HT treatment with estrogens alone or in combination with progestogens was associated with a small to moderate improvement in sexual function , particularly in pain , when used in women with menopausal symptoms or in early postmenopause ( within five years of amenorrhoea ) , but not in unselected postmenopausal women .
The current evidence does not suggest an important effect of tibolone or of SERMs alone or combined with estrogens on sexual function .
BACKGROUND The perimenopausal and postmenopausal periods are associated with many symptoms , including sexual complaints .
OBJECTIVES To assess the effect of hormone therapy ( HT ) on  sexual function in perimenopausal and postmenopausal women .
Tibolone increases bone mineral density but also relapse in breast cancer survivors: LIBERATE trial bone substudy
Introduction The Livial Intervention Following Breast Cancer : Efficacy , Recurrence and Tolerability Endpoints ( LIBERATE : Clinical http://Trials.gov number NCT00408863 ) , a r and omized , placebo-controlled , double-blind trial that demonstrated that tibolone ( Livial ) , a tissue-selective hormone-replacement therapy ( HRT ) , increased breast cancer ( BC ) recurrence HR 1.40 ( 95 % CI , 1.14 to 1.70 ; P = 0.001 ) . A subgroup of women was entered into a study of bone mineral density ( BMD ) . Methods Women with surgically excised primary BC ( T1 - 3 , N0 - 2 , M-0 ) within the last 5 years , complaining of vasomotor symptoms , were assigned to tibolone , 2.5 mg daily , or placebo treatment for a maximum of 5 years . The BMD sub study enrolled 763 patients , using dual-energy X-ray absorptiometry ( DXA ) scanning at baseline and at 2 years . Results In the bone sub study , 699 of 763 women were eligible ( 345 allocated to tibolone , and 354 , to placebo ) . After undergoing DXA scans , 300 ( 43 % ) women had normal BMD ; 317 ( 45 % ) , osteopenia ; and 82 ( 11.7 % ) , osteoporosis . Low body-mass index ( P < 0.001 ) , Asian race ( P < 0.001 ) , and late age at menarche ( P < 0.04 ) predicted low bone mass at baseline . Tibolone  increased BMD by 3.2 % at the lumbar spine and 2.9 % at the hip compared with placebo ( both P < 0.001 ) . The majority of fractures ( 55 % ) occurred in osteopenic patients . Women with normal BMD had increased recurrence with tibolone , 22 ( 15.6 % ) of 141 compared with placebo , 11 ( 6.9 % ) of 159 ( P = 0.016 ) , whereas no increased BC recurrence was seen in women with low BMD ; 15 ( 7.4 % ) of 204 taking tibolone versus 13 ( 6.7 % ) of 195 taking placebo . Conclusions Tibolone is contraindicated after BC treatment , as it increases BMD and BC recurrence . Risk of BC recurrence was elevated in BC women with normal BMD ( compared with low ) who took tibolone
HT treatment with estrogens alone or in combination with progestogens was associated with a small to moderate improvement in sexual function , particularly in pain , when used in women with menopausal symptoms or in early postmenopause ( within five years of amenorrhoea ) , but not in unselected postmenopausal women .
The current evidence does not suggest an important effect of tibolone or of SERMs alone or combined with estrogens on sexual function .
BACKGROUND The perimenopausal and postmenopausal periods are associated with many symptoms , including sexual complaints .
OBJECTIVES To assess the effect of hormone therapy ( HT ) on  sexual function in perimenopausal and postmenopausal women .