Role of androgens, progestins and tibolone in the treatment of menopausal symptoms: a review of the clinical evidence

Abstract

Maria Garefalakis, Martha HickeySchool of Women’s and Infants’ Health, The University of Western Australia, King Edward Memorial Hospital, Subiaco, Western Australia, AustraliaAbstract: Estrogen-containing hormone therapy (HT) is the most widely prescribed and wellestablished treatment for menopausal symptoms. High quality evidence confirms that estrogen effectively treats hot flushes, night sweats and vaginal dryness. Progestins are combined with estrogen to prevent endometrial hyperplasia and are sometimes used alone for hot flushes, but are less effective than estrogen for this purpose. Data are conflicting regarding the role of androgens for improving libido and well-being. The synthetic steroid tibolone is widely used in Europe and Australasia and effectively treats hot flushes and vaginal dryness. Tibolone may improve libido more effectively than estrogen containing HT in some women. We summarize the data from studies addressing the efficacy, benefits, and risks of androgens, progestins and tibolone in the treatment of menopausal symptoms.Keywords: androgens, testosterone, progestins, tibolone, menopause, therapeutic