Question 1

How is Livial different from other HRT treatments?

Accepted Answer

Livial contains tibolone, which is different from conventional HRT that contains actual oestrogen and progestogen hormones. Your body converts tibolone into metabolites that have oestrogenic effects on some tissues (like bone and brain) and progestogenic effects on others (like the womb lining). This means Livial can provide benefits similar to combined HRT in a single tablet, without typically causing monthly bleeding.

Question 2

When should I take Livial - morning or evening?

Accepted Answer

You can take Livial at any time of day that is convenient for you, but it's important to take it at approximately the same time each day to maintain consistent hormone levels. Many women find taking it with breakfast or before bed helps them remember. Taking it with food may help if you experience stomach upset.

Question 3

Will Livial cause monthly periods or bleeding?

Accepted Answer

Unlike some combined HRT regimens, Livial usually does not cause regular monthly bleeding. However, in the first 3-6 months of treatment, you may experience irregular bleeding or spotting. According to NHS guidelines for continuous combined HRT, if bleeding continues beyond 6 months, starts after you've been on Livial for more than 6 months, or continues after stopping treatment, you should consult your doctor.

Question 4

How long does it take for Livial to work for hot flushes?

Accepted Answer

Most women notice an improvement in hot flushes and night sweats within a few weeks of starting Livial, with maximum benefit usually achieved by 3 months. If you don't notice improvement after 3 months, consult your doctor as the dose or treatment may need adjustment.

Question 5

Can I drink alcohol while taking Livial?

Accepted Answer

Moderate alcohol consumption is generally acceptable with Livial, but discuss this with your doctor. Alcohol can affect liver function, and since Livial is metabolised by the liver, excessive alcohol consumption may affect how your body processes the medication. Also, alcohol can sometimes worsen hot flushes in some women.

Question 6

Does Livial protect against osteoporosis?

Accepted Answer

Yes, Livial can help prevent postmenopausal osteoporosis by reducing bone loss. Studies including clinical research on tibolone show it increases bone mineral density in the spine and hip. However, it should only be used for osteoporosis prevention if you are at increased risk of fractures and other treatments are not suitable for you. Lifestyle measures like adequate calcium, vitamin D, and weight-bearing exercise are also important.

Question 7

What should I do if I forget to take a dose?

Accepted Answer

If you remember within 12 hours of your usual time, take the missed tablet as soon as you remember. If it's been more than 12 hours, skip the missed dose and take your next tablet at the usual time. Do not take a double dose to make up for a forgotten tablet.

Question 8

Can I use Livial if I've had a hysterectomy?

Accepted Answer

Yes, women who have had a hysterectomy can use Livial. In fact, you can start Livial immediately after surgery (once you've recovered) - you don't need to wait 12 months like women with intact uterus. However, you still need to be postmenopausal (unless ovaries were also removed, which causes immediate menopause).

Question 9

How long can I safely take Livial?

Accepted Answer

You should use Livial for the shortest duration necessary to relieve your symptoms. The risks (particularly of breast cancer, blood clots, and stroke) increase with longer duration of use. Your doctor should reassess your need for continued treatment at least once a year. Many women use HRT for 2-5 years, but individual circumstances vary.

Question 10

Will Livial help with menopausal mood swings and low libido?

Accepted Answer

Livial may help improve mood and sexual desire in some women experiencing these symptoms due to menopause. The weak androgenic activity of one of tibolone's metabolites may contribute to improved libido. However, individual responses vary, and Livial is not specifically licensed for these symptoms alone.

Question 11

What monitoring do I need while taking Livial?

Accepted Answer

While taking Livial, you should have regular check-ups with your doctor (at least annually). This should include blood pressure monitoring, discussion of any new symptoms, and review of continuing benefits versus risks. You should also perform regular breast self-examinations and attend routine breast screening (mammograms) as recommended for your age group.

Question 12

Can I stop Livial suddenly or do I need to taper off?

Accepted Answer

You can stop Livial suddenly if needed, but some women may experience a return of menopausal symptoms when stopping. Your doctor may recommend gradually reducing the dose if you've been on long-term treatment, but since Livial only comes in one strength (2.5mg), this would involve taking it every other day for a period before stopping completely.

Question 13

Does Livial affect cholesterol levels?

Accepted Answer

Yes, Livial affects cholesterol levels. It causes a dose-dependent decrease in HDL cholesterol ("good" cholesterol) and also reduces triglycerides and lipoprotein(a). The clinical significance of these changes is not fully understood, but your doctor may monitor your lipid profile periodically, especially if you have other cardiovascular risk factors.

Question 14

Is weight gain a common side effect of Livial?

Accepted Answer

Weight gain is listed as a common side effect (may affect up to 1 in 10 women). Some women may experience fluid retention or changes in fat distribution. Maintaining a healthy diet and regular exercise can help manage weight while on treatment. If you experience significant weight gain, discuss this with your doctor.

Question 15

Can I use Livial if I have migraines?

Accepted Answer

If you have a history of migraines, you should discuss this with your doctor before starting Livial. Migraine with aura is a particular concern as it increases stroke risk, and HRT may further increase this risk. If you develop new migraines or your migraines worsen or become more frequent while taking Livial, you should stop treatment and consult your doctor.

Product Name	Livial
Manufacturer	Organon Pharma (UK) Limited
Active Ingredient	Tibolone
Administration	Oral tablet
Presentation	White tablets marked "Organon*" on one side and "MK2" on the other
Available Strengths	2.5mg / 28 tablets
Product Type	POM — Prescription Only
Starting Price	£45.00
Suitable for pregnancy?	No - Contraindicated
Use with alcohol	Consult your doctor
Link to Patient Information Leaflet	Livial PIL ↗

Livial Tablets

Livial Treatment