[Clinical aspects of Livial in postmenopausal replacement therapy]

It's a review of literature on the clinical effects of Livial. Livial (generic name-tibolone) makes a therapy of choice for postmenopausal women. It's a synthetic steroid with estrogenic, progestagenic and androgenic properties due to its tissue specific effects. Livial is effective in reducing wasomotors symptoms and has positive effects on mood and libido. It also prevents bone loss and reduces risk of fractures. Livial is safe for cardiovascular system. The incidence of side effects is very low, about 3 in every one hundred. Because of its progestagenic activity in endometrium it results in endometrial atrophy but in vagina the studies showed oestrogen--like effects, i.e. improvement in vaginal dryness. Livial may be used as an "add-back" therapy in conjunction with GnRH agonists treatment. The rates of discontinuation is lower than HTR preparations, about 25%. Livial may have benefits over conventional HRT in older women (over 65 years old), in women with history of endometrial cancer, breast cancer and endometriosis.