Klayra in premenopause and menopause after 50 years: indications, reviews

Hormone-based contraception is constantly updated with new drugs and keeps time-tested methods in its arsenal. During menopause, the need for protection from unwanted pregnancy remains, but many drugs are no longer suitable due to hormonal changes that have begun in the body. In premenopausal women, Qlaira not only has a contraceptive effect, but also helps to cope with disorders that are provoked by changed hormonal levels.

Pharmacological properties of the drug Qlaira

Pharmacodynamics . Qlaira is a combined oral contraceptive used to prevent pregnancy. Each colored active tablet contains a small amount of female sex hormones (estradiol valerate in combination with dienogest). 2 white tablets do not contain active ingredients and are called inactive tablets (placebo). Contraceptives containing 2 hormones are called combined oral contraceptives (COCs). In addition to the contraceptive effect, PDAs have a number of other positive effects. When using COCs, the intensity and duration of menstrual bleeding decreases. As a result, the risk of anemia is reduced. Menstruation may become less painful or painless. It has been found that when using high-dose COCs (50 mcg ethinyl estradiol), the risk of developing serious diseases is reduced. These include benign diseases of the mammary glands, ovarian cysts, infectious and inflammatory diseases of the pelvic organs, ectopic pregnancy, endometrial and ovarian cancer. It is possible that a decrease in the level of these diseases is also observed with the use of low-dose oral contraceptives, but this fact has been confirmed only for endometrial and ovarian cancer.

Compound

The main component is estradiol valerate and excipients. This applies to dark yellow coated tablets. The main component of the pink-coated tablets is estradiol valerate.

Pale yellow film-coated tablets include estradiol valerate and dienogest. Red coated tablets contain estradiol valerate. Tablets differ from each other in their main and auxiliary components.

There are also white placebo tablets that have no active ingredient.

Use of the drug Qlaira

Each package contains 26 colored active tablets and 2 white inactive tablets. Take 1 tablet 1 time per day at approximately the same time, with a small amount of water, regardless of meals. When combined oral contraceptives are used correctly, the incidence of unwanted pregnancy is approximately 1% per year. The incidence of unwanted pregnancy may increase if a dose is missed or due to improper use. Preparing packaging. To make it easier to control your pill intake, the package comes with 7 sticker strips with the names of the days of the week. Select a strip that begins on the day corresponding to the start of taking the drug (for example, for the medium, use a strip starting with “Wed”). Stick a strip on top of the Qlaira package in the place where it says “Stick the strip here”, so that the 1st day of taking the drug is above the tablet numbered “1”. If there is a specified day above each tablet, you can control the intake of tablets. You must take the tablets one at a time, following the direction of the arrows, until you finish taking all 28 tablets. Usually, menstrual-like bleeding begins when you take the second dark red tablet or white tablet and may not stop until you start taking a new tablet from the package. Some women continue bleeding even after taking the first pills from a new package. There is no break before starting to take tablets from a new package; the use of tablets from the next package begins the next day after the end of taking tablets from the current package, even if menstrual-like bleeding continues. Thus, the start of taking a new package will be on a certain day of the week, and each month the start of menstruation will be approximately the same day of the week. When taking the drug in the manner described above, the contraceptive effect is also maintained when taking inactive tablets for 2 days. How to start taking Qlaira. No hormonal contraceptives were used in the previous month. Taking the pills should start on the 1st day of the menstrual cycle (1st day of menstrual bleeding). Switching from another PDA, contraceptive vaginal ring or transdermal patch. The use of Qlaira should be started the day after taking the last active tablet of the previous COC. Do not take inactive tablets from the package of the previous PDA (if any), but start taking Qlaira tablets without interruption. When using a combined contraceptive vaginal ring or transdermal patch, it is advisable that a woman begin using Claira on the day of removal of the product or as recommended by a doctor. Switching from a progestogen-based method (mini-pills, injections, implants) or a progestogen-containing intrauterine system. You can start taking Qlaira any day after you stop taking the mini-pill (in the case of an implant or intrauterine system - on the day of their removal, in the case of an injection - instead of the next injection). However, in all cases it is recommended to additionally use a barrier method of contraception during the first 9 days of taking the pills. After a miscarriage. On doctor's recommendation. After childbirth. Taking Qlaira begins after the end of the first physiological menstrual cycle. In some cases, this is possible earlier (on the recommendation of a doctor). However, if sexual intercourse has already taken place, then before starting to use the PDA it is necessary to exclude the possibility of pregnancy or wait until menstruation. When using the drug during breastfeeding, as well as in the absence of certainty about the timing of starting use of the drug, prior consultation with a doctor is necessary. What to do if you miss a pill Inactive pills . If you miss taking a white tablet (2 tablets at the end of the package), there is no need to take it later, since it does not contain active ingredients, and the contraceptive effect of the drug is not reduced. It is important to take your next tablet at the usual time and remove any forgotten inactive white tablets from the package. The contraceptive effectiveness of the drug may decrease if the period during which active tablets are not used is accidentally increased. If you miss the last white tablet in a pack, take the first tablet in the next pack at the usual time. Active tablets (1–26 tablets per pack). Depending on the day of the menstrual cycle on which the active pill was missed, additional contraception may be necessary (use of a barrier method of contraception - a condom). Tablets must be taken according to the recommendations given (see also Guidelines for use in case of a missed tablet ). If the delay in taking the active pill does not exceed 12 hours, the contraceptive effect of Qlaira is not reduced. The missed pill should be taken as soon as possible. The following tablets in this pack should be taken at the usual time. If the delay in taking the active pill exceeds 12 hours, the contraceptive effect may be reduced. Depending on the day of the menstrual cycle on which the active pill was missed, additional contraception (using a barrier method of contraception - a condom) may be necessary (see also Principles of use in case of a missed pill ). Principles of use in case of a missed pill . If you miss more than 1 active tablet, consult a doctor. If you miss taking the 1st active tablet (delay in taking more than 12 hours) and if taken during the 1st week before missing sexual intercourse, you must adhere to the following recommendations:

