Tibolone is a synthetic hormone used to relieve menopausal symptoms such as hot flushes, night sweats, and vaginal dryness. It belongs to a class of medications known as menopausal hormone therapy (MHT), the term that has replaced "hormone replacement therapy" (HRT) in current medical practice.

Though classified as MHT, tibolone works differently from conventional formulations such as oestrogen-only tablets or combined oestrogen-progestogen therapies.

Once absorbed, tibolone acts as a prodrug, meaning it converts into three active compounds (metabolites) in the body, each acting like a different hormone:

• Oestrogenic metabolites help reduce hot flushes, night sweats, and vaginal dryness by restoring some of the oestrogen your body loses during menopause.
• Progestogenic metabolites protect the uterine lining (endometrium) from excess growth, reducing the need for a separate progestogen medication.
• Androgenic metabolites may support libido, energy levels, and mood through testosterone-like activity.

These metabolites are tissue-selective, meaning their effects vary depending on which part of the body they reach. This is why a single tablet can address multiple menopausal symptoms without requiring separate hormone medications.

The main difference between tibolone and conventional MHT is that tibolone combines oestrogenic, progestogenic, and androgenic effects in a single tablet, whereas standard MHT typically requires separate oestrogen and progestogen medications.

Tibolone is generally prescribed for postmenopausal women who are at least 12 months past their last menstrual period. Conventional MHT can be started earlier during perimenopause, making it suitable for a broader range of women experiencing hormonal changes.

Tibolone is primarily prescribed to relieve common menopausal symptoms and may also help with bone health. Symptoms it can address include:

Low Libido

Unlike standard oestrogen-only MHT, tibolone has androgenic properties that may improve sexual desire and arousal. This makes it a consideration for women who experience a noticeable drop in libido during menopause.

Mood Changes

Some women experience mood swings, irritability, or low mood during menopause. Tibolone's combined hormonal activity may help stabilise mood, though individual responses vary.

Bone Loss

Tibolone helps maintain bone mineral density in postmenopausal women, reducing the risk of osteoporosis-related fractures. While it is not typically a first-line treatment for osteoporosis, it provides bone-protective benefits alongside symptom relief.

Tibolone is not suitable for everyone. It is generally not recommended if you:

• Have a history of breast cancer or other hormone-sensitive cancers
• Have active or recent blood clots (deep vein thrombosis or pulmonary embolism)
• Have a history of stroke or heart disease
• Have unexplained vaginal bleeding
• Have untreated endometrial hyperplasia (abnormal thickening of the uterine lining)
• Have active liver disease or a history of liver tumours
• Are still having menstrual periods or are less than 12 months postmenopausal
• Are pregnant or breastfeeding

If you have risk factors for blood clots, cardiovascular disease, or hormone-sensitive conditions, your doctor will assess whether tibolone is appropriate for you.

Like all medications, tibolone can cause side effects, though not everyone experiences them. Most side effects are mild and tend to settle within the first few months of treatment.

Common side effects include:

• Breast tenderness
• Weight changes (some women report modest weight gain)
• Increased hair growth (due to androgenic activity)

Less common side effects include:

• Headache or migraine
• Skin changes such as acne or itching
• Fluid retention
• Joint or muscle pain
• Changes in liver function (detected through blood tests)

Contact your doctor promptly if you experience unusual or heavy vaginal bleeding after the first few months of treatment, or leg swelling (possible signs of a blood clot), yellowing of the skin or eyes (possible signs of liver problems), or new or worsening breast lumps.

Seek immediate emergency care if you experience sudden chest pain or breathlessness (possible signs of a blood clot in the lungs), or difficulty speaking, weakness in your arm or leg, or drooping on one side of the face (possible signs of a stroke).

Tibolone and Breast Cancer Risk

The link between tibolone and breast cancer risk is not clear-cut. Some studies have reported a small increase in risk, while others, including research involving Asian women, have found no increased risk or even a reduced risk. Overall, the evidence suggests that tibolone carries a lower breast cancer risk than conventional oestrogen-progestogen therapy.

Where an increased risk has been reported, it appears to be small and linked to longer duration of use. Your doctor can help you weigh the benefits against the risks based on your personal and family history.

At ATA Medical, we offer consultations for menopause management including tibolone, with the prices as follows:

Test / Treatment	Price*^
Consultation	From $65.40
Menopausal Hormone Therapy
Systemic MHT (Oral Tablets) – Tibolone	$75.21
Systemic MHT (Oral Tablets) – Progesterone	$43.60
Systemic MHT (Transdermal Oestrogen Gel)	$35.97
Local Vaginal Oestrogen Therapy (Vaginal Tablet)	$70.85
Hormone & Deficiency Testing
Estradiol / Oestrogen (E2)	$32.70
Follicle-Stimulating Hormone (FSH)	$32.70
Thyroid Function Test (TSH)	$32.70
Vitamin D Deficiency Test	$130.80
DEXA Bone Densitometry	$141.70
Female Acne / Weight Gain Screen** Testosterone, Estradiol, Progesterone, TSH, Cortisol, FSH, LH, Prolactin, DHEAS, SHBG (May be recommended for those suspected with hormonal acne)	$218
Comprehensive Deficiency / Hair Loss Screen Folate, Vitamin B12, Vitamin D, Iron, Total Iron Binding Capacity, % Iron Saturation, Ferritin, Zinc, Magnesium, Free T4, TSH	$263.78
Women Wellness (Full Body Screening)	From $152
Breast Health Screening
Mammogram	$239.80
Ultrasound Breast	$163.50
Mammogram with Ultrasound Breast	$327

*Prices are NETT and inclusive of GST.
^Prices last updated on Apr 29, 2026. While every effort is made to keep pricing information up to date, please contact our team to confirm the latest rates.

**Recommended to be done during days 2–5 of menstrual cycle and between 8:30 AM and 10:00 AM for accuracy.

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