Short-term and long-term effects of tibolone in postmenopausal women

Formoso, Giulio; Perrone, Enrica; Maltoni, Susanna; Balduzzi, Sara; Wilkinson, Jack; Basevi, Vittorio; Marata, Anna Maria; Magrini, Nicola; D'Amico, Roberto; Bassi, Maria Chiara; Maestri, Emilio

doi:10.1002/14651858.cd008536.pub3

Cited by 88 publications

(91 citation statements)

References 96 publications

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“…Similarly, a new finding is our observation that tibolone use is associated with SUI risk elevation. These regimens operate through the same estrogen and/or progestin receptors in the pelvic floor as do the other forms of HT [18]; therefore, the SUI risks accompanying ET+ Levo-IUD or tibolone could be expected. However, these study groups, although large enough to produce statistical differences in SUI risk, were so small that conclusions of their impact on SUI risk must be drawn with caution.…”

Section: Discussionmentioning

confidence: 99%

Increased risk for stress urinary incontinence in women with postmenopausal hormone therapy

et al. 2018

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Section: Discussionmentioning

confidence: 99%

Increased risk for stress urinary incontinence in women with postmenopausal hormone therapy

et al. 2018

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“…Tibolone is a synthetic steroid compound that is, in itself, inert, but whose metabolites have estrogenic, progestogenic, and androgenic actions. It is classified as menopausal hormone therapy 16. Availability of different menopausal hormone therapy preparations varies worldwide.…”

Section: Introductionmentioning

confidence: 99%

European Menopause and Andropause Society (EMAS) and International Gynecologic Cancer Society (IGCS) position statement on managing the menopause after gynecological cancer: focus on menopausal symptoms and osteoporosis

Rees

Angioli

Coleman

et al. 2020

Int J Gynecol Cancer

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Worldwide, it is estimated that about 1.3 million new gynecological cancer cases are diagnosed each year. For 2018, the predicted annual totals were cervix uteri 569 847, corpus uteri 382 069, ovary 295 414, vulva 44 235, and vagina 17 600. Treatments include hysterectomy with or without bilateral salpingo-oophorectomy, radiotherapy, and chemotherapy. These can result in loss of ovarian function and, in women under the age of 45 years, early menopause. The aim of this position statement is to set out an individualized approach to the management, with or without menopausal hormone therapy, of menopausal symptoms and the prevention and treatment of osteoporosis in women with gynecological cancer. Our methods comprised a literature review and consensus of expert opinion. The limited data suggest that women with low-grade, early-stage endometrial cancer may consider systemic or topical estrogens. However, menopausal hormone therapy may stimulate tumor growth in patients with more advanced disease, and non-hormonal approaches are recommended. Uterine sarcomas may be hormone dependent, and therefore estrogen and progesterone receptor testing should be undertaken to guide decisions as to whether menopausal hormone therapy or non-hormonal strategies should be used. The limited evidence available suggests that menopausal hormone therapy, either systemic or topical, does not appear to be associated with harm and does not decrease overall or disease-free survival in women with non-serous epithelial ovarian cancer and germ cell tumors. Caution is required with both systemic and topical menopausal hormone therapy in women with serous and granulosa cell tumors because of their hormone dependence, and non-hormonal options are recommended as initial therapy. There is no evidence to contraindicate the use of systemic or topical menopausal hormone therapy by women with cervical, vaginal, or vulvar cancer, as these tumors are not considered to be hormone dependent.

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“…Postmenopausal hormone therapy (HT) is recognized as the most effective treatment currently available for menopausal symptoms [ 1 , 2 ]. Nevertheless, findings of a number of observational studies and randomized controlled trials (RCTs) of the influence of HT on stroke risk have been inconsistent [ 3 – 9 ].…”

Section: Introductionmentioning

confidence: 99%

Postmenopausal hormone therapy and risk of stroke: A pooled analysis of data from population-based cohort studies

et al. 2017

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BackgroundRecent research indicates a favourable influence of postmenopausal hormone therapy (HT) if initiated early, but not late, on subclinical atherosclerosis. However, the clinical relevance of timing of HT initiation for hard end points such as stroke remains to be determined. Further, no previous research has considered the timing of initiation of HT in relation to haemorrhagic stroke risk. The importance of the route of administration, type, active ingredient, and duration of HT for stroke risk is also unclear. We aimed to assess the association between HT and risk of stroke, considering the timing of initiation, route of administration, type, active ingredient, and duration of HT.Methods and findingsData on HT use reported by the participants in 5 population-based Swedish cohort studies, with baseline investigations performed during the period 1987–2002, were combined in this observational study. In total, 88,914 postmenopausal women who reported data on HT use and had no previous cardiovascular disease diagnosis were included. Incident events of stroke (ischaemic, haemorrhagic, or unspecified) and haemorrhagic stroke were identified from national population registers. Laplace regression was employed to assess crude and multivariable-adjusted associations between HT and stroke risk by estimating percentile differences (PDs) with 95% confidence intervals (CIs). The fifth and first PDs were calculated for stroke and haemorrhagic stroke, respectively. Crude models were adjusted for age at baseline only. The final adjusted models included age at baseline, level of education, smoking status, body mass index, level of physical activity, and age at menopause onset. Additional variables evaluated for potential confounding were type of menopause, parity, use of oral contraceptives, alcohol consumption, hypertension, dyslipidaemia, diabetes, family history of cardiovascular disease, and cohort. During a median follow-up of 14.3 years, 6,371 first-time stroke events were recorded; of these, 1,080 were haemorrhagic. Following multivariable adjustment, early initiation (<5 years since menopause onset) of HT was associated with a longer stroke-free period than never use (fifth PD, 1.00 years; 95% CI 0.42 to 1.57), but there was no significant extension to the time period free of haemorrhagic stroke (first PD, 1.52 years; 95% CI −0.32 to 3.37). When considering timing as a continuous variable, the stroke-free and the haemorrhagic stroke-free periods were maximal if HT was initiated approximately 0–5 years from the onset of menopause. If single conjugated equine oestrogen HT was used, late initiation of HT was associated with a shorter stroke-free (fifth PD, −4.41 years; 95% CI −7.14 to −1.68) and haemorrhagic stroke-free (first PD, −9.51 years; 95% CI −12.77 to −6.24) period than never use. Combined HT when initiated late was significantly associated with a shorter haemorrhagic stroke-free period (first PD, −1.97 years; 95% CI −3.81 to −0.13), but not with a shorter stroke-free period (fifth PD, −1.21 years; 95% CI −3....

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Short-term and long-term effects of tibolone in postmenopausal women

Abstract: Short-term and long-term effects of tibolone in postmenopausal women (Review)

Cited by 88 publications

References 96 publications

Increased risk for stress urinary incontinence in women with postmenopausal hormone therapy

Increased risk for stress urinary incontinence in women with postmenopausal hormone therapy

European Menopause and Andropause Society (EMAS) and International Gynecologic Cancer Society (IGCS) position statement on managing the menopause after gynecological cancer: focus on menopausal symptoms and osteoporosis

Postmenopausal hormone therapy and risk of stroke: A pooled analysis of data from population-based cohort studies

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