Days 1–9 of the menstrual cycle - additional consultation with a doctor;
On the 10th–17th day of the menstrual cycle, take the forgotten pill, all subsequent pills at the usual time, even if you need to take 2 pills on 1 day, use additional methods of contraception for the next 9 days (condom);
On the 18th–24th day of the menstrual cycle, do not take the forgotten pill, but start with the 1st tablet of the new package, use additional methods of contraception in the next 9 days;
On the 25th–26th day of the menstrual cycle, take the forgotten pill, all subsequent pills at the usual time, even if you need to take 2 pills on 1 day, there is no need for additional methods of contraception;
On the 27th–28th day of the menstrual cycle, do not take the missed pill and continue taking the pills at the usual time; there is no need for additional methods of contraception.

If you miss taking another tablet, do not take more than 2 active tablets per day . If the start of taking tablets from the next package is missed or ≥1 tablet is missed during the 3rd–9th day of the current package, there is a risk of pregnancy (if there was sexual intercourse within 7 days before the missed tablet). In this case, you need to consult a doctor. Depending on the number of pills missed (especially on days 3–24) and the closer they are to the inactive pill phase, the risk of decreased contraceptive effectiveness increases. If a woman misses a dose of active tablets and does not have her expected menstrual period while taking the last tablets in the pack, the possibility of pregnancy must be ruled out. Before starting to take tablets from a new package, you should consult a doctor. If vomiting or severe diarrhea occurs while taking any of the 26 active tablets of Qlaira, the absorption of the active substances may be reduced. If vomiting develops within 3-4 hours after taking the tablets, this is similar to skipping a dose of the drug; you must follow the instructions for missed tablets. If diarrhea is severe, you should consult a doctor. The presence of vomiting or diarrhea when taking the last 2 inactive white tablets does not affect the contraceptive effectiveness of the drug. Stop taking the drug . You can stop taking Qlaira at any time. If you stop using the drug to become pregnant, you must wait until the next menstrual bleeding begins before conceiving. This will help in determining the due date.

Reviews

Let's look at reviews of Qlaira for menopause. Reviews from women over 40 and experiencing menopause about Klayra are usually good, as the drug helps with menopausal symptoms. However, patients also note disadvantages in the form of side effects and multiple contraindications.

Author: Natalya

The drug has both pros and cons. My blood pressure jumped during menopause, and endometriosis was suspected. The drug helped cope with these troubles. Well, the contraceptive effect will be a plus. There are a lot of contraindications, including varicose veins, which I had. But after the drug the condition did not worsen. The downsides are dryness, spotting and breast enlargement. A very expensive medicine.

Author: Nina

Comparison table for hormonal contraceptives.

The drug helped. Before using it, I went to the doctor and read reviews of Klaira in premenopause. The pills are considered low-hormonal, so they are allowed for women of all ages. The packaging is convenient, it is easy to track the number of tablets taken. Menstruation became less frequent. I felt a little dizzy. The drug coped with hot flashes and insomnia, which is the most important thing. The price is steep.

