New contraceptive options give more choice to Irish women
Qlaira is the only pill with natural oestrogen in it. Other pills have the synthetic compound ethinylestradiol. Qlaira has estradiol valerate – the valerate component breaks off in the gastric mucosa, leaving the same oestrogen levels as women naturally have in their system. Most pills will reduce heavy periods. The progestogen in Qlaira, dienogest, seems to be particularly good for heavy menstrual bleeding. Qlaira has been available in Germany for a number of years, where it is used for endometriosis.
There are two progesterone-only pills. “People starting on progesterone-only pills tend to use Cerazette, though it is slightly more expensive,” said Dr Shirley McQuade, Medical Director of the Dublin Well Woman Centre. Cerazette – which because it inhibits ovulation, can be used across all age groups – has been available here since last autumn. There is a 12-hour window before it becomes a ‘missed pill’, which is the same as the combined pills.
Noriday, commonly known as the ‘mini pill’, contains the active ingredient norethisterone, which is a synthetic progestogen. It has a three-hour window, potentially making it more difficult to remember. If cost is an issue, Noriday is less expensive. Traditionally this product was used in the over 30s. It does not inhibit ovulation and this may mean a somewhat higher risk of pregnancy, in Dr McQuade’s view.
All of the pills can cause side-effects. There are pills with and without oestrogen. Oestrogen is contraindicated for people with focal migraine or women over 35 with any kind of migraine. There is a thrombosis risk in certain women. The oestrogen-related side-effects are mostly headaches, breast tenderness and sometimes bloating.
“With the progesterone-only pills, headaches don’t seem to be as much of an issue,” said Dr McQuade.
(Source: IMT)
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