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For endometriosis, Qlaira is used as an alternative to potent hormonal drugs that disrupt menstrual function and suppress ovarian activity. A special feature of the drug is the combination of several active ingredients, each of which has an individual effect on the functioning of the female body. Endometriosis appears in women of reproductive age, mainly at 20-35 years of age. The disease depends on hormonal levels and progresses rapidly if left untreated. Therapy uses medications and surgical procedures. To consolidate the result after cauterization of foci of endometriosis, doctors prescribe oral contraceptives, including Qlaira tablets.
Why Klaira? Benefits of hormonal contraception
Various drugs are used in the treatment of endometriosis - gonadotropic hormone agonists, gestagens, anti-inflammatory drugs. But Qlaira has advantages over other medications:
- Contains dienogest, the effectiveness of which is comparable to strong agonists of gonadotropic hormones;
- Contains natural estrogen, which makes it well tolerated and rarely causes adverse reactions;
- Protects against unwanted pregnancy during treatment;
- Reliably controls the menstrual cycle and relieves symptoms of the disease.
With the help of Klaira, a woman can confidently control her menstrual cycle.
According to clinical guidelines, combined oral contraceptives and gestagens are first-line drugs in the treatment of endometriosis. Only products with the hybrid gestagen dienogest are selected for therapy. Other hormonal drugs are prescribed when first-line treatments cannot be used.
Doctor's reviews
Experts recommend the drug to many women; the main advantage of these tablets is considered to be a low dose of the hormone. Only natural elements enter into the structure.
Qlaira is often determined to determine the treatment of diseases in the gynecological field. It is easy to use and does not cause serious side effects. The drug normalizes the menstrual cycle, reduces bleeding when it is heavy, and eliminates pain during menstruation.
Andrey Vasilievich, gynecologist:
The drug was prescribed for treatment for many women. As a rule, almost everyone was satisfied with the results obtained from using Qlaira. I would like to highlight that if you stop taking the drug, the risk of developing an unwanted pregnancy may increase significantly. This happens due to the body’s reaction to stopping the use of the contraceptive. For this reason, during the first week you should take care of preventing sexual intercourse. In certain situations, I can prescribe this remedy for women with fibroids and endometriosis. But the prescriptions will be effective only for small fibroids, since the drug is useless for large tumors.
Composition and release form of the drug
Qlaira belongs to the group of combined oral contraceptives. The drug contains two components:
- Estradiol valerate, micro 20 (3 mg). It is a natural estrogen, similar in structure to the natural female hormone estradiol. Contained in the minimum permissible dosage, it refers to microdosed products;
- Dienogest 2 mg. This is a hybrid gestagen, similar in structure to natural progesterone. Clinical studies have shown that it is at this dosage that dienogest interacts well with estrogen and has the desired effect.
Qlaira is available in tablets. One package contains 28 tablets of different colors. Each option has its own composition. You need to take the pills in strict sequence: from the first to the last. According to the developers of the drug, this scheme allows you to make the cycle while taking Qlaira as close to natural as possible.
All 28 Qlaira tablets should be taken in strict sequence.
The cost of the drug is 1000-1200 rubles. This is one of the most expensive representatives of COC. The price is determined by the composition of the contraceptive and the expected therapeutic effect.
Complications after treatment
Although treatment for endometrial hyperplasia is successful in most cases, there are certain types of complications. The most common complication is a relapse of the disease, so constant monitoring of the body’s condition is necessary. In addition, even after treatment, oncological changes in the body are possible, which should also be carefully monitored.
Chronic anemia may develop against the background of frequent bleeding. Also, after treatment of endometrial hyperplasia, complete infertility is possible.
How dienogest suppresses endometriotic lesions
The therapeutic effect of the drug is associated with dienogest, which is part of it. Estradiol valerate only stabilizes the menstrual cycle, but does not treat endometriosis. On the contrary, many researchers believe that estrogens in COCs can provoke the growth of heterotopias and lead to the progression of the disease. But not all gynecologists agree with this statement. There is an opinion that estradiol in combination with dienogest is not dangerous - provided the dosage and dosage regimen are followed.
