Clinical experience with tibolone (Livial) over 8 years

Tibolone (Livial), a synthetic steroid, relieves climacteric symptoms and maintains skeletal integrity in postmenopausal women. We have been using this compound for 8 years and have now reviewed our clinical experience in 301 postmenopausal women. The majority (65.12%) had not previously received climacteric therapy; 34.55% had previously received oestrogen/progestogen therapy. A significant proportion of those started on tibolone were specifically referred for consideration of non-oestrogenic therapy because of a past history of breast dysfunction--27 women with benign breast disease and 11 women who had undergone surgery for carcinoma of the breast. Overall tibolone was well tolerated and climacteric symptoms were relieved within 3-5 weeks. The major side effect was weight gain and/or a tendency to bloating and oedema which occurred in 11.28% of our women. Vaginal bleeding occurred in 33 women (12.69%) but in 17 of these women the bleeding was due to recent oestrogen therapy. Bleeding resulted from a polyp or fibroid in 11 women; no cause was found in the remaining five. Breast symptoms were reported by only 7.52% and no breast symptoms were reported in any of the 27 women referred because of benign breast disease. The total 'drop-out-rate' due to side effects was only 2.66% (eight women).