Editorial Does tibolone exacerbate atherosclerosis?

Thiseditorial refers to ‘Theeffectof tiboloneandcontinuous combined conjugated equine oestrogens plus medroxypro-gesterone acetate on progression of carotid intima–media thickness: the Osteoporosis Prevention and Arterial effects of tiboLone (OPAL) study’ † by M.L. Bots et al., on page 746 Tibolone is widely used in many countries (though not in the USA) for the treatment of post-menopausal symptoms and to inhibit post-menopausal bone loss. Tibolone’s popularity likely reflects the observation that it equals traditional hormone therapy in the relief of hot flushes, vaginal dryness, and the prevention of bone loss and, in addition, appears to increase libido. The post-menopausal benefits of tibolone relate to the uniqueness of the metabolism of the parent molecule. In human and non-human primates