The mechanism of action of dienogest:
- Suppresses the growth of endometriotic lesions. Hybrid gestagen inhibits proliferation in altered tissues, suppresses local hormone production and triggers apoptosis - programmed cell death;
- Inhibits the development of the inflammatory process in tissues. Dienogest inhibits the release of prostaglandins and growth factors. It relieves pain and allows you to reduce the dosage of analgesics. In some cases, it is possible to do without additional prescription of non-steroidal anti-inflammatory drugs;
- Suppresses ovulation. Dienogest inhibits the synthesis of FSH and LH in the pituitary gland, prevents the maturation of follicles and the selection of the dominant one among them. No ovulation means no monthly changes in the endometrium, which means the lesions do not grow;
- Prevents the growth of new vessels around endometriotic lesions. Dienogest deprives heterotopias of nutrition, and they regress.
Endometrioid heterotopias begin to regress under the influence of dienogest.
It is assumed that dienogest can also influence the immunological mechanisms of the development of endometriosis, but this process has not yet been fully studied.
On a note
The clinical effectiveness of dienogest in Qlaira is comparable to the effect of strong hormonal drugs - agonists of gonadotropic hormones. However, unlike the latter, hybrid gestagen does not reduce the level of sex hormones to the point of artificial menopause and does not lead to the development of osteoporosis. It is better tolerated and reliably suppresses the growth of heterotopias.
During the course of taking Klaira, the following is expected:
- Reduction in the size of endometrioid lesions (according to ultrasound and other examination methods);
- Normalization of the menstrual cycle. Menstruation occurs regularly, becomes scanty and painless;
- Subsidence or complete disappearance of pain;
- Improving the general condition of a woman;
- Restoring fertility after discontinuation of the drug.
It is also useful to read: The use of suppositories in the treatment of endometriosis
Useful video
Watch this video about what drugs are used to treat endometriosis:
The main treatment of endometriosis in women: drugs are supposed to be selected from a specific group. Conventional contraceptives can only reduce symptoms.
Not all contraceptives work for endometriosis. The best ones are those based on dienogest. Such tablets include, for example, Visanne. There are other treatments available. For example, the Mirena spiral.
Endometriosis occurs after cesarean section due to decreased immunity, as well as a number of circumstances beyond the woman’s control. The symptoms are similar at different sites of dislocation - on the suture, uterus, scar: pain, discharge, inflammation during menstruation, etc. Treatment is surgical and conservative.
Sometimes endometriosis can return after laparoscopy, causing pain. To avoid it after removal of the retrocervical, ovaries, etc., treatment and prevention with drugs are carried out. Rehabilitation also includes lifestyle changes. How are your periods after endometriosis treatment by laparoscopy?
Indications for the use of dienogest
The instructions for use state only one indication for Qlaira - contraception. In practice, doctors prescribe this drug for the treatment of certain gynecological diseases, including endometriosis. Dienogest is used in the following situations:
- Adenomyosis I-II degrees with moderate damage to the muscular layer of the uterus;
- External endometriosis with the spread of the process to the ovaries, fallopian tubes, peritoneum - before and/or after surgery;
- Combination of endometriosis with small uterine fibroids;
Qlaira is prescribed for endometriosis in combination with fibroids.
- Planning pregnancy against the background of endometriosis.
Qlaira is used in various treatment regimens:
- As the main treatment method for moderate development of endometriosis;
- In addition to surgery. Before surgery, the drug reduces the size of the lesions, reduces blood loss and allows you to save the organ. After surgery, dienogest suppresses the growth of remaining heterotopias.
Effect on hyperplasia of the uterine mucosa
You should know that Qlaira was developed for safe birth control. This function is predominant. However, the drug is no less effective for the treatment of hyperplasia.
It acts on the inner layer of the uterus, stopping prolonged heavy bleeding. The product restores healthy menstruation, thereby increasing iron synthesis.
Gynecologists say that the earlier the pathology is detected, the better it responds to drug therapy. Taking Qlaira at the initial stage of development of endometrial hyperplasia will help get rid of unpleasant symptoms and avoid surgical intervention.
In addition to the treatment of gynecological diseases, the drug improves the structure of the skin, hair, nails, and controls menstrual cycles.
Based on the research, it was found that more than 80% of women who took Qlaira noted an improvement in their emotional and physical well-being.
