The Effects of Tibolone on Risk Factors of Cardiovascular Disease in Menopausal Women

Tibolone is frequently used as a hormone-like alternative to traditional HRT. Therefore, it is valuable to compare the effects of tibolone and HRT on cardiovascular diseases risk factors. A total of 156 healthy non-surgical postmenopausal women were included in an open randomized study. They were assigned to receive daily 2.5 mg tibolone plus one Cal+D (500 mg calcium and 200 IU vitamin D) tablet (n=52), 0.625 mg conjugated equine estrogen and 2.5 mg medroxy progesterone (CEE/MPA) plus one Cal+D tablet (n=52), or one Cal+D tablet (n=52). The latter group was used as control. The women were followed for six months. The body mass index (BMI), blood pressure (BP), serum levels of high density lipoprotein (HDL), low-density lipoprotein (LDL), and triglyceride (TG), C reactive protein (CRP), sex hormone binding globulin (SHBG), free testosterone index (FTI), and free estradiol index (FEI) were determined before and after the interventions. Compared to baseline values, BMI, BP, CRP, SHBG, HDL, FTI, and FEI were significantly different after the treatments in the tibolone and CEE/MPA receiving groups (P<0.05), but not in the control group. Moreover, serum LDL and TG levels changed significantly after the treatments in all the three groups (P<0.01). There were significant differences between the tibolone and CEE/MPA groups in terms of CRP, LDL, HDL, TG, SHBG, FTI, FEI and BP (P<0.01). Tibolone may be considered an alternative to conventional HRT in postmenopausal women. However, clinical recommendations regarding the effects of tibolone on cardiovascular outcome needs further studies.