Tibolone (Generic Livial) (28 Tablets)


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  • Non-Hormonal Ingredients
  • Effective Relief From Menopause Symptoms
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Livial 2.5 mg tablets provide relief from menopausal symptoms, including osteoporosis. It is a form of hormone replacement therapy (HRT).

Livial contains one ingredient, Tibolone, which breaks down in the body into components which emulate the sex hormones oestrogen, progesterone and testosterone.

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Tibolone (Generic Livial)

Tibolone (Generic Livial) is a medication used as Hormone Replacement Therapy (HRT). It contains tibolone, a substance that has favourable effects on different tissues in the body, such as brain, vagina and bone.

For at least 12 months since their last natural period, Tibolone (Generic Livial) is used in postmenopausal women.

There are two conditions Tibolone (Generic Livial) help treat and prevent. Prevention of osteoporosis, which is the development on fragile bones after menopause and symptom relief during menopause, alleviating symptoms due to a drop in oestrogen production.

Tibolone HRT

Tibolone HRT and other HRT (Hormone Replacement Therapies) are treatment options for women who are suffering the most from symptoms of the menopause. The production of the hormone called oestrogen is reduced as a woman enters menopause and requires ‘topping up’ so to speak, thus HRT and Tibolone HRT are used.

The main benefits of Tibolone HRT are relieving menopausal symptoms, such as:

  • Hot flushes
  • Night sweats
  • Mood swings
  • Vaginal dryness
  • Reduced sex drive

Many of these symptoms are unpleasant and can make life difficult. Tibolone HRT offers relief until symptoms pass after a few years.

Tibolone BNF

The Following are cautions and guidance’s from the Tibolone BNF. The Tibolone BNF guidance states that:

  • Unsuitable for use in the premenopause and as an oral contraceptive.
  • Also unsuitable for use within 12 months of the last menstrual period. This could cause irregular bleeding.
  • Transferring from a cyclical HRT, treatment should be started at the end of that regimen; transferring from a continuous-combined HRT, start treatment at any time.

Further information can be found on the Tibolone BNF page on the British National Formulary website, including further interactions and cautions.

Tibolone Tablets

During the menopause, the amount of oestrogen produced by the body is reduced. This causes symptoms such as hot flushes on the neck and face. Tibolone Tablets alleviate these symptoms after menopause. Tibolone tablets will only be prescribed if symptoms seriously hinder day to day life.

After the menopause some women may develop a condition called osteoporosis. Osteoporosis is a bone disease that cause the body to lose too much bone, makes too little bone, or both. As a result of this, the bones become weak and may break from a simple fall, or in more severe cases, from sneezing and minor bumps.

If you are at an increased risk of fractures due to osteoporosis and other medications have been unsuitable for you, Tibolone tablets can be prescribed to prevent osteoporosis after menopause.

Livial Tibolone 2.5 mg

Before being prescribed Livial Tibolone 2.5 mg your medical history may need to be examined. This is because of the risks associated with HRT use that need to be considered when deciding whether to start taking it, or to carry on taking it.

A physical examination may also be required. This could include examination of the breasts and/or an internal examination, if necessary. Your doctor should be made aware of any medical problems or illnesses before Livial Tibolone 2.5 mg is used.

Once the course of Livial Tibolone 2.5 mg has been started, regular check-ups with your doctor should have already been arranged. This will consist of discussions about the benefits and risks of continuing use of Livial Tibolone 2.5 mg.

Make sure to:

  • Attend regular breast screenings and cervical smear tests
  • Regularly check your breasts for any changes such as dimpling of the skin, changes in the nipple, or any lumps you can see or feel.

Is Tibolone a HRT

Is Tibolone a HRT?

Yes, Tibolone is indeed a hormone replacement therapy medication. However, due to the ingredient, it’s different from other HRT.

There are three different types of hormone replacement therapy:

  • Oestrogen-only HRT
  • Combined HRT, containing two kinds of female hormone, an oestrogen and a progestogen.
  • Tibolone, which contains the substance called tibolone.

Instead of containing hormones such as progestogen and oestrogen, Tibolone contains tibolone. Tibolone is broken down by the body to create hormones. The effects and benefits are similar to combined HRT.

Other related questions about “Is Tibolone a HRT?” should be directed at a doctor or pharmacist.

