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

Definition

What is Tibolone?

DotS the definition of Tibolone may vary. In Hormone Replacement Therapy (HRT): Tibolone – About Tibolone: Brand Name: Livial 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

In Menopausal Hormone Therapy the European Menopause and Andropause Society’s definition is:

  • “Tibolone is a synthetic steroid with estrogenic, progestogenic and weak androgenic activity used to manage menopausal symptoms and urogenital atrophy in postmenopausal women”.3

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”.4

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”.5

In Tibolone As Menopausal Hormone Therapy: Summary, updated 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”.6

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”.7

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)”.8

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”.9

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”.10

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”.11

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”.12

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?

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Links

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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: 2023 Consumer Videos and Podcasts – NAMS 2023 Nonhormone Therapies Position Statement for Bothersome Menopause Symptoms
  12. Consumer Video and Podcast Series: 2023 Consumer Videos and Podcasts – New FDA-Approved Nonhormone Option for the Treatment of Hot Flashes
  13. Consumer Video and Podcast Series: 2023 Consumer Videos and Podcasts – Premature and Early Menopause
  14. Consumer Video and Podcast Series: 2024 Consumer Videos and Podcasts – Preparing for Your Menopause Health Care Visit
  15. Contraception for the Older Woman: Hormone Replacement Therapy
  16. Custom-Mixed Hormone Therapies Misleading Menopausal Women To Think Personalised Products Are Necessary, Experts Say
  17. Deciding About Hormone Therapy
  18. EMAS On-Demand Webinars [European Menopause and Andropause Society] [Multiply Languages]: Impact of Estrogen Deficiency on Quality of Life In Asia and the Role of Continuous Combined MHT In Treatment (EN)
  19. Emotional Wellness In Menopause
  20. FAQs: Hormone Therapy for Menopause
  21. Find A Menopause Practitioner [United States and Other]
  22. Find An AMS Member [Australasian Menopause Society i.e. Australia and New Zealand]
  23. Find Your Nearest BMS Menopause Specialist [British Menopause Society]
  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. Hormone Replacement Therapy (HRT)
  31. Hormone Replacement Therapy (HRT): Benefits and Risks of Hormone Replacement Therapy (HRT)
  32. Hormone Replacement Therapy (HRT): Side Effects of Hormone Replacement Therapy (HRT)
  33. Hormone Replacement Therapy (HRT): Tibolone – About Tibolone: Brand Name: Livial
  34. Hormone Replacement Therapy (HRT): Tibolone – Brand Name: Livial
  35. Hormone Replacement Therapy (HRT): Tibolone Brand Name: Livial – Common Questions About Tibolone
  36. Hormone Replacement Therapy (HRT): Tibolone Brand Name: Livial – How and When To Take Tibolone
  37. Hormone Replacement Therapy (HRT): Tibolone Brand Name: Livial – Side Effects
  38. Hormone Replacement Therapy (HRT): Tibolone Brand Name: Livial – Taking Tibolone With Other Medicines and Herbal Supplements
  39. Hormone Replacement Therapy (HRT): Tibolone Brand Name: Livial – Who Can and Cannot Take Tibolone
  40. Hormone Replacement Therapy (HRT): Types of Hormone Replacement Therapy (HRT)
  41. Hormone Replacement Therapy (HRT): Vaginal Oestrogen
  42. Hormone Therapy: Is It Right for You?
  43. Hot Flashes
  44. Hot Flashes
  45. Hot Flashes: What Can I Do? [+ Video: What Are the Signs and Symptoms of Menopause?]
  46. How To Find Relief for Hot Flashes At Night
  47. 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
  48. Later Years (Around 50 Years and Over): Menopause and Post Menopause Health – After the Menopause [Other Languages and Formats]
  49. Livial Tablets
  50. Managing Menopause Symptoms [+ Video Courtesy: Mayo Clinic News Network]
  51. Mastering Midlife Mood Changes With Marlene Freeman, MD
  52. May Is Osteoporosis Awareness and Prevention Month!
    Hormone Therapy and Tibolone
  53. Mayo Clinic Minute: Help With Hot Flashes Due To Menopause [+ Video Courtesy: Mayo Clinic News Network]
  54. Menopausal Hormone Therapy
  55. Menopause
  56. Menopause Management Options
  57. Menopause Map: Downloadable Resources – My Personal Path Print Tools: Questions for Your Health Care Provider
    Hormone Therapy and Tibolone
  58. Menopause Map: Downloadable Resources – Stages of Menopause: Postmenopause
    Postmenopause
  59. Menopause Patient Information [Videos] 2. Talking To Your GP About Menopause
  60. Menopause Patient Information [Videos] 3. The Risks & Benefits of HRT
  61. Menopause Patient Information [Videos] 4. The Different Types of HRT
  62. Menopause Preparedness Toolkit Video Series: Common Conditions Associated With Menopause and Midlife
  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
  67. Menopause and HRT: Fact and Fiction
  68. Menopause and Mental Health
  69. Menopause, Perimenopause, Hormone Therapy and Other Treatments With Madelyn Butler, MD [Podcast]
  70. Menopause: Identification and Management [NICE Guideline Published: 12 November 2015 Last Updated: 07 November 2024]
    Hormone Therapy and Tibolone
  71. Menopause: Identification and Management: NICE Guideline [NG23] [07 November 2024]
  72. Menopause: Things You Can Do
  73. Menopause: Understanding the Changes and Finding Relief | Dr Susan Davis | The Proof Podcast EP 256
  74. Mood and the Menopause
  75. Mymenoplan.org [My Menoplan, United States]
  76. National Center for Complementary and Integrative Health: Herbs At A Glance
  77. National Center for Complementary and Integrative Health: How Safe Is This Product or Practice?
  78. Navigating Menopause: Expert Insights and Solutions | Dr Susan Davis | The Proof Podcast EP 245
  79. Postmenopause
  80. Practical HRT Tips | Dr Louise Newson
  81. Professional Video and Podcast Series: 2025 Professional Videos and Podcasts – Hypoactive Sexual Desire Disorder HSDD—Open the Door To Discussion
  82. Short-Term and Long-Term Effects of Tibolone In Postmenopausal Women
  83. Testosterone Therapy In Women: Does It Boost Sex Drive?
  84. The 2023 Practitioner’s Toolkit for Managing Menopause
  85. The Menopause Society Statement on Misinformation Surrounding Hormone Therapy [September 2024]
    Hormone Therapy and Tibolone
  86. The North American Menopause Society Releases Its 2022 Hormone Therapy Position Statement
  87. Tibolone Tablets
  88. Towards Better Patient Care: Drugs To Avoid In 2025: Gynaecolgy/Endocrinology – Tibolone [01 February 2025]
    Hormone Therapy and Tibolone
  89. Updated 2024 NICE Menopause Guidance Summary
  90. Vaginal Dryness
  91. Video & Podcast Library: Videos – World Menopause Day 2024: Menopause and Hormone Therapy: Current Perspectives and Controversies
  92. Videos & Podcasts: Videos – Preventing Bone Loss At Menopause
  93. Webinars: Previous – Approach To Bone Health In the Perimenopause and Postmenopause?
  94. Webinars: Previous – Changing the Paradigm for Earlier Osteoporosis Prevention
  95. Webinars: Previous – IMS & ISE Symposium: What’s Hot? Options for Treatment of Hot Flushes 2025
  96. Webinars: Previous – Osteoporosis for Midlife Women and Beyond
  97. What Types of Vaginal Oestrogens Are There?
  98. World Menopause Day 2024: Leaflet for Women – Menopause and Menopause Hormone Therapy [Multiply Languages]
  99. Hormone Therapy and TiboloneWorld Menopause Day 2024: Poster for Women – The 5 Ws of Menopause Hormone Therapy (MHT)

