Comparison of the Efficacy of Tibolone and Transdermal Estrogen in Treating Menopausal Symptoms in Postmenopausal Women

Abstract

Objectives: This study aimed to compare the efficacy of tibolone and transdermal estrogen in treating menopausal symptoms in postmenopausal women with an intact uterus. Methods: Overall, 26 women consumed tibolone orally and 31 women received transdermal estrogen gel mixed with progestogen. The menopause rating scale (MRS) was used to assess their menopausal symptoms at their first outpatient visit and 6 months later. Results: The transdermal estrogen group showed significant improvements in more items of the MRS questionnaire. There was a favorable change in body weight in the transdermal estrogen group compared with that in the tibolone group. Depressive mood, irritability, physical and mental exhaustion, sexual and bladder problems, and joint and muscular discomfort improved only in the transdermal estrogen group, whereas heart discomfort and vaginal dryness improved only in the tibolone group. Nevertheless, the intergroup differences in each item were insignificant after adjusting for body mass index and hypertension, which differed before treatment. Conclusions: Both the therapeutic options improved menopausal symptoms within 6 months of use. However, transdermal estrogen appeared to be more effective in preventing weight gain in menopausal women than tibolone.

Tibolone among drugs in the therapy of postmenopausal women

“…Alternative therapy is the administration of tibolone, which, due to its unique mechanism of action, also works well in alleviating menopausal symptoms, and studies comparing oral hormone replacement therapy with tibolone shows similar effectiveness. At the same time, the incidence of vaginal bleeding and breast tenderness is lower than with standard HRT [11,12].…”

“…However, in another study comparing the effects of tibolone and transdermal estrogen in surgically menopausal women, tibolone was more effective [12].…”

“…It is important to remember about the side effects of hormone replacement therapy, such as mastodynia, fluid retention, nausea, leg cramps, headache, uterine bleeding, increased risk of thromboembolism (it seems that the solution could be the percutaneous supply of estrogen, which poses a lower risk of a thromboembolic event) as well as depression, anxiety, bloating and increased appetite if the progesterone component is also included. And in long-term follow-up, they can lead to the development of tumors, which will be discussed in more detail later in this article [10,11,12].…”

Menopause Hormone Therapy

“…Tibolone has been shown effective in managing VMS, reducing bone fracture, and improving sexual dysfunction related to the menopause transition [89][90][91][92]. Tibolone may have an improved breast cancer and endometrial cancer risk profile over E + P [93]. As breast cancer is a rare to infrequent event after prolonged duration of exposure to E + P, the small sample sizes and limited duration of tibolone studies make interpretation of actual risk difficult.…”

Uso de estrogênio e progesterona na terapia hormonal pós-menopausa: revisão sistemática de sua influência no domínio cognitivo

“…Os sintomas da menopausa afetam aproximadamente 75% das mulheres (Kim et al, 2019). São relatados sintomas vasomotores, ressecamento vaginal, diminuição da libido, insônia, fadiga, dor nas articulações e nos músculos (Lund et al, 2018;Santoro et al, 2015).…”