Hormone Replacement Therapy (HRT) Overview – NHS Website

Tibolone Side Effects

The following disease are reported more often in women using HRT compared to women not using HRT:

  • Breast cancer
  • Abnormal growth or cancer of the lining of the womb
  • Ovarian cancer
  • Blood clots in the veins of the legs or lungs
  • Heart disease
  • Stroke
  • Probable memory loss if HRT is started over the age of 65.

Like with all medicine, Tibolone Side Effects can occur but aren’t experienced by everyone. If you experience any of these Tibolone Side Effects, especially if any of them are getting progressively worse, immediately stop and speak to your doctor as soon as possible.

Serious Tibolone Side Effects – see a doctor straight away

  • Notice a rise in blood pressure
  • The white of the eyes or skin turn yellow
  • Suddenly experience migraine-like headaches
  • Signs of a blood clot
  • If you get any of the problems listed in section 2 of the patient information leaflet

Common Side Effects

  • Breast pain
  • Stomach or pelvic pain
  • Unusual hair growth
  • Vaginal bleeding or spotting
  • Vaginal problems such as more secretions, itching, irritation
  • Inflammation of the vulva and vagina
  • Thrush
  • Thickening of the lining of the womb or the lining of the cervix
  • Tissue changes in the cervix
  • Abnormal cervical smear
  • Weight gain

Uncommon Side Effects

  • Swollen hands, ankles or feet – a sign of fluid retention
  • Stomach upset
  • Acne
  • Painful nipples or breasts feeling uncomfortable
  • Vaginal infections
  • Fungal infection

Rare Side Effects

  • Itchy skin

Losing Weight On Tibolone

One of the main concerns we see about using this specific HRT ingredient, tibolone, is losing weight whilst taking it. Losing weight on Tibolone is not a side effect that has been commonly reported. However, HRT can reverse weight gain when regulating estrogen levels. Estrogen plays a major role in metabolism, body weight, muscles mass and insulin production. When estrogen levels fall, interference with weight can occur, causing weight gain or difficulty losing weight.

Losing weight on Tibolone because of taking it won’t happen. But trying to lose weight whilst taking Tibolone may be harder than when not taking it.

On the flip side, the NHS disagrees with the argument that HRT causes weight gain. They say that no evidence currently supports HRT weight gain claims. According to the NHS, you’ll gain weight during the menopause, but that will happen regardless of whether or not you take HRT.

Can Tibolone Cause Depression

Can Tibolone cause depression? A recent randomized controlled trial found that 12 weeks of tibolone significantly improved depression severity in women around the menopause who presented with depression, without any significant side effects.

However, many women have reported that they have noticed an increase in depression when using Tibolone.

This will vary from person to person. Side effect such as depression will need to be taken into account when deciding whether or not to continue or start taking Tibolone.

Ask questions or similar questions related to “Can Tibolone cause depression?” to your doctor. They will help you decide which HRT treatment is best for you. If you already struggle with depression, this will be taken into consideration when choosing.

Tibolone Anxiety

Low mood and feelings of depression can be a very common symptom of menopause and perimenopause. Other psychological symptoms related to depression can also appear; reduced motivation, irritability, poor concentration etc.

Taking the right type of oestrogen, such as Tibolone anxiety, can truly improve low mood and anxiety. Many women find that they feel calmer, have more energy, and are generally happier when taking HRT.

If you experience Tibolone anxiety and it doesn’t improve 3 months after starting your treatment, speak to your doctor. Anxiety doesn’t need to be a side effect you suffer from endlessly whilst taking HRT.

What Is Tibolone Used For

“What is Tibolone used for?” is a commonly asked question, so let’s answer “What is Tibolone used for?”

The main ingredient in each Tibolone tablet is called tibolone. Tibolone works by mimicking the activity of the female sex hormones called oestrogen and progesterone. By restoring the balance between these two hormones, symptoms such as hot flushes and irritability seen in a majority of menopausal cases, can be eased.

Tibolone is also used for treating osteoporosis. The first few years after the menopause, women lose bone rapidly, particularly if menopause begins early (before the age of 45).

Tibolone Over 60

For women using Tibolone over 60 years of aged, the risks associated with tibolone start to outweigh the benefits due to the increased chance of stroke and memory related issues.

When deciding between different hormone replacement therapy medications, healthcare professionals will need to weigh the risks of stroke against the potential benefits of giving Tibolone over 60 years of age.