Author: Anna

Helped against endometriosis, which arose during menopause. I read reviews of Klaira during early menopause. Only I myself noticed more minuses than pluses. First of all, it's very expensive. Secondly, I probably encountered all the side effects! My legs and my head hurt. My stomach was swollen and I gained 7 kg.

Author: Lyudmila

Good pills, helped with menopause symptoms. I didn’t notice any side effects on myself. I took it according to a doctor's prescription.

Reviews from women over 45 years old about Klaira during menopause are different: some are positive, some are negative.

Contraindications to the use of the drug Qlaira

Combined oral contraceptives should not be used if you have one of the following conditions or diseases:

deep vein thrombosis of the lower extremities, pulmonary embolism or thrombosis of another location, currently or in the past;
acute coronary syndrome (ACS) and acute cerebrovascular accident (ACVA) - ischemic or hemorrhagic in nature - currently or in the past;
prodromal manifestations of ACS (angina) or stroke (transient ischemic attack - TIA) currently or in the past;
migraine accompanied by focal neurological symptoms (impaired vision, speech, paresthesia or paresis of various localizations);
diabetes mellitus with vascular complications;
pancreatitis associated with hyperlipidemia, currently or in history;
liver disease currently or in history until liver function tests return to normal;
hormone-dependent malignant tumors of the genital organs or breast, currently or in history;
benign or malignant liver tumor currently or in history;
vaginal bleeding of unknown origin;
established or probable pregnancy;
hypersensitivity to estradiol valerate or dienogest, or other components of the drug.

You should immediately stop using the drug if one of the above conditions occurs and switch to taking non-hormonal contraceptives (see also section Special instructions ).

Contraindications and side effects

Like any hormonal drug, along with its advantages, the medication also has disadvantages in the form of numerous contraindications, which include:

Intolerance to basic (hormone-modulating) substances.
Lactose deficiency, glucose-galactose malabsorption syndrome, galactosemia.
Thrombosis, thromboembolism.
Angina, stroke.
Vascular diseases associated with diabetes mellitus.
Migraine, accompanied by impaired vision, hearing, and speech apparatus.
Pancreatitis.
Liver and kidney diseases.
Renal, adrenal insufficiency.
Vaginal bleeding of unknown origin.
Neoplasms or suspicions of such.
Pregnancy, breastfeeding period.
Diabetes.
Arrhythmia.
Anemia.
Gallbladder diseases.

This list is not exhaustive. There are still a large number of diseases for which the drug should be taken with caution.

Side effects such as gastrointestinal upset or vaginal bleeding may occur in case of overdose or concomitant use of the drug with barbiturates. You should first consult with a specialist about combinations with other drugs.

Side effects of the drug Qlaira

When taking Qlaira, the following side effects may develop:

Violations of organs and systems		Often ≥1/100 and ≤1/10	Rarely ≥1/1000 and ≤1/100	Sometimes ≥1/10,000 and ≤1/1000
Infections and infestations		Fungal infection, vaginal candidiasis, vaginal infection	Candidiasis, herpes simplex, suspected ocular histoplasmosis syndrome, ringworm, urinary tract infection, bacterial vaginitis, vulvovaginal mycosis
Metabolism		Increased appetite	Fluid retention in the body, hypertriglyceridemia
From the mental side		Depression/depressed mood, decreased libido, mental disorders, mood changes	Affective lability, aggression, anxiety, dysphoria, increased libido, nervousness, anxiety, sleep disturbance, stress
From the side of the central nervous system		Headache1	Dizziness	Distraction, paresthesia, vertigo
From the side of the organ of vision		Contact lens intolerance
From the vascular system		AH, migraine 2	Bleeding from varicose veins, hot flashes, hypotension, venous pain
From the gastrointestinal tract		Abdominal pain3	Diarrhea, nausea, vomiting	Constipation, dyspepsia, gastroesophageal reflux
From the hepatobiliary system		Increased ALT activity, focal nodular hyperplasia of the liver
From the skin and subcutaneous fat		Acne	Alopecia, itching4, rash5	Allergic skin reactions6, chloasma, dermatitis, hirsutism, hypertrichosis, neurodermatitis, pigmentation, seborrhea skin diseases7
From the musculoskeletal system		Back pain, muscle spasms, feeling of heaviness
From the reproductive system and mammary glands	Amenorrhea, discomfort in the mammary glands8, dysmenorrhea, intermenstrual bleeding (metrorrhagia)9		Enlargement and hardening of the mammary glands, cervical dysplasia, dysfunctional uterine bleeding, dyspareunia (pain during sexual intercourse), fibrocystic mastopathy, menorrhagia, menstrual irregularities, ovarian cysts, pain in the pelvic organs, premenstrual syndrome, uterine leiomyoma, uterine spasm, vaginal discharge, vulvar and vaginal dryness	Benign diseases of the mammary glands, breast cyst, bleeding during sexual intercourse, galactorrhea, genital bleeding, hypomenorrhea, delayed menstruation, rupture of an ovarian cyst, burning sensation in the vagina, uterine/vaginal bleeding, including spotting and vaginal odor, discomfort in the vulvovaginal area
From the blood and lymphatic system			Lymphadenopathy
General disorders and reactions at the injection			Irritation, swelling	Chest pain, feeling tired, malaise
Survey	Weight gain		Reducing body weight

