Tibolone is a synthetic hormone used by many post menopausal women to help them through the menopause. It is not termed as “menopausal hormone therapy” (MHT) as it is a synthetic drug (made mainly from Mexican yam) that has the following properties:
• Estrogen like activities – helps with prevention of hot flushes, prevention of bone loss (and osteoporosis), and helps decrease dryness in the vagina.
• Progesterone like activities – does not increase the lining of the uterus and cuts down the risk of post-menopausal bleeding.
• Testosterone like activities – helps increase mood and libido.
Tibolone is best taken 1 year after the last period as if taken sooner may cause irregular bleeding. Slight bleeding may still occur initially but will subside after 3-4 months. Women with a uterus need not add progestin when taking Tibolone.
The side effects of tibolone are similar to conventional hormone therapy i.e. headaches, nausea and breast tenderness.
• Tibolone helps prevent bone loss and reduces the risk of spinal fractures.
• Women on Tibolone still require the regular breast mammograms. However mammographic breast density is not increased with Tibolone improving chances of early detection. It is contraindicated in women with breast cancer.
• Tibolone decreases total cholesterol, HDL and LDL cholesterol and triglyceride levels. It should not be given solely for cardiovascular disease prevention.
• The risk of stroke whilst on Tibolone is increased in older women who are 10 years past menopause. The data on venous thromboembolism is not known.
Please consult your doctor before starting on tibolone or menopausal hormone therapy. You also need to have regular reviews whilst on these drugs.
1. Kloosterboer HJ. Tibolone: a steroid with a tissue-specific mode of action. J Steroid Biochem Mol Biol. 2001;70:231-238.
2. Formoso G, Perrone E, Maltoni S, Balduzzi S, D’Amico R, Bassi C, Basevi V, Marata AM, Magrini N, Maestri E. Short and long term effects of tibolone in postmenopausal women.Cochrane Database Syst Rev. 2012 Feb 15;2:CD008536. doi: 10.1002/14651858.CD008536.pub2
3. Cummings SR, Ettinger B, Delmas PD, Kenemans P, Stathopoulos V, Verweij P, et al.LIFT Trial Investigators. The effects of tibolone in older postmenopausal women. New England Journal of Medicine 2008;359(7):697–708.