Tibolone is a medication used as hormone replacement therapy to relieve symptoms in postmenopausal women. It may also help prevent osteoporosis, especially when other treatments are not recommended.
This medication is mainly sold as 2.5 mg or 1.25 mg oral tablets, under brand names such as Livial, Libiam, and Tibial, or as generic tibolone. However, tibolone is not FDA-approved or commercially available in the United States.
Tibolone should only be used when prescribed by a doctor. It is contraindicated for women with current or suspected breast or endometrial cancer, severe liver disease, or circulation problems.
Main uses
Tibolone is indicated as hormone replacement therapy to:
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Relieve menopause symptoms, such as hot flashes, night sweats, mood changes, and vaginal dryness
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Prevent osteoporosis in women who have a higher risk of fractures, especially when other treatments are not recommended
Tibolone acts in the body in a similar way to several natural hormones. It is converted into substances that mimic the effects of estrogen, progesterone, and testosterone-like hormones.
According to the NHS, tibolone is a type of hormone replacement therapy used after menopause, including when symptoms are affecting quality of life.
Symptoms usually begin to improve after a few weeks, although the best results are typically seen after three months of treatment.
How to take
Tibolone is usually taken by mouth as a tablet once a day, ideally at the same time each day. You can take it with a glass of water, with or without food.
The typical dose is 1.25 mg or 2.5 mg once a day, for as long as your doctor has prescribed, which is usually at least three months.
If you forget a dose, take the tablet as soon as you remember, as long as no more than 12 hours have passed. If more than 12 hours have gone by, skip the missed tablet and take your next dose at the usual time. Do not take a double dose to make up for the one you missed.
Possible side effects
The most common side effects that may occur during treatment with tibolone are:
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Vaginal bleeding or discharge at the start of treatment
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Nausea
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Breast tenderness, especially in the first few weeks
Some less common side effects may include swelling, dizziness, mood changes, and abdominal discomfort.
In rare cases, tibolone may cause serious side effects, such as blood clots that can block veins or arteries. This can reduce blood flow and may lead to complications like thrombosis or embolism.
Effects of tibolone on the skin
Tibolone may have positive effects on the skin, such as increased elasticity, less dryness, and better hydration. This is due to its estrogen-like action, which helps maintain skin health after menopause.
However, some people may have mild side effects, such as acne, skin sensitivity, or excessive facial hair growth.
Does tibolone cause weight gain?
Tibolone does not usually cause significant weight gain in most women.
However, some people may notice changes in appetite or mild fluid retention at the start of treatment. There is no evidence that tibolone directly increases body fat.
Contraindications for use
Tibolone should not be used by people with:
- A history of hormone-dependent cancer, including breast cancer or endometrial cancer
- Genital bleeding with no clear cause
- Active liver disease or severe liver impairment
- Blood clotting disorders or thrombosis
- A known allergy to tibolone or any ingredient in the medication
According to the NHS, tibolone is also not recommended during pregnancy or breastfeeding. It should not be started within 12 months of the last natural menstrual period.