Including: 1 - headache caused by changes in blood pressure; 2 - migraine with or without aura; 3 - increased intra-abdominal pressure; 4 - generalized itching and itching with rash; 5 - macular rash; 6 - allergic dermatitis and urticaria; 7 - feeling of skin tightness; 8 - pain in the mammary glands and nipples, nipple disorders; 9 - irregular menstruation.

In addition to these side effects, cases of skin diseases such as erythema nodosum and erythema multiforme, as well as increased sensitivity and discharge from the mammary glands have been observed in women taking COCs with ethinyl estradiol. Although these symptoms were not observed during clinical studies of the drug, the possibility of their occurrence during use of the drug cannot be ruled out. In women with hereditary angioedema, administration of exogenous estrogens may induce or worsen symptoms of angioedema. Thrombosis . There is no data on the risk of thrombotic complications while taking Qlaira. The following warnings are based on data from studies of other COCs containing ethinyl estradiol. However, it is unknown whether they apply to the use of Clair. Deep vein thrombosis develops quite rarely. The risk of developing venous thromboembolism is highest during the 1st year of taking COCs (compared to subsequent years of their use). The risk of thrombosis in women taking COCs is slightly higher than in those who do not use them. When using COCs, you should stop smoking, especially if the woman is over 35 years old. Although slight increases in blood pressure have been reported in many women taking COCs, clinically significant increases in blood pressure occur very rarely. If blood pressure increases when using COCs, it is possible to stop taking them. In women taking COCs during prolonged immobilization or during surgical interventions, the risk of developing thrombosis increases. Taking COCs should be stopped several weeks before surgery or during forced immobility; it can be resumed during the period of convalescence after consulting a doctor. The risk of developing thrombosis in women during the postpartum period is increased, so you can start using Qlaira only as prescribed by a doctor. If symptoms of possible thrombosis develop, it is necessary to stop using the drug. Tumors. Breast cancer was slightly more likely to be diagnosed in women taking COCs compared to women of the same age who did not use them. There is no data on the causal relationship of the tumor with taking COCs. This may be due to more frequent medical examination of women taking COCs. This risk gradually decreases after you stop taking COCs. It is necessary to regularly examine the mammary glands to identify any lumps. In isolated cases, benign and, less frequently, malignant liver tumors were noted in patients taking COCs, which in some cases led to intra-abdominal bleeding. It is necessary to consider the possibility of this complication when intense abdominal pain occurs. An important risk factor for the development of cervical cancer is the persistence of papillomavirus. Some epidemiological studies suggest an additional increase in this risk with long-term use of COCs, but this remains controversial because the extent to which the studies account for associated risk factors such as cervical screening and sexual behavior, including the use of barrier methods of contraception, remains unclear. .

