What is a quadriphasic combined oral contraceptive?
Qlaira is a combined oral contraceptive (COC) containing both estrogen and progestin. It is classified as quadriphasic because the hormone dosage changes four times during the 28-day cycle, aiming to imitate natural hormonal fluctuations. The active ingredients are estradiol valerate and dienogest. Estradiol valerate is converted to 17ß-estradiol, which is identical to the body's natural estrogen, unlike the synthetic ethinylestradiol in many other COCs. The varying doses are indicated by different colored tablets in the 28-day pack.
The mechanism of action
Qlaira prevents pregnancy through multiple mechanisms including inhibiting ovulation, thickening cervical mucus, and altering the uterine lining. These combined actions make Qlaira highly effective when used correctly.
Beyond contraception: Treating heavy periods
Qlaira is approved for treating heavy and/or prolonged menstrual bleeding in women using oral contraception. The dienogest component helps stabilize the uterine lining, potentially reducing bleeding duration and intensity.
Qlaira vs. other combined oral contraceptives
Qlaira differs from standard monophasic combined oral contraceptives primarily in its hormone type and dosing schedule. The table below highlights these distinctions:
| Feature | Qlaira (Quadriphasic) | Standard COC (Monophasic) |
|---|---|---|
| Pill Type | Quadriphasic (4 different doses) | Monophasic (1 constant dose) |
| Estrogen Type | Estradiol valerate (natural-identical) | Ethinylestradiol (synthetic) |
| Hormone Dosage | Varies across the cycle | Constant dose in active pills |
| Dosing Schedule | 28-day pack with 26 active and 2 inactive pills | Typically 21 active and 7 inactive pills |
| Main Advantage | Designed to mimic natural cycle, useful for heavy menstrual bleeding | Simple, consistent dosing schedule |
| Disadvantage | More complex dosing schedule | May cause more estrogen-related side effects in some women |
Potential side effects and safety considerations
Common side effects of Qlaira include headache, nausea, acne, breast discomfort, mood changes, and irregular bleeding, which often improve over a few months. A more serious, though rare, risk is an increased chance of blood clots (VTE). Factors like smoking, age over 35, or certain health conditions can increase this risk. A doctor should review an individual's medical history to determine if Qlaira is suitable. More detailed information on side effects and warnings can be found in the consumer medicine information leaflet provided by Medsafe.
Conclusion
Qlaira is a distinctive quadriphasic combined birth control pill. Its use of estradiol valerate and a variable hormone dose throughout the cycle effectively prevents pregnancy and can help manage heavy menstrual bleeding. Following the complex dosing schedule is important, and consultation with a healthcare provider is essential to confirm its safety and suitability based on individual health needs and history. Qlaira provides a specialized option for those seeking an alternative to standard combined oral contraceptives, particularly for managing heavy periods.
