Hi suzysunday - yes I remember your situation. 5 mm is only just over the limit but in your case this was sufficient to cause bleeding. It may well have resolved but with an HRT like that you would probably have had to take extra progestogen probably - to stop the bleeding - in order to continue with it - which kind of defeats the object of that particular type?
Hi Kilted Cupid – I know you didn't advocate anyone trying it but I was just sounding a note of caution as this forum is read by hundreds of women every day and the fact that your consultant said it was OK may suggest that it is in fact OK or within normal parameters of prescription – which it isn't!
To anyone else reading this – Tibolone isn't like normal HRT where you have oestrogen and a progestogen – it is a compound which breaks down into other compounds which broadly act like oestrogens progestogens and androgens. Although the mode of action appears more or less balanced on the dose available - 2.5 mg - changing this by addition of more oestrogen will upset the balance and could cause endometrial hyperplasia (abnormal thickening) and then bleeding etc.
The link to the info I read a few years back (showing endometrial thickening as side effect for some women) which decided me against Tibolone does not exist any more, and I think that document is no longer on the web. Nevertheless as I understand ( and some other data report this) that there is a small risk of endometrial thickening on Tibolone so personally I would not want to add any extra oestrogen. If your gynae or doc has advised this and is prepared to scan you regularly then that's great!
Also re doubling the dose – I could find the paper on this – and the results (from short term trials) showed little difference in response (in terms of flushes etc) between 2.5 mg and double dose 5 mg but the latter was associated with more bleeding hence the 2.5 mg dose was considered the best one.
https://obgyn.onlinelibrary.wiley.com/doi/pdf/10.1111/j.1471-0528.2002.02020.xLike I said gynaes recommend all sorts of treatments to private patients who are paying and can therefore be monitored for any non-standard treatment - and pay for this individualised service.
As for Studd – of course he is very eminent – but - well – as you are new you won't know that his regime has been raised many times and caused much controversy. I know it's not the subject of this thread – and I only put it in as an example of a (private) gynae recommending something that is not standard and maybe questionable re endometrial safety for all women (according to his own research!). Suffice to say there is no question that the 7 day prog regime as a general principle is too low to be used as standard by all women. In fact from what some women have recently reported I think he now prescribes 10 days – due to adverse effect on endometrium from some of his patients (I recall reported on here?). Individualised regimes are great for those who are prog intolerant or suffer from reproductive depression but need to be supervised.
Those without extra funds rely on NHS treatments and the research that has gone into them – even though we dearly wish for more research, greater variety and individualisation!
Hurdity x
