Hormone Therapy and Tibolone

“Tibolone is a type of hormone replacement therapy (HRT)
that contains a synthetic (artificial) hormone. Your body
breaks down tibolone to make substances that work in a…”.1

Umbrella

What may the Hormone Therapy and Tibolone Umbrella include?

Depending on the Source (DotS) this Umbrella may include:

  • Hormone Replacement Therapy (HRT)
  • Hormone Therapy (HT)
  • Livial
  • Menopausal Hormone Therapy (MHT)
  • Tibolone
  • Xyvion

Date

What can it be important to be clear about with Hormone Therapy (HT) and Tibolone information?

It can be important to be clear about the date of all information including the date of HT information, because this information may have been updated.

Symptoms or Chronic Conditions

What can it also be important to be clear about with HT and Tibolone information?

It can also be important to be clear about whether HT information is about the use of HT for the management of menopausal symptoms such as hot flushes, night sweats and vaginal dryness or for the prevention of chronic conditions such as cardiovascular disease and osteoporosis.

Definition

What is Tibolone?

DotS the definition of Tibolone may vary. In Hormone Replacement Therapy (HRT): Tibolone – About Tibolone: Brand Name: Livial, last reviewed 05 January 2023, the (United Kingdom) NHS’s definition is:

“Tibolone is a type of hormone replacement therapy (HRT) that contains a synthetic (artificial) hormone. Your body breaks down tibolone to make substances that work in a similar way to the hormones oestrogen, progesterone and testosterone”.2

Bleed-Free

Is Tibolone bleed-free?

On page two in HRT: Which HRT? Tibolone the (British) Women’s Health Concern’s (WHC) note:

“The first “bleed-free” HRT contains a synthetic hormone known as Tibolone, which is taken orally every day. Tibolone has combined oestrogen, progestogen and testosterone effects and relieves menopausal symptoms, prevents bone loss, and may improve interest in sex. As with other continuous therapies, it is normally prescribed at least 12 months after the last menstrual period, so many women switch to these continuous types after taking a sequential HRT”.3

Menopause Symptoms

What menopause symptoms does Tibolone help to improve?

In Hormone Replacement Therapy (HRT): Tibolone – About Tibolone: Brand Name: Livial the NHS note:

“Tibolone helps to improve menopause symptoms, such as hot flushes, low mood and vaginal dryness or irritation”.4

In Tibolone As Menopausal Hormone Therapy: Summary, updated 25 September 2023, the Australasian Menopause Society (AMS) explain:

“Tibolone is indicated for the management of vasomotor symptoms associated with the menopause and for the prevention of bone loss. It can be considered an alternative to conventional MHT where improvement in libido is desired”.5

In The 2023 Practitioner’s Toolkit for Managing Menopause: The 2023 Practitioner’s Toolkit for Managing the Menopause Supporting Notes – Management: MHT Formulations and Options: Tibolone, published online 30 October 2023, the authors also note:

“It may improve sexual interest and responsiveness. Breast tenderness is uncommon and tibolone does not increase mammographic density”.6

Osteoporosis

How useful is Tibolone in women who have osteoporosis?

The NHS note:

“It can also be prescribed to help stop your bones getting thinner after the menopause (osteoporosis)”.7

Endometriosis and Fibroids

How useful is Tibolone in women who are known to have endometriosis and fibroids?

On page two in HRT: Which HRT? Tibolone the WHC explain:

“Tibolone has also been shown to be particularly useful in women who are known to have endometriosis and fibroids as it does not appear to stimulate these conditions”.8

Health Care Provider

What if I choose to use Tibolone?

If you choose to use Tibolone it may be in your best interest to also choose to talk to your health care provider about this.

