Publication:

A prospective randomized study comparing drug efficacy of tibolone, conjugated equine estrogen, combined estrogen and progesterone for symptomatic relief in postmenopausal women

Background Menopause is linked to various vasomotor, psychological, and urogenital symptoms that greatly impact quality of life. Menopausal hormone therapy (MHT), such as tibolone, conjugated equine estrogen (CEE), and combined estrogen-progesterone treatments, is commonly used to alleviate these symptoms. Nevertheless, comparative data regarding their efficacy and safety remain limited.

Methods This prospective randomized controlled trial involved 99 postmenopausal women aged between 45-65 years, divided into three groups: tibolone, CEE, and combined estrogen-progesterone (33 participants each). The severity of symptoms was measured at baseline, 3 months, and 6 months. Adverse effects and treatment tolerability were also evaluated. Statistical analysis was performed using SPSS software with significance set at p<0.05.

Results Baseline symptom severity was similar across all groups, with the majority of participants having mild to moderate symptoms. Mean symptom scores stayed mostly consistent at 3 and 6 months in all groups, showing no statistically significant difference in overall symptom improvement. However, the occurrence of side effects differed between groups. Tibolone had the lowest rates of breast tenderness and vaginal bleeding, whereas CEE and combined therapy were associated with higher rates of these side effects.

Conclusions While all three treatments showed similar effectiveness in managing overall symptoms, tibolone had a better safety profile. These results emphasize the importance of individualized treatment selection based on patient characteristics, symptoms, and tolerability.