Tibolone versus conjugated estrogens and sequential progestogen in the treatment of climacteric complaints.
OBJECTIVE
Tibolone has been shown to alleviate climacteric symptoms. This study was designed to compare the effect of tibolone (Livial, 2.5 mg daily) on different climacteric complaints and its impact on the endometrium, determined by vaginal ultrasound, with that of conjugated estrogens (Premarin, 0.625 mg daily) continuously for 6 months in combination with the progestogen medrogestone (Colpron, 2 x 5 mg daily for 12 days each month).


METHODS
One hundred and twenty-nine postmenopausal women were recruited and the severity of climacteric symptoms as well as endometrial thickness were recorded at the pre-trial examination and after 1, 3, and 6 months.


RESULTS
With the exception of vertigo, mood depression, mood disorder, loss of libido, and dryness of skin, where tibolone was found to be more effective than conjugated estrogens/medrogestone, climacteric symptoms improved significantly in both groups over the 6-month study period. Endometrial thickness did not increase significantly in the tibolone group, whereas in the conjugated estrogens/medrogestone group there was a highly significant increase after 1 month and still a trend towards significance after 6 months. Recurrence of vaginal bleeding occurred significantly less frequently in the tibolone group than in the comparison group.


CONCLUSIONS
Tibolone seems to offer a complete treatment of the climacteric complaints whilst avoiding some of the problems associated with classical hormone replacement therapy.
Egarter
C
C
Department of Obstet. Gynecol., University of Vienna, Austria.
Huber
J
J
Leikermoser
R
R
Haidbauer
R
R
Pusch
H
H
Fischl
F
F
Putz
M
M
D002979:Climacteric / Q000187:drug effects* / Q000502:physiology; D004305:Dose-Response Relationship, Drug; D004717:Endometrium / Q000033:anatomy & histology / Q000000981:diagnostic imaging / Q000187:drug effects; D004967:Estrogens / Q000009:adverse effects / Q000592:standards / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D009652:Norpregnenes / Q000009:adverse effects / Q000592:standards / Q000627:therapeutic use*; D011372:Progestins / Q000009:adverse effects / Q000592:standards / Q000627:therapeutic use*; D011795:Surveys and Questionnaires; D013997:Time Factors; D014463:Ultrasonography; D014592:Uterine Hemorrhage / Q000188:drug therapy / Q000453:epidemiology
D004967:Estrogens; D009652:Norpregnenes; D011372:Progestins; C027385:tibolone