Differential effects on the androgen status of postmenopausal women treated with tibolone and continuous combined estradiol and norethindrone acetate replacement therapy

Dören, Martina; Rübig, Alexander; Bennink, Herjan J.T. Coelingh; Holzgreve, Wolfgang

doi:10.1016/s0015-0282(00)01768-4

Cited by 92 publications

(41 citation statements)

References 28 publications

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“…However, a similar trend was observed at three and six months, and previous studies of tibolone use have also shown an improvement in a variety of sexual factors 36,37 . The improvement may be related to the increase in free testosterone levels, and the consequent increase in androgenic activity, previously reported during tibolone use 38 . In contrast, the significant difference noted in economic status at three months is likely to be spurious as the data at 6 and 12 months did not show a similar trend.…”

Section: Discussionsupporting

confidence: 53%

Effects of tibolone and continuous combined hormone replacement therapy on bleeding rates, quality of life and tolerability in postmenopausal women

Huber¹

2002

BJOG: An International Journal of Obstetrics and Gynaecology

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Objective To compare the effects of tibolone and conjugated equine oestrogens continuously combined with medroxyprogesterone acetate on bleeding rates, quality of life (QoL) and tolerability. Design A double-blind, randomised comparative trial.Setting Thirty-seven centres in six European countries.Population Five hundred and one postmenopausal women, under 65 years of age with an intact uterus.Interventions For 12 months, women received daily treatment with tibolone 2.5 mg (n ¼ 250), or conjugated equine oestrogens 0.625 mg continuously combined with medroxyprogesterone acetate 5 mg (CEE-MPA, n ¼ 251). Main outcome measures The primary outcome was vaginal bleeding rate during cycles 4 -6. The secondary outcomes were vaginal bleeding rate during cycles 1 -3, 7-9 and 10 -13, cumulative bleeding rate, QoL, wellbeing, climacteric symptoms, urogenital complaints and tolerability. Results Treatment with tibolone led to a significantly lower bleeding rate during cycles 4 -6 compared with CEE -MPA (15.0% vs 26.9%; P ¼ 0.004); there was a similar difference during cycles 1-3. Both treatments improved QoL, wellbeing, climacteric symptoms and urogenital complaints. By intent-to-treat analysis, tibolone significantly improved sexual drive, interest and/or performance, compared with CEE -MPA at 12 months ( P ¼ 0.017). Although both treatments were well tolerated, there was a significantly lower incidence of breast tenderness with tibolone than CEE -MPA (2.4% vs 17.1%; P < 0.001). Conclusion The vaginal bleeding rate during cycles 4-6 was significantly lower in women using tibolone.Both treatments improved QoL, wellbeing, climacteric symptoms and urogenital symptoms. Breast tenderness was significantly less frequent with tibolone.

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Section: Discussionsupporting

confidence: 53%

Effects of tibolone and continuous combined hormone replacement therapy on bleeding rates, quality of life and tolerability in postmenopausal women

Huber¹

2002

BJOG: An International Journal of Obstetrics and Gynaecology

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“…Hence, a progestogen is not required and cyclical bleeding is not induced. In addition to having weak androgenic effects, tibolone significantly lowers SHBG, and increases circulating free testosterone further adding to its androgenicity [91]. The incidence of breast tenderness after treatment with tibolone is low [90] and mammographic density does not increase with tibolone, unlike with traditional oral HT [92].…”

Section: Tibolonementioning

confidence: 99%

Drugs for the treatment of menopausal symptoms

Davis

Jane

2010

Expert Opinion on Pharmacotherapy

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“…It is, therefore, very likely that another mechanism is operational that may contribute to the androgenic effects of tibolone. It is well-known that tibolone decreases the sex hormone binding globulin (SHBG) by about 50% in contrast to an oestrogen-containing therapy regimen [58] that increases SHBG levels by about 40%. The reduction of SHBG production by the liver may be explained by the high levels of the androgenic 4 -tib in liver tissue (Table 4).…”

Section: Levels Of Tibolone Metabolites In Brain Tissues and Relationmentioning

confidence: 99%

Metabolism of exogenous sex steroids and effect on brain functions with a focus on tibolone

Verheul¹,

Kloosterboer²

2006

The Journal of Steroid Biochemistry and Molecular Biology

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Differential effects on the androgen status of postmenopausal women treated with tibolone and continuous combined estradiol and norethindrone acetate replacement therapy

Cited by 92 publications

References 28 publications

Effects of tibolone and continuous combined hormone replacement therapy on bleeding rates, quality of life and tolerability in postmenopausal women

Effects of tibolone and continuous combined hormone replacement therapy on bleeding rates, quality of life and tolerability in postmenopausal women

Drugs for the treatment of menopausal symptoms

Metabolism of exogenous sex steroids and effect on brain functions with a focus on tibolone

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