Livial

Livial tablets contain the active ingredient tibolone, which is a synthetic steroid medicine used for hormone replacement therapy (HRT). It mimics the activity of the female sex hormones oestrogen and progesterone and the androgen testosterone in the body.
Oestrogen is the main sex hormone in the female body. Certain parts of the body, such as the vagina, bones and breasts, rely on oestrogens to function normally. When the levels of oestrogen are low, these tissues can slowly degenerate, as is experienced during and following the menopause. In addition, low levels of oestrogen can cause distressing symptoms such as hot flushes, night sweats, mood swings or depressed mood, reduced sex drive and vaginal dryness. Oestrogen levels decrease naturally during the menopause, but also decrease following a hysterectomy (surgical menopause) and in women taking medicines called gonadorelin analogues, eg leuprorelin for endometriosis.
When taken by mouth, tibolone is broken down into three compounds that act in a similar way to the natural oestrogen, progesterone and testosterone found in the body. This helps restore the balance of hormones in the body and reduces the symptoms of menopause, whether natural or otherwise.

Livial (Tibolone) is also sometimes used to prevent osteoporosis in postmenopausal women. The declining level of oestrogen at menopause can affect the bones, causing them to become thinner and more prone to breaking. Livial Tibolone's oestrogenic effect can help prevent bone loss and fractures that may occur in women in the years after menopause. However, it is only used as a second-line option for women at high risk of fractures who cannot take other medicines that are licensed for preventing osteoporosis.
Women considered to be at high risk of developing fractures following the menopause include those who have had an early menopause, those with a family history of osteoporosis, those who have had recent prolonged corticosteroid therapy (eg prednisolone), those with a small thin frame, and smokers.
Women experiencing a natural menopause should not start treatment with this medicine until 12 months after their last natural menstrual bleed. This is because the medicine may cause irregular menstrual bleeding if it is started sooner than this.
Women who have had a surgical menopause or are taking gonadorelin analogues can start treatment immediately.

Side effects

• Vaginal bleeding or spotting
• Vaginal discharge
• Vaginal thrush
• Vaginal itching
• Breast pain
• Rash or itching
• Seborrhoeic dermatitis
• Abnormal hair growth (hypertrichosis)
• Dizziness
• Headache/migraine
• Weight gain
• Pain in the muscles and joints
• Depression

The side effects listed above may not include all of the side effects reported by the drug's manufacturer.