Tibolone therapy

Tibolone is a synthetic steroid that can be used in postmenopausal individuals as an alternative to continuous combined MHT. It has combined estrogenic, progestogenic and androgenic actions; concurrent therapy with a progestogen is not required.

Tibolone improves bone mineral density and decreases risk of vertebral and nonvertebral fractures. When compared to placebo, this risk reduction is similar to that with combined MHT, but there are no head-to-head trials with combined MHT. Tibolone may improve libido.

Tibolone does not increase breast density; however, it increases the risk of breast cancer recurrence. It may increase the risk of stroke in people older than 60 years (absolute risk excess of 23 cases per 10 000 person years). Ongoing use should be reviewed at age 60 years; see Systemic MHT in older people.

Tibolone is not associated with an increased risk of venous thromboembolism.

In postmenopausal individuals use: