Efficacy, tolerability, and rare side effects of tibolone treatment in postmenopausal women

Egarter, Christian; Sator, Michael; Berghammer, Peter; Huber, Johannes

doi:10.1016/s0020-7292(99)00002-8

Cited by 39 publications

(10 citation statements)

References 10 publications

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“…Improvements on psychological and somatic scales have also been found to be superior with tibolone compared with traditional HRT10. Tibolone is well tolerated11 and does not cause weight gain in menopausal women. Tibolone does not stimulate the endometrium13,14, and, in comparison to EPT, does not increase the size of uterine myomas15.…”

Section: Introductionmentioning

confidence: 95%

Updated clinical recommendations for the use of tibolone in Asian women

Huang

Baber

2010

Climacteric

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Tibolone, which is indicated for the relief of climacteric symptoms and the prevention of osteoporosis in postmenopausal women, has a tissue-specific mode of action different to that of conventional hormone replacement therapy (HRT). A large proportion of Asian postmenopausal women experience symptoms that most frequently include musculoskeletal pain, insomnia, forgetfulness, hot flushes and sexual dysfunction, and there is a need to address their specific requirements. Recent studies show that, in comparison to HRT, tibolone is as effective in alleviating menopausal symptoms and preventing bone loss, has a greater positive effect on sexual dysfunction and is associated with less vaginal bleeding, but it is rarely mentioned in guidelines for menopausal treatment. Levels of awareness amongst women about treatments for menopausal symptoms vary between Asian countries but, even in countries where awareness is high, HRT usage is much lower than in the West. To provide a practical approach to the use of tibolone in Asian postmenopausal women, a panel of experts in the management of menopause from 11 Asia Pacific countries has developed recommendations for its use, based on the evidence from clinical studies published since 2005. However, as much of the clinical data reviewed are from international studies, the recommendations and the treatment algorithm presented here are widely applicable.

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Section: Introductionmentioning

confidence: 95%

Updated clinical recommendations for the use of tibolone in Asian women

Huang

Baber

2010

Climacteric

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“…The purpose of HRT is not only to prevent major health disorders related to menopause such as osteoporosis, but also to relieve climacteric and postmenopausal symptoms of central origin 33 . The purpose of HRT is not only to prevent major health disorders related to menopause such as osteoporosis, but also to relieve climacteric and postmenopausal symptoms of central origin 33 .…”

Section: Introductionmentioning

confidence: 99%

Effect of different hormonal replacement therapies on circulating allopregnanolone and dehydroepiandrosterone levels in postmenopausal women

Bernardi

Pieri

Stomati

et al. 2003

Gynecological Endocrinology

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The effects of hormone replacement therapy (HRT) on the central nervous system in postmenopausal women might be mediated by changes in neurosteroid synthesis and/or release. The aim of this study was to evaluate the impact of HRT on the levels of allopregnanolone, a sedative anxiolytic GABA(A) agonist steroid, and dehydroepiandrosterone (DHEA), a GABA(A) antagonist steroid. We evaluated allopregnanolone and DHEA circulating levels after 1, 3, 6, 9 and 12 months of HRT with ten different estrogen or estrogen-progestin molecules, regimens and routes of administration in 186 postmenopausal women. Cortisol, luteinizing hormone, follicle stimulating hormone, estradiol and progesterone levels were also evaluated. Allopregnanolone levels significantly increased during follow-up with all HRT preparations. The addition of progestin molecules (except for 19-nor derivatives) to transdermal estradiol administration alone determined a higher increase in allopregnanolone levels. Transdermal HRT showed a significantly higher percentage change in allopregnanolone levels compared with oral HRT. DHEA levels showed a progressive decline starting from the 3-month follow-up, without significant differences between the transdermal and oral groups, as well as among the ten groups, independently of the presence and type of progestin molecule used. In conclusion, HRT strongly modifies circulating neurosteroid levels in postmenopausal women.

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“…Table 4 shows that frequencies of nauseas, headache, breast tenderness, and weight gain were significantly higher in CEE group as compared with tibolone and DHEA (p \ 0.05). In a similar study, Egarter [7] concluded that tibolone very effectively alleviates complaints that are normally attributed to ERT, e.g., headache, breast tenderness, and edema. In the current study, DHEA caused mainly androgenic side effects.…”

Section: Discussionmentioning

confidence: 91%

A Comparative Study of CEE, Tibolone, and DHEA as Hormone Replacement Therapy for Surgical Menopause

Gupta

Mittal

Khuteta

et al. 2012

J Obstet Gynecol India

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Objective(s) The objective of this study was to compare the efficacy and safety of CEE, tibolone, and DHEA for prevention of menopausal symptoms. Method(s) One hundred patients with surgical menopause were included in this study: 25 of whom were not treated with any HRT, 25 were treated with 0.625 mg of CEE, 25 were treated with 2.5 mg of tibolone, and 25 were treated with 25 mg of DHEA for 1 year, and the results were statistically analyzed regarding drug efficacy and side effects at follow-up periods of 1, 6 and 12 months. Result(s) Frequency of menopausal symptoms was significantly less in cases received with CEE, tibolone, DHEA with p values 0.001, 0.004 and 0.004, respectively. Percentage gain in BMD was 2.8 % with CEE at lumbar spine, which was greater than that caused by DHEA and tibolone, but this difference was not statistically significant. CEE caused side effects like headache (40 %) and nausea (28 %). Conclusion(s) CEE, Tibolone, and DHEA are very effective in alleviating climacteric symptoms. CEE has beneficial effects on lipid and bone and is a low-cost drug but frequently causes side effects. Tibolone offers beneficial androgenic effects on mood and libido with fewer side effects but is a costly drug. DHEA shows positive effects on psychological symptoms. However, its cost and androgenic side effects limit its use as long-term HRT.

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Efficacy, tolerability, and rare side effects of tibolone treatment in postmenopausal women

Abstract: Tibolone provides an efficient and safe means of treating the postmenopausal syndrome in every-day practice.

Cited by 39 publications

References 10 publications

Updated clinical recommendations for the use of tibolone in Asian women

Updated clinical recommendations for the use of tibolone in Asian women

Effect of different hormonal replacement therapies on circulating allopregnanolone and dehydroepiandrosterone levels in postmenopausal women

A Comparative Study of CEE, Tibolone, and DHEA as Hormone Replacement Therapy for Surgical Menopause

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