Tibolone

TIBOLONE ANTIBIOTICS-RIFAMPICIN 1 tibolone levels Induction of metabolism of tibolone Watch for poor response to tibolone consider T dose 

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A subsequent large epidemiologic study found a greater risk for breast cancer with combined estrogen-progestogen use, as well as increased risk for estrogen-only therapy and tibolone, but selection bias was found in the study population. 

FIGURE 31-1. Algorithm for management of postmenopausal women. °Tibolone is currently not approved for use in the United States. 

Tibolone is not recommended during the perimeno-pause because it may cause irregular bleeding... 

The Million Women Study reported that current use of hormone therapy increased breast cancer risk and breast cancer mortality. Increased incidence was observed for estrogen only, estrogen plus progestogen, and for tibolone. 

In conclusion, SERMs exhibit changes in inflammatory markers that do not match those found with oral HT. Some variability exists within HT itself, depending on the compound (estrogens or tibolone) and on the administration route (oral vs. transdermal). There is sufficient background to hold the value... 

Palomba S, Affinito P, Di Carlo C, Bifulco G, Nappi C (1999) Longterm administration of tibolone plus gonadotropin-releasing hormone agonist for treatment of uterine leiomyomas effectiveness and effects on vasomotor symptoms, bone mass, and lipid profile. Fertil Steril 72 889-895... 

Q60 Tibolone is preferred to continuous combined HRT preparations in premenopausal women. Tibolone poses an increased risk of thromboembolism compared with combined HRT or women not taking HRT. 

V.a.1.1. Oral HRT preparations. For oral therapy, there is a choice between conjugated equine oestrogens purified from urine, synthetic oestro-gens such as ethinyloestradiol and tibolone, and oestradiol itself. In women with an intact uterus, the oestrogen should normally be given in conjunction with a progestagen in order to protect the endometrium from unopposed oestrogenic stimulation. 

Another approach to the study of the effects of hormone replacement therapy on the breast is to examine breast density, using mammography and the Wolfe classification. In a randomized study of 166 menopausal women, using this technique, there was increased breast density after 6 months of treatment eight times more commonly in those who took estradiol and norethisterone acetate than in those who took tibolone (186). The significance of this increased density is not clear, but it should for the present be regarded as undesirable,... 

Berlanga C, Mendieta D, Alva G, Del Carmen Lara M. Failure of tibolone to potentiate the pharmacological effect of fluoxetine in postmenopausal major depression. J Women s Health 2003 12 33-9. 

Lundstrom E, Christow A, Kersemaekers W, Svane G, Azavedo E, Soderqvist G, Mol-Arts M, Barkfeldt J, von Schoultz B. Effects of tibolone and continuous combined hormone replacement therapy on mammographic breast density. Am J Obstet Gynecol 2002 186(4) 717-22. 

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