In Tibolone As Menopausal Hormone Therapy: Summary the AMS note:

“It is not recommended for use in women with a history of breast cancer and should be used with caution in women over age 60 because of the increased stroke risk”.9

On page two in HRT: Which HRT? Tibolone the WHC elaborate on:

“Irregular bleeding or spotting can occur during the first 4-6 months of taking continuous combined HRT or Tibolone, and is not a cause for alarm. However, you should consult your doctor if you get heavy (rather than light) bleeding, if it lasts for more than six months, or if bleeding starts suddenly after some time without bleeding. Irregular bleeding may sometimes be improved by changing the type or route of HRT”.10

In Hormone Replacement Therapy (HRT): Tibolone – About Tibolone: Brand Name: Livial – Key Facts the NHS elaborate on:

  • “It’s important to see your doctor at least once a year for a check-up and to review whether you need to keep taking tibolone”.11

Health Topics A-Z

Where may I find Health Topics A-Z related to Hormone Therapy and Tibolone?

In Health Topics A-Z you may find:

Health Topics A-Z

Links

Where may I find Links related to Hormone Therapy and Tibolone?

Your Country may have Links similar to:

Links

This Links List to third party websites is neither comprehensive nor exhaustive. Inclusion on this Links List does not imply endorsement or recommendation. Non-inclusion on this Links List does not imply non-endorsement or non-recommendation. Third party websites are not under the control of Meno Martha International Menopause Directory. Third party websites may contain explicit medical images and/or sexual references. Please read Meno Martha International Menopause Directory’s Links Policy before proceeding to a Link. Please contact Webmaster if you experience a problem with a Link.

