Tibolone among drugs in the therapy of postmenopausal women

The ageing of society is undoubtedly a success, but also a challenge of modern medicine. Postmenopausal women struggle with many health problems, and their treatment recommended so far is often associated with many side effects such as the increased risk of hormone-dependent tumours or thromboembolism. The purpose of this article is to discuss the effects of a relatively new drug called tibolone against the currently recommended treatment. The unique mechanism of estrogenic, progestogenic, and androgenic action of tibolone is due to the breakdown of the parent compound into 3 active metabolites, each selectively acting on different tissues differently. Tibolone is approved for the relief of menopausal symptoms and its effectiveness is similar to that of hormone replacement therapy and the prevention of osteoporosis. The article will also discuss the results of various studies on the risk of cancer during treatment with tibolone, especially in comparison to hormone replacement therapy. Tibolone affects also the cardiovascular system, including reducing the level of lipoprotein a, total cholesterol, triglycerides, and HDL. Tibolone also has a neuroprotective effect and improves mood and libido. Like all medicines, tibolone is not free from side effects such as weight gain, vaginal bleeding, hirsutism, and inflammation of the reproductive organs, so the benefits and risks of therapy should always be considered. There are still no clear conclusions regarding many aspects of the influence of tibolone on the patient’s body, therefore large studies are needed to assess the effectiveness and safety of tibolone