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[Frankie41]

Hi ladies

Has anyone here trialled combining tibolone with an estrogen patch? I am well aware of the very mixed experiences on tibolone itself, but I am specifically interested in the any prior experience of adding in estrogen with tibolone.  I know we are a self- selected bunch (!) on this website and often the experiences reported are sub-optimal, but am willing and open to hear any reports on this specific regime.

Thanks heaps in advance!

[Annie0710]

I can't see it being a problem as I've read that a lady is using testosterone gel along with Tibolone and feeling great

I'm now on half Tibolone tablet and feel better so I think for me I don't need as much oestrogen x

[Leahjay]

Hi, I'm trying 1mg progynova (estradiol) with 2.5mg tibolone. Just started and a bit nervous because I also have a dvt! It's tricky isn't it.

I had a total hysterectomy 2 weeks ago, prior to that I was on zoladex and tibolone with no issues. Have been having depression and hot sweats since my surgery, even though I stayed on the tibolone so that's why I'm trying the combo.

I did notice that the handout for tibolone says not to take it in combination with other HRT- tempted to just ask my gyn if I can try 5mg tibolone instead.

[Tempest]

Leah, have you double and tripe checked with your doctor whether oral HRT is OK to have as you've had DVT? The Tibolone doesn't raise clotting risk, but the Progynova may. You'd be much better and safer in the long term on a transdermal HRT such as gel or the patch. xxxxx

[Leahjay]

Hi Tempest,

Yeah the progynova does raise clotting risk- I think the patch is a good idea, I didn't know it's risk for dvt was less. I think they're in over their heads personally but the line was that the factor that brought about the dvt was being immobile after surgery. GP wanted me to go off HRT altogether but I can't possibly because my mood would be so terrible.

Thanks for the idea x

[Hurdity]

Hi ladies

Has anyone here trialled combining tibolone with an estrogen patch? I am well aware of the very mixed experiences on tibolone itself, but I am specifically interested in the any prior experience of adding in estrogen with tibolone.  I know we are a self- selected bunch (!) on this website and often the experiences reported are sub-optimal, but am willing and open to hear any reports on this specific regime.

Thanks heaps in advance!

Frankie41 - I hope no-one on here is trialling this without medical supervision, as in my view it would not be advised and should not be prescribed due to potential adverse effects on the endometrium. The compound in Tibolone which acts to prevent endometrial thickening would not be high enough dose to protect against further oestrogen stimulation. In fact there are reports of endometrial thickening even on standard Tibolone only, after long term use (can't remember the time-scale here).

Hurdity x

[Tempest]

You're absolutely right, Hurdity! If you have a uterus, there is not going to be enough 'Prog element' going on with Tibolone to prevent thickening. Adding extra T. is another ball game altogether - no one really knows of the effect long term and T in women is assumed safe as it has a long track record (since the 30's apparently) but not enough study has really been done historically.

I think Nick Panay is organising studies at present, as you stated before in another thread.

But - when it comes to adding extra estrogen and no Prog. to Tibolone in women with an intact uterus, the implications could be dire.

Thank you for always being vigilant in these matters - I know in the past you've averted disaster when ladies have been prescribed estrogen only by mistake by their GP who still have a uterus. Good grief - I hope one day GP's will get a handle on all this as a good few really don't seem to know what they're doing! xxxxx

[Tempest]

You're welcome, Leah! I actually think it would be best if your GP referred you to a menopause clinic if there is one available in your area - they would be better able to assess your risk and advise on best HRT in your circumstances - don't worry, I'm sure you'll be able to continue with it transdermally but you'll need a bit of monitoring possibly if your risk is considered higher for future DVT's.

Were you on HRT at the time of your surgery, and if so weren't you advised to stop it prior to surgery? Surgery and inactivity afterwards plus HRT are known to be risk factors for DVT. xxxxx

[Leahjay]

Hi Tempest,
I was on tibolone prior to surgery (as an add back for zoladex) and wasn't advised to stop. Interestingly, my gyn added the 1mg progynova 2 days before I had clot symptoms... although this isn't definitively the cause, I've been pretty inactive since surgery and also have a family history, which may contribute. Xx

[Hurdity]

Hi Leahjay - yes as Tempest says I would ask for referral. Re the endometrium - obviously in your case as having had a hysterectomy you don't need to worry about thickening and it would be interesting to see how you get on ( if you are given the OK to continue) with tibolone and extra oestrogen because I think the insufficient oestrogen level on the combi Tibolone tab is the reason many women stop this treatment (apart from side effects?)? It would be a way for women who have had a hysterectomy to obtain extra oestrogen and boost their libido without having to take testosterone - which some docs including specialists still refuse to countenance.

Hurdity x