This information is for women who have menopausal symptoms. It tells you about tibolone, a treatment used for these symptoms. It is based on the best and most up-to-date research.
Does it work?
Yes. If you take tibolone, you're likely to have fewer hot flushes. Tibolone can also help with vaginal dryness.
Tibolone is better than hormone replacement therapy (HRT) at increasing your sex drive. But, like HRT, tibolone slightly increases the risks of some serious side effects. In particular it increases your risk of a stroke, even more so than HRT.
If you are older than 60, the risks of taking tibolone may outweigh the benefits.  You need to discuss the pros and cons of this treatment with your doctor.
What is it?
Tibolone is a hormone treatment. You can take it for symptoms of the menopause such as hot flushes and a low sex drive. The brand name for tibolone is Livial.
Your doctor might also prescribe tibolone to prevent your bones thinning (a condition known as osteoporosis).
Tibolone is made in a laboratory. It affects your body in the same way that some of your natural sex hormones do.
The good thing about tibolone is that it doesn't stimulate the lining of your womb. This means that if you start taking it at least one year after your periods have stopped, you shouldn't get any monthly periods as you would with some other hormone treatments. (To learn more, see Ways to take HRT.)
But if your last period was less than a year ago and you take tibolone, you have a high chance of getting a monthly period. So doctors usually give this treatment only to women who have definitely reached the menopause.
How can it help?
If you take tibolone, you're likely to have:       
Almost half as many hot flushes
Less vaginal dryness
Improved sexual satisfaction
More sexual fantasies and more sexual arousal
More desire for sex.
Researchers have found that sex drive increases much more in women taking tibolone than in women taking combined HRT (oestrogen and progestogen).
Your number of hot flushes should fall sharply during the first four weeks of taking tibolone.  If you were getting eight hot flushes a day before you started treatment, you may get about three on tibolone. 
How does it work?
When you take tibolone, your body breaks it down into substances that act like your body's natural hormones. This means it replaces the action of hormones that you lose when you reach the menopause. So, you don't get the symptoms linked with falling hormone levels.
Can it be harmful?
Part of tibolone's effect comes from increasing the amount of hormones in your body called androgens. Androgen hormones may affect your sex drive, but they also do other things, such as causing hair to grow. So, doctors were concerned that tibolone could cause extra hair growth and other problems, such as oily skin. But the studies we looked at didn't find any good evidence that this is a problem.