Special instructions for the use of the drug Qlaira: General instructions . When using the drug Qlaira, calendar and temperature methods are not used; they may be unreliable, since the combined oral contraceptive changes the normal fluctuations in body temperature and the properties of cervical mucus characteristic of the menstrual cycle. Qlaira, like other CCPs, does not protect against HIV infection (AIDS) and other sexually transmitted diseases. If you have one of the following conditions or diseases when using the drug Qlaira, constant monitoring is necessary: smoking, diabetes mellitus, excess body weight, hypertension (arterial hypertension), damage to the heart valves or cardiac arrhythmias, superficial phlebitis, varicose veins, thrombosis of various locations, ACS or stroke in close relatives, migraine, epilepsy, hypercholesterolemia or hypertriglyceridemia in close relatives currently or in history, breast cancer in close relatives currently or in history, liver or gallbladder disease, Crohn's disease or ulcerative colitis, systemic lupus erythematosus, hemolytic uremic syndrome, sickle cell anemia, alopecia, porphyria, herpetic infection, Sydenham's chorea, current or past chloasma (avoid prolonged exposure to the sun or ultraviolet radiation), hereditary angioedema (drugs containing estrogens may induce or increase its symptoms). If possible signs of thrombosis or stroke occur, the use of the drug should be stopped immediately. When using oral contraceptives during the first few months, irregular vaginal bleeding is possible during the intermenstrual period, but the regimen of use of the drug is not changed; these conditions are relieved as they adapt to the drug (usually after 3 cycles of taking tablets). If the drug Qlaira is taken incorrectly or irregularly, or if there is severe vomiting or diarrhea, or if there is no expected bleeding after the 26th day of the menstrual cycle 2 times in a row, it is necessary to consider the possibility of pregnancy; the drug should not be resumed until pregnancy has been ruled out. During pregnancy and breastfeeding . The drug is not used during pregnancy or if pregnancy is suspected. If you are planning a pregnancy, you can stop using the drug at any time. The drug Qlaira is not recommended for use during breastfeeding. Children . There are no data regarding the use of the drug in children and adolescents under 18 years of age. There is no data on the effect on reaction speed when driving vehicles or working with machinery.

Features of drug analogues

Estradiol is included in several other contraceptives, but in combination with other components it acquires new properties. In pharmacies you can buy drugs with similar effects without a prescription:

Diana is 35, if taken at the right time, it has a high degree of contraceptive protection, improves the condition of the skin and hair,
Tri-regol is three-phase, maintains the concentration of sex hormones, relieves painful symptoms of PMS,
Estriol cream and suppositories improve the condition of the mucous membranes of the intimate area, provide hydration,
The Nuvaring vaginal ring acts as a barrier method; the reliability of the product increases in combination with spermicides.

Each drug has a number of contraindications. With the help of a doctor, you can choose the option that best suits your individual needs.

Interactions of the drug Qlaira

reduce the effectiveness of Qlaira or may cause bleeding: primidone, phenytoin, barbiturates, carbamazepine, oxcarbazepine, topiramate, felbamate, rifampicin, ritonavir, nevirapine, penicillin, tetracycline, griseofulvin, drugs based on St. John's wort. Increase the concentration of the active substances of Qlaira in the blood plasma : antifungal drugs containing ketoconazole, erythromycin antibiotics. Qlaira may affect the effectiveness of lamotrigine. Laboratory research . Oral contraceptives may interfere with the results of some laboratory tests.

Klaira for menopause, reviews from women over 45 years old

With age, a woman's reproductive function gradually fades away. The balance of hormones in the body changes, which affects the functioning of all systems. To alleviate the condition during this period, many doctors recommend taking hormonal contraceptives. During menopause, Klaira allows you to control the menstrual cycle - right up to menopause, and also reduce discomfort.

Doctors' opinion

I like that the drug is easily tolerated in most cases; the active ingredients are identical to natural female hormones. I recommend Klaira to patients 40+ to maintain weakened estrogen levels.

I recommend contraception to patients over 35 years of age to prevent unwanted pregnancy, as well as to maintain beauty and health. Considering the need for constant use, the cost is high, but quite justified by the effectiveness of the product. There were no serious side effects encountered.

I prescribe the drug Qlaira to patients experiencing discomfort associated with menopause. Of course, I draw attention to the absence of contraindications. Like other contraceptives, Qlaira has its side effects, but in general the medication is well tolerated, as confirmed by reviews of Qlaira from women over 50 years of age.

Women over 40 note that with the help of Klaira they managed to stabilize menstruation, get out of a state of apathy, and get rid of hyperhidrosis, pain, cramps, and irritability.

Many managed to practically not feel the unpleasant manifestations of premenopause. Experts recommend taking the medication as a preventative measure to reduce the risk of malignant neoplasms and pathologies of blood vessels and heart.

Klaira in the postmenopausal period

The use of Qlaira for menopause after 50 years is recommended for the following purposes:

maintaining bone mineral density, preventing fractures;
therapy for pathological bleeding;
prevention of endometrial hyperplasia, anemia;
relief of vasomotor disorders;
prevention of cysts, ovarian, endometrial, rectal cancer.

COCs can be used for 2 years after the last menstrual period in women under 50 and for 1 year after 50 years. Treatment in postmenopause is carried out in long courses for more than 6 months.