New or Updated

  1. ACOG Explains: Managing Menopause Symptoms [American College of Obstetricians and Gynecologists]
  2. Active Ingredient: Tibolone [Tibolone (Sandoz), Xyvion and Livial]
  3. Askearlymenopause.org [Ask EM] [+ Video: What Is Early Menopause?]
  4. BMS TV: HRT and Breast Cancer: Overall Risks and Benefits
  5. BMS TV: HRT and the Risk of Breast Cancer
  6. BMS TV: Hormone Replacement Therapy (HRT)
  7. BMS TV: Testosterone Explained
  8. Bioidentical Hormones: Are They Safer?
  9. Brand Name Tibolone (Sandoz)
  10. Build Better Bones.org [International Osteoporosis Foundation]
  11. Consumer Video and Podcast Series: 2024 Consumer Videos and Podcasts – Preparing for Your Menopause Health Care Visit
  12. Custom-Mixed Hormone Therapies Misleading Menopausal Women To Think Personalised Products Are Necessary, Experts Say
  13. Deciding About Hormone Therapy
  14. Deciding About Hormone Therapy Use
  15. Emotional Wellness In Menopause
  16. FAQs: Hormone Therapy for Menopause
  17. FDA Direct: Removing Black Box Warnings for HRT (Part 1/2)
  18. FDA Direct: Removing Black Box Warnings for HRT (Part 2/2)
  19. FDA Expert Panel on Menopause and Hormone Replacement Therapy for Women
  20. Find A Menopause Practitioner [United States and Other]
  21. Find A Practitioner [Australasian Menopause Society i.e. Australia and New Zealand]
  22. Find Your Nearest BMS Menopause Specialist [British Menopause Society]
  23. Genitourinary Syndrome of Menopause
  24. Genitourinary Syndrome of Menopause
  25. Guidance on Menopausal Hormone Therapy
  26. HRT
  27. HRT Questions Answered
  28. HRT – Types, Doses and Regimens
  29. HRT: Benefits and Risks
  30. Handling Hot Flushes and Night Sweats| Dr Louise Newson
  31. Hormone Replacement Therapy (HRT)
  32. Hormone Replacement Therapy (HRT): Benefits and Risks of Hormone Replacement Therapy (HRT)
  33. Hormone Replacement Therapy (HRT): Side Effects of Hormone Replacement Therapy (HRT)
  34. Hormone Replacement Therapy (HRT): Tibolone – About Tibolone: Brand Name: Livial
  35. Hormone Replacement Therapy (HRT): Tibolone – Brand Name: Livial
  36. Hormone Replacement Therapy (HRT): Tibolone Brand Name: Livial – Common Questions About Tibolone
  37. Hormone Replacement Therapy (HRT): Tibolone Brand Name: Livial – How and When To Take Tibolone
  38. Hormone Replacement Therapy (HRT): Tibolone Brand Name: Livial – Side Effects
  39. Hormone Replacement Therapy (HRT): Tibolone Brand Name: Livial – Taking Tibolone With Other Medicines and Herbal Supplements
  40. Hormone Replacement Therapy (HRT): Tibolone Brand Name: Livial – Who Can and Cannot Take Tibolone
  41. Hormone Replacement Therapy (HRT): Types of Hormone Replacement Therapy (HRT)
  42. Hormone Replacement Therapy (HRT): Vaginal Oestrogen
  43. Hormone Therapy: Is It Right for You?
  44. Hot Flashes
  45. Hot Flashes
  46. How To Find Relief for Hot Flashes At Night
  47. Handling Hot Flushes and Night Sweats| Dr Louise Newson
  48. Hot Flashes
  49. How To Talk To Your Doctor About Painful Sex
    Tibolone
  50. How Vaginal Hormones Can Transform the Health of Women
  51. International Menopause Society (IMS) Recommendations and Key Messages on Women’s Midlife Health and Menopause
  52. Joint Position Statement By the British Menopause Society, Royal College of Obstetricians and Gynaecologists and Society for Endocrinology on Best Practice Recommendations for the Care of Women Experiencing the Menopause
  53. Later Years (Around 50 Years and Over): Menopause and Post Menopause Health – After the Menopause [Other Languages and Formats]
  54. Livial Tablets
  55. Managing Menopause Symptoms [+ Video Courtesy: Mayo Clinic News Network]
  56. Mastering Midlife Mood Changes With Marlene Freeman, MD
  57. May Is Osteoporosis Awareness and Prevention Month!
    Hormone Therapy and Tibolone
  58. Menopause
  59. Menopause Checklist Podcast: Episode 6: Hello Lubricant!
  60. Menopause Management Options
  61. Menopause Map: Downloadable Resources – My Personal Path Print Tools: Questions for Your Health Care Provider
    Hormone Therapy and Tibolone
  62. Menopause Map: Downloadable Resources – Stages of Menopause: Postmenopause
    Postmenopause
  63. Menopause Symptoms: Mayo Clinic Expert Outlines Hormone and Nonhormonal Therapies
  64. Menopause Treatment
  65. Menopause Treatments: What Works, What Doesn’t
  66. Menopause and HRT: Fact and Fiction
  67. Menopause and Mental Health
  68. Menopause, Perimenopause, Hormone Therapy and Other Treatments With Madelyn Butler, MD [Podcast]
  69. Menopause: Identification and Management [NICE Guideline Published: 12 November 2015 Last Updated: 07 November 2024]
    Hormone Therapy and Tibolone
  70. Menopause: Identification and Management: NICE Guideline [NG23] [07 November 2024]
  71. Mood and the Menopause
  72. National Center for Complementary and Integrative Health: Herbs At A Glance
  73. National Center for Complementary and Integrative Health: How Safe Is This Product or Practice?
  74. Navigating Menopause Care Resource Guide
  75. Practical HRT Tips | Dr Louise Newson
  76. Professional Video and Podcast Series: 2025 Professional Videos and Podcasts – Hypoactive Sexual Desire Disorder HSDD—Open the Door To Discussion
  77. Taking Tibolone For Menopause Relief? NHS Warns Of Possible Health Risks
  78. Testosterone Therapy In Women: Does It Boost Sex Drive?
  79. The 2023 Practitioner’s Toolkit for Managing Menopause
  80. The Menopause Society Statement on Misinformation Surrounding Hormone Therapy [September 2024]
    Hormone Therapy and Tibolone
  81. Tibolone Tablets
  82. Towards Better Patient Care: Drugs To Avoid In 2025: Gynaecolgy/Endocrinology – Tibolone
    Hormone Therapy and Tibolone
  83. Updated 2024 NICE Menopause Guidance Summary
  84. Urogenital Problems
  85. Video & Podcast Library: Videos – World Menopause Day 2024: Menopause and Hormone Therapy: Current Perspectives and Controversies
  86. Videos & Podcasts: Videos – Menopause and Hormone Therapy: Current Perspectives and Controversies [18 October 2024]
  87. Videos & Podcasts: Videos – Preventing Bone Loss At Menopause
  88. Webinars: Approach To Bone Health In the Perimenopause and Postmenopause?
  89. Webinars: Changing the Paradigm for Earlier Osteoporosis Prevention
  90. Webinars: Osteoporosis for Midlife Women and Beyond
  91. Webinars: Symposia – What’s Hot? Options for Treatment of Hot Flushes 2025
  92. Webinars: The Burn, the Itch, the Pain, the Urge: GSM In Women
  93. What Types of Vaginal Oestrogens Are There?
  94. Hormone Therapy and Tibolone World Menopause Day 2024: Leaflet for Women – Menopause and Menopause Hormone Therapy [Multiply Languages]