Stroke has been identified to occur up to 2.2 times more in tibolone users, especially in the first year of treatment. The base line risk of experiencing a stroke increases with age without tibolone, so with tibolone the risk is increased further.

Tibolone Risks

Before using this medication you should be aware of the many Tibolone risks. You and your doctor will need to decide if the Tibolone risks outweigh the benefits.

  • Risk of increased cell growth and cancer of the lining of the womb. The risk of cancer of the lining of the womb increase the longer you take Tibolone.
  • Reports suggest that taking combined HRT and possibly oestrogen-only HRT increases the risk of breast cancer. Again, additional risk will be determined by how long you take the medication.
  • Slightly increased risk of ovarian cancer.
  • Risk of blood clots in the veins is up to 1.3 to 3 times higher in HRT user than non-users, especially in the first year of taking it.
  • Women taking Tibolone and other HRT medication are more likely to develop heart disease than those not using HRT.
  • Risk of stroke is increase 1.5 times higher when using Tibolone.

Tibolone Withdrawal Symptoms

It’s common to experience Tibolone withdrawal symptoms when coming off Tibolone HRT. The chance of experiencing these withdrawal symptoms increase if the correct guidance isn’t followed. Menopausal symptoms may come back or, even worse, become more pronounced.

As HRT medication is only supposed to be used as a temporary solution, coming off Tibolone and avoiding Tibolone withdrawal symptoms can only happen if it’s appropriately managed. The majority of HRT medication needs to be stopped gradually, over a course of a two-to-four month period.

Gradually decreasing the HRT dose reduces the risk of Tibolone withdrawal symptoms from appearing. It will also reduce the risk of menopausal symptoms returning in the short-term.


The menopause is when a woman stops having periods and is no longer able to get pregnant naturally.

Periods usually start to become less frequent over a few months or years before they stop altogether.
The menopause is a natural part of ageing that usually occurs between 45 and 55 years of age, as a woman’s oestrogen levels decline. In the UK, the average age for a woman to reach the menopause is 51.

Symptoms of the menopause

Most women will experience menopausal symptoms. Some of these can be quite severe and have a significant impact on your everyday activities.

Common symptoms include:

hot flushes
night sweats
vaginal dryness and discomfort during sex
difficulty sleeping
low mood or anxiety
reduced sex drive (libido)
problems with memory and concentration

When to see a GP

It’s worth talking to a GP if you have menopausal symptoms that are troubling you or if you’re experiencing symptoms of the menopause before 45 years of age.

Treatments for menopausal symptoms

Your GP can offer treatments and suggest lifestyle changes if you have severe menopausal symptoms that interfere with your day-to-day life.

These include:

hormone replacement therapy (HRT) – tablets, skin patches, gels and implants that relieve menopausal symptoms by replacing oestrogen
vaginal oestrogen creams, lubricants or moisturisers for vaginal dryness
cognitive behavioural therapy (CBT) – a type of talking therapy that can help with low mood and anxiety
eating a healthy, balanced diet and exercising regularly – maintaining a healthy weight and staying fit and strong can improve some menopausal symptoms
Your GP may refer you to a menopause specialist if your symptoms do not improve after trying treatment or if you’re unable to take HRT.

What causes the menopause?

The menopause is caused by a change in the balance of the body’s sex hormones, which occurs as you get older.

It happens when your ovaries stop producing as much of the hormone oestrogen and no longer release an egg each month.


Most women will experience some symptoms around the menopause. The duration and severity of these symptoms varies from woman to woman.

On average, most symptoms last around 4 years from your last period. However, around 1 in every 10 women experience them for up to 12 years.

Changes to your periods
The first sign of the menopause is usually a change in the normal pattern of your periods. Eventually, you’ll stop having periods altogether.

Common menopausal symptoms

These can have a significant impact on daily life for some women.

Common symptoms include:

hot flushes – short, sudden feelings of heat, usually in the face, neck and chest, which can make your skin red and sweaty
night sweats – hot flushes that occur at night
difficulty sleeping – this may make you feel tired and irritable during the day
a reduced sex drive (libido)
problems with memory and concentration
vaginal dryness and pain, itching or discomfort during sex
mood changes, such as low mood or anxiety
palpitations – heartbeats that suddenly become more noticeable
joint stiffness, aches and pains
reduced muscle mass
recurrent urinary tract infections (UTIs)
The menopause can also increase your risk of developing certain other problems, such as weak bones (osteoporosis).