Scheme for using the drug for endometriosis
Qlaira contains 26 active tablets and 2 placebo tablets. This allows you to minimize the gap between taking hormones and prevent the growth of lesions.
The drug is prescribed from the first day of the menstrual cycle - the first day of bleeding. You must take the tablets strictly according to the regimen indicated in the instructions. You cannot change the order of taking the drug! The composition of the tablets is different, and only with consistent use can the desired effect be achieved.
The pills, including placebo, are taken continuously. When the pack is finished, you need to start a new one the next day.
Scheme for using Qlaira.
The course of therapy lasts at least three months. The maximum is not defined - a woman can take the drug for as long as needed. As long as the patient takes hormonal pills, she is protected from the progression of the disease. The medical literature indicates that you can take contraceptives until the age of natural menopause - 45-50 years.
It is important to know
You should not take Qlaira at the same time as other hormonal medications. You must first finish the contraceptive package to the end and only then switch to another means.
Contraindications to hormonal therapy
Qlaira is not prescribed for the following conditions:
- Revealed hypersensitivity to the drug - an allergic reaction to a previous prescription;
- Vascular pathology with thrombosis currently or in history (including pulmonary embolism, deep vein thrombosis);
- Diseases in which the development of thrombosis is possible: deep vein thrombophlebitis, myocardial infarction, cerebral stroke, angina pectoris, transient ischemic attacks, congenital and acquired heart defects, diabetes mellitus with vascular complications, uncontrolled arterial hypertension, congenital thrombophilic conditions;
- Severe diseases of the liver, pancreas, kidneys;
- Hormone-dependent neoplasms of any location;
- Vaginal bleeding of unknown etiology;
- Pregnancy or suspicion of it;
- Breastfeeding period.
Qlaira should not be taken during lactation.
Qlaira is not prescribed to women over 35 years of age who smoke – the risk of developing thrombosis is too high.
Side effects from taking COCs
In the first months of taking the contraceptive, adaptation to the drug occurs. At this time, there may be spotting and spotting from the genital tract. They usually occur in the middle of the cycle and go away on their own within a few days. Breakthrough bleeding, requiring discontinuation of the drug, is less common.
It is also useful to read: Use of Duphaston for endometriosis
In the first months of use, there may be other reactions:
- Nausea, vomiting, abdominal discomfort;
- Tension and soreness of the mammary glands;
- Changes in mood, depression;
- Headache.
Such symptoms persist for 2-3 months, after which the body gets used to the influence of hormones and the condition improves. If there is no change, you need to change the drug.
Other undesirable reactions may occur throughout the course of treatment:
- Attacks of dizziness, migraine-like headaches, increased nervous excitability and irritability;
- Decreased mood, insomnia, suppressed sexual desire;
- Dry conjunctiva and intolerance to contact lenses;
- Abnormal bowel movements, abdominal pain, nausea;
- Dry skin, dermatitis, acne;
- Increased appetite and weight gain;
One of the side effects of taking Qlaira may be increased appetite.
- Increased blood pressure, deterioration of the veins;
- Functional ovarian cysts.
If unwanted symptoms appear, you should consult a doctor. Some reactions are not dangerous and go away on their own, while others require changing the drug.
Klaira and pregnancy planning
While a woman is taking contraceptives, she cannot conceive a child. Klaira reliably suppresses ovulation, and pregnancy does not occur. You can conceive a child after stopping hormonal medications. Pregnancy can occur in the first cycle after completion of therapy - as soon as the pituitary gland and ovaries are restored. But it is better to wait three months - to allow the body to replenish its supply of vitamins and microelements, the deficiency of which is observed while taking COCs.
It is extremely rare that pregnancy occurs during treatment. This is possible if you violate the rules for taking a contraceptive - if you miss a pill, use antibiotics at the same time, or due to vomiting or prolonged diarrhea. If your period does not come while taking white placebo pills, you need to take a pregnancy test. Further tactics depend on the result:
- If the result is positive, you must stop taking the contraceptive and consult a doctor. Qlaira is not dangerous for the fetus, abortion is not indicated;
- If the result is negative, you can continue taking the drug. Sometimes Klaira suppresses the function of the pituitary gland so much that menstruation does not come.
