you do try it, then persevere.
Good luck xx