Sources

Where may I find the Sources quoted?

You may find the Sources quoted at:

Sources

  1. Hormone Replacement Therapy (HRT): Tibolone – About Tibolone: Brand Name: Livial. Page Last Reviewed: 05 January 2023. NHS https://www.nhs.uk/medicines/hormone-replacement-therapy-hrt/tibolone/about-tibolone/ Accessed: 07 January 2026
  2. Hormone Replacement Therapy (HRT): Tibolone – About Tibolone: Brand Name: Livial. Page Last Reviewed: 05 January 2023. NHS https://www.nhs.uk/medicines/hormone-replacement-therapy-hrt/tibolone/about-tibolone/ Accessed: 07 January 2026
  3. HRT: Which HRT? Tibolone. Reviewed: November 2021:2. Women’s Health Concern https://www.womens-health-concern.org/wp-content/uploads/2022/12/09-WHC-FACTSHEET-HRT-NOV2022-B.pdf Accessed: 07 January 2026
  4. Hormone Replacement Therapy (HRT): Tibolone – About Tibolone: Brand Name: Livial. Page Last Reviewed: 05 January 2023. NHS https://www.nhs.uk/medicines/hormone-replacement-therapy-hrt/tibolone/about-tibolone/ Accessed: 07 January 2026
  5. Tibolone As Menopausal Hormone Therapy: Summary. 25 September 2023. Australasian Menopause Society https://www.menopause.org.au/hp/information-sheets/tibolone-as-menopausal-hormone-therapy Accessed: 07 January 2026
  6. Davis, S. R., Taylor, S., Hemachandra, C., Magraith, K., Ebeling, P. R., Jane, F., and Islam, R. M. The 2023 Practitioner’s Toolkit for Managing Menopause: The 2023 Practitioner’s Toolkit for Managing the Menopause Supporting Notes – Management: MHT Formulations and Options: Tibolone. Published Online: 30 October 2023 https://www.tandfonline.com/doi/full/10.1080/13697137.2023.2258783 Accessed: 07 January 2026
  7. Hormone Replacement Therapy (HRT): Tibolone – About Tibolone: Brand Name: Livial. Page Last Reviewed: 05 January 2023. NHS https://www.nhs.uk/medicines/hormone-replacement-therapy-hrt/tibolone/about-tibolone/ Accessed: 07 January 2026
  8. HRT: Which HRT? Tibolone. Reviewed: 2021:2. Women’s Health Concern https://www.womens-health-concern.org/wp-content/uploads/2022/12/09-WHC-FACTSHEET-HRT-NOV2022-B.pdf Accessed: 07 January 2026
  9. Tibolone As Menopausal Hormone Therapy: Summary. 25 September 2023. Australasian Menopause Society https://www.menopause.org.au/hp/information-sheets/tibolone-as-menopausal-hormone-therapy Accessed: 07 January 2026
  10. HRT: Which HRT? Tibolone. Reviewed: 2021:2. Women’s Health Concern https://www.womens-health-concern.org/wp-content/uploads/2022/12/09-WHC-FACTSHEET-HRT-NOV2022-B.pdf Accessed: 07 January 2026
  11. Hormone Replacement Therapy (HRT): Tibolone – About Tibolone: Brand Name: Livial – Key Facts. Page Last Reviewed: 05 January 2023. NHS https://www.nhs.uk/medicines/hormone-replacement-therapy-hrt/tibolone/about-tibolone/ Accessed: 07 January 2026
Topic Last Updated: 07 January 2026 – Topic Last Reviewed: 07 January 2026

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