Surgical treatment
Surgery is necessary in most cases of endometrial hyperplasia. It is effective and allows you to avoid relapses of the disease. However, the method of surgical intervention is also determined individually, after an accurate diagnosis of the disease.
- Scraping. Quite often, treatment of endometrial hyperplasia without curettage is impossible. The essence of the procedure: the functional layer of the endometrium is removed along with all the pathological formations that are present in it. The operation is performed under anesthesia, a hysteroscope is inserted into the uterine cavity, which allows you to use surgical instruments and see on the screen everything that is happening inside. The contents of the uterus obtained after curettage are sent for histology, after which the doctor determines the need for further treatment.
- Cryodestruction. The affected area of the endometrium is exposed to low temperatures, causing this layer to be rejected.
- Cauterization or laser use. The affected area of the endometrium is cauterized or exposed to a laser. The pathological layer is destroyed, after which the epithelial layer begins to grow and develop normally.
- Uterus removal. If the disease has a complex form and is diagnosed in a premenopausal woman, then removal of the uterus is the optimal solution to the problem. If tissue testing for cancer is negative, then the ovaries are preserved. However, if obvious oncological changes begin in the body, the uterus is removed along with the appendages.
Klaira in premenopause
Combined oral contraceptives after 40 years of age are prescribed with caution. At this time, the number of chronic diseases for which hormonal drugs are contraindicated is growing. These are primarily heart and vascular diseases with a high risk of thrombosis, liver and kidney pathologies. COCs are strictly prohibited for smoking women over 40 years of age.
If a woman smokes after 40 years, then Qlaira is contraindicated for her.
In the absence of contraindications, Qlaira can become the drug of choice for premenopausal women. The minimum dosage of estrogen, good tolerability, rare development of side effects - all this makes the contraceptive one of the best means for controlling endometriosis. Feedback from patients clearly makes it clear: the drug is a worthy competitor to agonists and other strong hormonal agents.
Gynecologists speak well of the hybrid dienogest in Qlaira. Practice shows that the drug copes with its task: it slows down the progression of the disease, prevents the appearance of new lesions and relieves the symptoms of endometriosis.
Drug interactions
Qlaira should be taken with caution in combination with medications that induce microsomal liver enzymes. This is due to the likelihood of an increase in the rate of excretion of sex hormones from the body, which can lead to severe uterine bleeding and a weakening of the contraceptive and therapeutic effect.
If simultaneous short-term use of Qlaira and drugs for inducing liver enzymes is necessary, it is recommended to use additional protection against pregnancy (for example, condoms). If medications for the liver are prescribed for a long period, then it is better to refuse hormonal therapy. In this case, it is necessary to consult a gynecologist who will help you choose a different treatment option.
The list of substances that reduce the effectiveness of Qlaira: phenytoin, bosentan, barbiturates, primidone, rifampicin, carbamazepine, oxcarbazepine, felbamate, topiramate, griseofulvin, drugs containing St. John's wort.
Some substances included in medications slow down the rate of elimination of dienogest and estradiol from the body. These include: voriconazole, itraconazole, fluconazole, erythromycin, clarithromycin.
Analogues of the drug: what is sometimes replaced with
There are no complete analogues of Klaira. But there are two combined oral contraceptives on the pharmaceutical market that also contain dienogest: Janine and Silhouette. The difference lies in the estrogen component. Qlaira contains natural estradiol valerate in a dosage of 20 mcg, while Janine and Silhouette contain synthetic ethinyl estradiol 30 mcg. Therefore, Qlaira is better tolerated and less likely to cause side effects associated with the influence of estrogen.
Other oral contraceptives (Regulon, Yarina, Jess, Novinet) are rarely used in the treatment of endometriosis. The gestagens in their composition do not have the desired effect on heterotopias, so their use is inappropriate.
Pure gestagenic drugs are also used in clinical practice. This is Visanne - a product containing 2 mg of dienogest. The drug reliably suppresses the growth of heterotopias, but is less well tolerated: it often causes intermenstrual bleeding.
Qlaira is a first-line treatment for endometriosis. The drug has proven itself well in mild and moderate forms of pathology. But in advanced cases you should not rely on it - you cannot do without surgery.
