The effect of tibolone versus 17β-estradiol on climacteric symptoms in women with surgical menopause: A randomized, cross-over study

Somunkiran, Aslı; Erel, C. Tamer; Demirci, Fuat; Şentürk, Levent M.

doi:10.1016/j.maturitas.2006.06.004

Cited by 22 publications

(17 citation statements)

References 32 publications

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“…An RCT that compared tibolone, 17A-estradiol, and placebo in a group of women with surgical menopause found differences in favor of tibolone in the alleviation of symptoms other than vasomotor symptoms (including nervousness, sleep disturbances, difficulty concentrating, sensation of fatigue or loss of energy, disinterest, crying, and migraines). 10 In our study, tibolone was better than estrogen therapy in alleviating mood and sexuality disorders, but it did not reach statistical significance (76.5% vs 42.8%, P = 0.08; and 91% vs 47%, P = 0.056, respectively). 9 One possible explanation for these findings is that tibolone normalizes A-endorphin levels, behavioral changes, and mood disorders caused by the combined activity of its metabolites on the central nervous system: that of the isomer $ 4 binding with receptors for androgens and those of the derived 3>-hydroxy and 3A-hydroxy forms binding with receptors for estrogens.…”

Section: Quality Of Lifecontrasting

confidence: 73%

Spanish Menopause Society position statement

et al. 2013

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Tibolone is a drug with complex tissue-specific action that exhibits a combination of estrogenic, progestogenic, and slight androgenic activity. Its variable profile explains its clinical effects, depending on the target tissue where it is metabolized, its metabolites' affinity for and potency in hormone receptors, and probable enzymatic activity modulation.In recent reviews and clinical trials, the effectiveness of tibolone in alleviating different hot flush menopause symptoms, mainly in mood and sexuality disorders, has been noted. In Spain, tibolone is the most prescribed hormonal treatment, and one of the most common complaints among postmenopausal women is change in sexual drive. For such reason, a panel of experts from the Spanish Menopause Society met to develop usage recommendations based on the best evidence available.

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Section: Quality Of Lifecontrasting

confidence: 73%

Spanish Menopause Society position statement

et al. 2013

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“…By contrast, the follow-up period in the study by Heyerick et al [9] was only 12 weeks, with discontinuation rates of 27% in the control group and 24% in the study group. Somunkiran et al [10] reported a follow-up period of 6 months, with subsequent crossover for a further 6 months.…”

Section: Discussionmentioning

confidence: 99%

“…Because estrogen can increase the levels of sex hormone-binding globulin (SHBG) and, therefore, lower the levels of free testosterone, the importance of androgen replacement in HRT is now becoming increasingly recognized. Because of its androgenic metabolite, tibolone can lower the levels of SHBG [10,11]; together with its effect on β-endorphins in the pituitary, this can help to alleviate sexual problems and improve mood in menopausal women. Improvements in urogenital symptoms were similar between the 2 groups.…”

Section: Discussionmentioning

confidence: 99%

“…Vehkavaara et al [12] reported an increase in SHBG levels with oral estrogen, and no change with transdermal estradiol. Somunkiran et al [10] reported that tibolone performed much better than estrogen in the alleviation of psychologic, somatic, and sexual symptoms. By contrast, in their study comparing tibolone with conjugated estrogen-medroxyprogesterone acetate, Huber et al [13] found no differences in total score on the Green Climacteric Scale [14].…”

Section: Discussionmentioning

confidence: 99%

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Effects of transdermal estradiol gel and oral tibolone on health‐related quality of life after surgical menopause

Bhattacharya

Jha

2010

Intl J Gynecology & Obste

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“…Wiklund et al,[113] further showed, in their study with transdermal estradiol, that there was an increase in feelings of physical attraction and sexual satisfaction compared to their placebo group. In addition, drugs like tibolone, which is a second generation SERM (selective estrogen receptor modulator), may even be beneficial after surgical menopause because of its effects in improving mood and sexual behavior [114,115]. …”

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confidence: 99%

Psychiatric Manifestations of Endocrine Disorders

Solomon¹

2017

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The endocrine system has been studied extensively from physiological, biochemical, and molecular approaches. However, much less attention has concentrated on the psychological aspects associated with these different endocrine diseases, and the necessity of addressing these psychological issues in order to effectively treat endocrine patients. Often, there is a significant impairment in the quality of life when it comes to these different endocrine diseases, and an interdisciplinary approach is needed in order to achieve the best possible outcome for the patient. It is our goal through this review to provide a comprehensive assessment of the psychological implications associated with different endocrine disorders. Specifically, we will address the psychological aspects associated with diabetes, Cushing's syndrome, Addison's disease, hyperthyroidism, hypothyroidism, hyperparathyroidism, hypoparathyroidism, pheochromocytoma, and androgen and estrogen disorders, as well as a brief correlation of transgender adults. Adrenal: Cushing's Syndrome and Addison's DiseaseOver the past few decades, a number of authors have found a significant amount of psychological disorders associated with Cushing's syndrome. Sonino and Fava [1] found that major depression is a life-threatening complication, which may affect 50-60% of patients with Cushing's syndrome. They found that it occurs in both the pituitary dependent and independent forms of the disease. Kelly et al., [2] found a similar association with 57% of 209 Cushing's syndrome patients having a significant psychiatric illness, usually depression. A follow-up study by Sonino et al.,[3] found that 54% of patients with pituitary-dependent Cushing disease had major depression according to DSM-IV criteria. They observed that the depression in Cushing's syndrome was significantly associated with female gender, older age, higher urinary cortisol levels, a relatively more severe clinical condition, and an absence of a pituitary adenoma. Other authors have also found the same correlation between depression and Cushing's syndrome [1,[4][5][6][7]. While depression is one of the most important psychological symptoms associated with Cushing's syndrome, other symptoms have been noticed. Starkman et al., [8] and Starkman [9] reported that around 66% of their Cushing's syndrome patients experienced generalized anxiety or panic disorders. Sonino et al., [10] also found a significant association between anxiety and Cushing's syndrome. In this same particular study, the authors also saw there was a significant association in their Cushing's syndrome patients with increased irritable mood, higher levels of stress, and lower physical well-being. Mania and hypomania are other psychological symptoms that have been associated with Cushing's syndrome by a number of authors [11,12].There has been a significant debate in the literature whether the psychological symptoms of Cushing's syndrome completely resolve after the remission of the disease. Several studies have found significant improvements or e...

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The effect of tibolone versus 17β-estradiol on climacteric symptoms in women with surgical menopause: A randomized, cross-over study

Cited by 22 publications

References 32 publications

Spanish Menopause Society position statement

Spanish Menopause Society position statement

Effects of transdermal estradiol gel and oral tibolone on health‐related quality of life after surgical menopause

Psychiatric Manifestations of Endocrine Disorders

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