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[anon2021]

Hello all,

I used to use Qlaira as combined contraception and peri-meno pill. It worked brilliantly.

Prior to this I had in fact seen a private HRT clinic (I had fluctuating rage, anxiety, tears and very occasional hot flush (but not really sweats) and they said my levels of oestrogen were very slightly low and prescribed me Oestrogel and Utrogestan and some Testosterone.

I found it all too much, in fact I had the ****ly tingling breasts that I think indicates too much oestrogen and the Utrogestan gave me heart palpitations. So having tried fine tuning it (was already at lowest doses)  I stopped and found Qlaira which although has the same/similar ingredients worked brilliantly with no side effects. I loved it!

Fast forward 2 years and I have just finished treatment for colon cancer which has dropped me straight into full menopause. I haven’t had a period since my first week of chemoradiation nearly 6 months ago. Basically the radiation has nuked my ovaries though I still have my womb but I will never have a period again.

Cue non stop hot sweats (not flushes, full on drenching sweats). Mood is fine. Anxiety not too bad. Sleep is horrendous! I was advised to start taking my HRT again on a continuous regime (though have had no blood tests). Utrogestan for some reason keeps me awake at night despite trying it vaginally as opposed to orally (I have to take this everyday continuously as I’m full menopause) so I take on 1 x Utrogestan in the morning. I was taking 2 pumps of gel a day which I’ve increased to 2 in morning and 1 at night and then up again to 2 in morning and 2 at night. It doesn’t seem to make a difference and yes I’ve done this over a period of 5 months. I’m having endless hot flushes and terrible sweats. I can’t sleep at night because of them and I’ve tried all the tricks.

For some reason I just don’t seem to get on with the Gel and the Utrogestan. Maybe because it’s difficult to fine tune I just don’t know. 

So, does anyone know or have any experience of if I can go back to Qlaira as just an HRT?

Any advice most welcome. Just thought I’d ask here first before emailing Dr Currie.

Many thanks
X

[sheila99]

Perhaps you should compare how much oestrogen is in it? I don't know the answer but I suspect it may be insufficient for you now. Might be worth a blood test as it may be you're not absobing the gel well and would benefit from a change to something different. Maybe try a patch or spray but there is oral hrt if you don't absorb well transdermally. If utro is no good for you you could try provera or a mirena. The other option would be long cycle sequi (6 weeks) to give you more time off utro.

[Hurdity]

Hi anon

I think it depends on your age although I have just looked at the product information https://www.medicines.org.uk/emc/product/6536/smpc#gref and there is no age-specific contra-indication, rather the risk factors of combined contraceptive pills are listed - which includes age over 35. However this age was set in place for the much stronger CCP that contain the synthetic oestrogen ethinyl-estradiol so may not apply to Qlaira. It also says this: "Qlaira is not indicated after menopause" but there can't seem to be any reason why not except that you don't need to suppress the cycle so tablets with such a high dose of progestogen are probably not needed. However if this is the tablet you tolerated and you don't have risk factors for stroke/VTE etc then why not?

To me the strongest argument is that you tolerated it well but just to say this may turn out to be different now you no longer have functioning ovaries and there is the issue of testosterone replacement too.

So in addition to sheila99's suggestions, there is a tablet Livial (Tibolone) although the oestrogen dose may not be high enough and if you are young you may want to maximise this?

There are also other tablets such as Femoston which contains a more "natural" progestogen - dydrogesterone - which I gather is often well tolerated.

Hope this  helps

Hurdity x