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: 16 April 2025
  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: 16 April 2025
  3. Menopausal Hormone Therapy. 2022. European Menopause and Andropause Society https://emas-online.org/wp-content/uploads/2022/05/Menopausal-hormone-therapy.pdf Accessed: 16 April 2025
  4. HRT: Which HRT? Tibolone. Reviewed November 2021. Publication Date 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: 16 April 2025
  5. 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: 16 April 2025
  6. Tibolone As Menopausal Hormone Therapy: Summary. Content Updated September 2023. Australasian Menopause Society https://www.menopause.org.au/hp/information-sheets/tibolone-as-menopausal-hormone-therapy Accessed: 16 April 2025
  7. 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: 16 April 2025
  8. 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: 16 April 2025
  9. HRT: Which HRT? Tibolone. Reviewed November 2021. Publication Date 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: 16 April 2025
  10. Tibolone As Menopausal Hormone Therapy: Summary. Content Updated September 2023. Australasian Menopause Society https://www.menopause.org.au/hp/information-sheets/tibolone-as-menopausal-hormone-therapy Accessed: 16 April 2025
  11. HRT: Which HRT? Tibolone. Reviewed November 2021. Publication Date 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: 16 April 2025
  12. 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: 16 April 2025
Topic Last Updated: 16 April 2025 – Topic Last Reviewed: 16 April 2025

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