“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:

Hormone Therapy and Tibolone“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 are known to have endometriosis and fibroids?

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:

Links

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

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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: 24 June 2024
  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: 24 June 2024
  3. Menopausal Hormone Therapy. 2022. European Menopause and Andropause Society https://emas-online.org/wp-content/uploads/2022/05/Menopausal-hormone-therapy.pdf Accessed: 24 June 2024
  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: 24 June 2024
  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: 24 June 2024
  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: 24 June 2024
  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: 24 June 2024
  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: 24 June 2024
  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: 24 June 2024
  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: 24 June 2024
  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: 24 June 2024
  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: 24 June 2024
Topic Last Updated: 24 June 2024 – Topic Last Reviewed: 24 June 2024

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