There is a good introduction to Tibolone here:
https://www.menopause.org.au/images/stories/infosheets/docs/AMS_Tibolone_for_post-menopausal_women_April_2015.pdfAlso the best source for information about safety and efficacy are the Cochrane reviews which trawl the net looking at all the studies and trying to come up with the pros and cons and if possible a consensus - since studies are so variable and often conflicting.
There is a short review here:
http://www.cochrane.org/CD008536/MENSTR_short-term-and-long-term-effects-tibolone-postmenopausal-womenAlthough it had not been shown conclusively to lead to endometrial cancer the product info I looked at said that the risk could be increased because Tibolone increases endometrial thickness - which can lead to cancer.
As far as I know there are no long term studies on its effects and safety so I understand its use is only recommended for a short time for this reason but I'm not sure if there is anything definitive on this? Also not recommended over 60 due to possible increased stroke risk - but I think this is the same as for any tablet HRT - that if you are already taking it the risk is less.
Re Tibolone vs "bio-identical hormones" - I think the argument would be the same for any synthetic hormones or hormone-like substances. The metabolic effects will be different from our own hormones so there could be unwanted or harmful effects. Also with Tibolone - in terms of the active substances that Tibolone converts to (ie two oestrogenic compounds and one compound which is weakly progestogenic and androgenic) - you can't control which of the three hormones you are getting, or rather, mimicking - so no possibility of tweaking doses.
In addition the oestrogenic effects are low so for some women the oestrogen is insufficient to eliminate all adverse symptoms. It does have a bone-protective effect though
. The other disadvantage is that some women may not be able to tolerate the negative progestogenic effects.
However I don't think the overall impact is fully understood - it is a tissue specific compound so the metabolites act in a different way in different tissues,
Thanks for posting that info Tempest! I looked up STEAR as I hadn't heard of it - and this is the name given to the type of compound Tibolone is Here is what it says on Wikipedia:
....and differs mechanistically from that of selective estrogen receptor modulators (SERMs) such as tamoxifen, which produce their tissue-selectivity via means of modulation of the ER.[15][16] As such, to distinguish it from SERMs, tibolone has been described as a "selective tissue estrogenic activity regulator" (STEAR),[16] and also as a "selective estrogen enzyme modulator" (SEEM).[17]https://en.wikipedia.org/wiki/TiboloneAnyone for whom conventional HRT is not working and have tried numerous options and doses, and is within the right age range, not contra-indicated, and if you are not bothered about what type of HRT you use as long as it works - well it's got to be worth a try at least in the short term! I did think about it myself a few years ago (for libido) but I was over 60 at the time and also worried about the possibility of endometrial thickening so decided against it.
Hope this helps
Hurdity x