How does tibolone work?
Tibolone is a type of hormone replacement therapy (HRT). Your body breaks tibolone down to produce substances that work in a similar way to oestrogen, progesterone and testosterone, hormones that decrease as you go through the menopause.
The fall in oestrogen caused by menopause can cause symptoms such as hot flushes, low mood, loss of interest in sex (low libido), and vaginal dryness or irritation. Progesterone is needed to protect your womb.
Taking tibolone increases your hormone levels so that they are similar to before the menopause. This helps to improve menopause symptoms.
When will I feel better?
It can take up to 3 months for hormone replacement therapy (HRT) to work fully in improving your symptoms.
There are different types of HRT, and it can take time to find the type and dose that works for you.
If you do not feel better after 3 months, speak to your doctor. They may suggest switching to a different type of HRT.
Are there any long-term side effects?
It's best to only take tibolone for as long as you need it to control your menopause symptoms.
This is because tibolone and other types of HRT can slightly increase the risk of breast cancer and blood clots. The risk is small, but it increases the longer you take it.
Usually, the risk is outweighed by the benefits of HRT, such as improving menopause symptoms, quality of life and preventing osteoporosis. But this depends on your age, symptoms and health. Speak to your doctor, who can help you decide.
How does it compare with other types of HRT?
There are several different types of HRT. There is not one type that is suitable for everyone. You may need to try different types to find what works best for you.
Tibolone is a synthetic (artificial) hormone. It may be recommended if you prefer not to take oestrogen or have problems with side effects. Some studies have suggested it may not be as effective as combined HRT.
Tibolone only comes as tablets. Some other types of HRT are available as tablets, capsules, patches, gel or spray.
Unlike oestrogen, with tibolone you do not need to also take progestogen if you still have your womb.
Your doctor can help you decide on the type of HRT that's best for you.
How does it compare with alternatives to HRT?
Hormone replacement therapy (HRT) such as tibolone or oestrogen and progestogen is usually the most effective treatment for menopause symptoms.
If you cannot take HRT, or prefer not to take it, your doctor may be able to recommend other medicines or lifestyle changes to help with your symptoms.
Medicines such as pregabalin, clonidine and some antidepressants (such as fluoxetine or sertraline) are sometimes used as an alternative to HRT to help with symptoms such as hot flushes, night sweats and mood swings.
What will happen if I stop taking it?
If you stop taking tibolone your menopause symptoms might come back.
Talk to your doctor if you're thinking of stopping. They will help you decide what's best for you.
If you're having problems with side effects, your doctor might suggest switching to another type of HRT.
Can I switch to a different brand?
Tibolone is available as a branded medicine called Livial, and as an unbranded (generic) medicine.
All tibolone medicines work in the same way, so changing to a different brand should not affect your treatment.
Can I get HRT for free?
You'll need to pay for your hormone replacement therapy (HRT) prescriptions unless you're eligible for free prescriptions.
However, you can reduce the cost by getting an HRT pre-payment certificate (PPC). This means you can pay a small fee that will cover all your HRT prescriptions for a year.
Find out how to save money with a prescription prepayment certificate.
Will I gain or lose weight?
Weight gain can be a side effect of taking tibolone. However, it's also common to gain weight around the time of the menopause, so it may not be your medicine that's causing you to put on weight.
Eating a balanced diet and exercising regularly will help you keep to a healthy weight.
Will it affect my contraception?
Tibolone is not contraception.
It's still possible to get pregnant while taking hormone replacement therapy (HRT). You'll need to use contraception until 2 years after your last period if you're under 50 years old, or for 1 year if you're over 50 years old.
You'll need to use a non-hormonal method of contraception, such as condoms or a diaphragm, or other options which you can speak to your doctor about.
Can I drive or ride a bike?
Tibolone will not usually affect your ability to drive or ride a bike.
Can I drink alcohol while taking tibolone?
You can drink alcohol while taking tibolone but it may be helpful to cut down on alcohol during the menopause to reduce symptoms of flushing, and improve your sleep.
Is there any food or drink I need to avoid?
You can eat and drink normally while taking tibolone.
Try to have a healthy diet, as this can help with menopause symptoms and keep you well.
Cutting down on alcohol and caffeine may help reduce hot flushes.
Can lifestyle changes help menopause symptoms?
The following lifestyle changes can sometimes help with menopause symptoms:
- Regular exercise. This helps with bone health and can reduce hot flushes and improve your sleep. It may also help improve your general mood, reduce stress and help you keep to a healthy weight.
- Cut down on caffeine and alcohol. This may help reduce hot flushes and improve your sleep.
- Quit smoking. This can help reduce hot flushes and reduce your risk of developing other health problems such as cancer, heart disease and stroke.
Find out more about lifestyle changes for menopause symptoms