Tibolone has been described as the hormone replacement therapy (HRT) you can use when you don’t want to use HRT. It was released in 2000 as a completely new method of managing the symptoms of the menopause and seems to suit many women very well, while others cannot tolerate it. It also prevents osteoporosis after the menopause. The normal dosage is one tablet a day.
It is not to be used in pregnancy, breastfeeding, children or if suffering from undiagnosed vaginal bleeding, hormone dependent tumours (eg. breast cancer), significant heart disease, recent stroke, blood clots or severe liver disorders.
Use tibolone with caution in patients with high cholesterol or triglycerides, liver disease or risk of blood clots (thromboses). It should not be started until a year after the last menstrual bleed before menopause.
Side effects may include weight gain, dizziness, headache and belly pain. Less commonly migraine, dermatitis, disturbed vision, skin irritation, nausea, constipation, breast pain and vaginal irritation may occur. Rare effects may include blood clots, liver damage and abnormal vaginal bleeding.
Interactions are possible between tibolone and other hormone replacement therapies used in menopause, anticoagulants (eg. warfarin), barbiturates, carbamazepine and rifampicin. Nausea and abnormal vaginal bleeding are the only likely effects of an overdose.