Tibolone is the
only first line treatment on the NHS for post menopausal women who are progesterone intolerant.
However my experience, as exactly that woman, is that the NHS GPs didn't know about it, so I wasn't offered it initially. I was made to suffer the effects of my
known intolerance repeatedly, before a pharmacist mentioned tibolone by chance.
After reading speculation I googled, "Why is tibolone only given to postmenopausal women?"
and AI gave me this statement; "It may be recommended if you prefer not to take oestrogen or have problems with side effects."
I know AI is an infant, I spent my last few working years trying to improve it, but it wasn't the slight misunderstanding by google that prompted this post, it's the phrase it picked out as the solution to the tibolone question.
That sentence starts talking about why tibolone might be recommended. Then suggests two likely reasons, first reason, "if you prefer not to take oestrogen" for whatever reason not given, second reason, "or have problems with side effects" of some description. Did they mean something in particular? Did they mention what they meant? No, unfortunately AI doesn't know what it is talking about.
The side effects are from progestins while the benefits are from oestrogens. Progestins can give you unpleasant side effects, oestrogen more rarely is unpleasant, usually only in very high doses.
Progestins are often so unpleasant that a woman will give up on HRT thinking it is one thing and that one thing makes her feel completely awful.
While tibolone falls into the class called progestins, it doesn't act like the others I've tried at all. Not even slightly, don't get hung up on that odd classification of a medicine specifically for progesterone intolerance that is itself a progestin, it's not the same.
So why isn't tibolone offered to more women? Most women who are intolerant to the hormones given in contraceptives know about it before menopause and will say so.
My experience was that
my words were dismissed as irrelevant, because progesterone intolerance only happens in younger women!!!
Nonsense, where did they get that idea? Progesterone intolerance might be actually worse when you're older and have less of the endogenous hormones to buffer you against a flood of alien molecules from a synthetic HRT.
Tibolone doesn't have a big marketing team because it's banned in the USA for spurious reasons that take no account of the women who need it. They banned it because if taken by young athletes it can be performance enhancing, but is very detectable so other countries allow their women to access this vital medicine. I have found it is indeed performance enhancing in every way, that's a good description.
By making HRT sound like one thing, it is misleading millions of women, perhaps deliberately. A problem of, "it's better for them if they believe this and don't medicate at all" is in play here. HRT is still being seen as a lifestyle choice instead of an essential medicine, so isn't it better to discourage women from clogging up the health service when they could lose some weight or go for a run instead?
If they prescribed tibolone more it would lead to fewer problems, not more. I was never off the phone to them when I was trying out their gold standard HRTs that noone but me ever had a problem with.
With tibolone I just get on with life and don't bother them at all.
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Topic: Progesterone intolerance, some thoughts (Read 2624 times)