Tibolone

Tibolone itself is devoid of activity, but it is metabolized in a tissue-selective manner to three metabolites. These metabolites have predominantly estrogenic, progestogenic, and androgenic activities, providing a combined hormonal effect.

Adult

Hormone replacement therapy (HRT) with small doses of an oestrogen (together with a progestogen in women with a uterus) is appropriate for alleviating menopausal symptoms such as vaginal atrophy or vasomotor instability.…

• Increased risk of irregular bleeding (unopposed estrogen)
• Existing breast cancer
• Pregnancy
• Thromboembolic, coronary and cerebrovascular disease or history
• Moderate-to-severe hypertension
• Hyperlipidaemia
• Active liver disease, hepatoma or history of jaundice during past pregnancy
• Suspected/overt malignancy of genitals/breast
• Porphyria
• Impending major surgery (to avoid excess risk of postoperative thromboembolism)