Tibolone: A Review Plan Before and After Starting

If tibolone has come up at an appointment, you may want time to understand the plan before agreeing to it. Bring the symptoms you most want help with and ask how the clinician will decide whether this option suits you.

This checklist is for a prescribing discussion. Ask your clinician to review each point against your own history and the medicine’s patient leaflet.

Confirm why it is being considered

The NHS¹ describes tibolone as an option for symptoms such as hot flushes, low mood and vaginal dryness or irritation.¹

Name the symptom that is interfering most with your day. Explain what you have already tried, what changed and what you want from treatment. If the clinician has a different reason for suggesting tibolone, ask them to write that reason in the plan.

You could say: “Which of my symptoms are we trying to improve, and how will we judge whether this is helping?”

Review your menopause stage

For symptoms after a natural menopause, the NHS¹ describes use more than a year after the last period. It also lists use after ovary-removal surgery or while taking gonadorelin analogues for endometriosis.²

Tell the clinician when your last period occurred, whether you have had surgery and what treatment you are currently taking. If you are unsure about a date, say so. Ask them to explain how your circumstances affect the recommendation.

Bring the medical history that matters

The NHS¹ asks people considering tibolone to disclose unexplained vaginal bleeding, breast cancer or relevant family risk, hormone-sensitive cancer, clotting problems and liver disease, among other conditions. Its list is not limited to these examples.²

Bring your medical history, current medicine list and any questions about previous test results. Ask which details affect suitability and whether anything needs assessment before a prescription. Do not leave an uncertain detail out because you cannot remember its medical name.

You could say: “I have a past result I do not fully understand. Can we check it before deciding?”

Agree how the response will be reviewed

Tibolone can take up to three months to work fully. The NHS¹ advises a doctor’s check-up at least once a year to review whether it should continue. If symptoms are not improving, talk to the doctor.¹

Ask when your first review will be, what to bring and whom to contact sooner with concerns. Write down the symptoms you and the clinician have chosen to track. Ask for the medicine leaflet and an explanation of the side effects or changes that need medical advice.

If you want to change or stop treatment, discuss that with the prescriber. Bring the reason, whether it is a new symptom, an unwanted effect or a treatment goal that has changed.

Leave with a plan you can find again

Before the appointment ends, check that you know the purpose of treatment, the instructions you have been given and the review date. Ask the clinician or pharmacist to clarify anything you do not understand.

My Body Changed. Now What? includes a symptom diary and Visit Brief. Use them to prepare the questions and observations you want to bring to this discussion. Explore the menopause playbook.