See your GP if you’re finding your symptoms particularly troublesome, as treatments are available. Read about how to manage symptoms of the menopause.


The main treatment for menopausal symptoms is hormone replacement therapy (HRT), although other treatments are also available for some of the symptoms.

Hormone replacement therapy (HRT)

HRT involves taking oestrogen to replace the decline in your body’s own levels around the time of the menopause. This can relieve many of the associated symptoms.

There are two main types of HRT:

combined HRT (oestrogen and progestogen) – for women with menopausal symptoms who still have their womb (oestrogen taken on its own can otherwise increase your risk of womb cancer)
oestrogen-only HRT – for women who have had their womb removed in a hysterectomy
HRT is available as tablets, skin patches, a gel to rub into the skin or implants.

HRT is extremely effective at relieving menopausal symptoms, especially hot flushes and night sweats, but there are a number of side effects, including breast tenderness, headaches and vaginal bleeding. It’s also associated with an increased risk of blood clots and breast cancer in some women.

HRT is not advisable for some women, such as those who have had certain types of breast cancer or are at high risk of getting breast cancer.

Your GP can give you more information about the risks and benefits of HRT to help you decide whether or not you want to take it.

Hot flushes and night sweats

If you experience hot flushes and night sweats as a result of the menopause, simple measures may sometimes help, such as:

wearing light clothing
keeping your bedroom cool at night
taking a cool shower, using a fan or having a cold drink
trying to reduce your stress levels
avoiding potential triggers, such as spicy food, caffeine, smoking and alcohol
taking regular exercise and losing weight if you’re overweight
If the flushes and sweats are frequent or severe, your GP may suggest taking HRT.

Mood changes

Some women experience mood swings, low mood and anxiety around the time of the menopause.
Self-help measures such as getting plenty of rest, taking regular exercise and doing relaxing activities such as yoga and tai chi may help. Medication and other treatments are also available, including HRT and cognitive behavioural therapy (CBT). Antidepressants may help if you’ve been diagnosed with depression.

Reduced sexual desire

It’s common for women to lose interest in sex around the time of the menopause, but HRT can often help with this.

Vaginal dryness and discomfort

If your vagina becomes dry, painful or itchy as a result of the menopause, your GP can prescribe oestrogen treatment that’s put directly into your vagina as a pessary, cream or vaginal ring.

This can safely be used alongside HRT.

You’ll usually need to use vaginal oestrogen indefinitely, as your symptoms are likely to return when treatment stops. However, side effects are very rare.

You can also use over-the-counter vaginal moisturisers or lubricants in addition to, or instead of, vaginal oestrogen.

Weak bones

Women who have been through the menopause are at an increased risk of developing osteoporosis (weak bones) as a result of the lower level of oestrogen in the body.

You can reduce your chances of developing osteoporosis by:

taking HRT – HRT can help to prevent osteoporosis, although this effect doesn’t tend to last after treatment stops
exercising regularly – including weight-bearing and resistance exercises
eating a healthy diet that includes plenty of fruit, vegetables and sources of calcium, such as low-fat milk and yoghurt
getting some sunlight – sunlight on your skin triggers the production of vitamin D, which can help to keep your bones strong
stopping smoking and cutting down on alcohol
taking calcium and/or vitamin D supplements if you don’t feel you’re getting enough of these – discuss this with your GP

Follow-up appointments

If you’re having treatment for your menopausal symptoms, you’ll need to return to your GP for a follow-up review after 3 months, and once a year after that.

Side Effects

Like all medicines, Livial HRT can cause side effects, although not everyone will experience them. HRT treatments generally cause temporary side effects, but it’s important to speak to your doctor if you have any concerns.

Three of the most common side effects of Livial are:

– Breast pain
– Stomach or pelvic pain
– Unusual hair growth

For a full list of Livial side effects, please see the patient information leaflet.

Because HRT tablets can increase your likelihood of developing a blood clot whilst HRT patches and gels don’t, you should be sure that you have discussed all the risks with your doctor before starting HRT.

The following diseases are more likely to be reported in women taking HRT than those that aren’t:

– Breast cancer
– Endometrial hyperplasia / cancer
– Ovarian cancer
– Blood clots in the veins of the legs or lungs
– Heart disease
– Stroke
– Memory loss (if HRT is started over the age of 65)

Further Information