Most HRT medications contain a synthetic version of oestrogen, sometimes alongside a synthetic version of progesterone, both of which are naturally produced by the body. It’s these hormones that help to control the menstrual cycle and in turn the symptoms of the menopause.
Livial is different in that it contains a substance called tibolone. Tibolone is broken down in the body to create oestrogen, which means it’s not exactly a hormone replacement therapy, although it essentially works in the same way.