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European Heart Journal Advance Access originally published online on January 16, 2006
European Heart Journal 2006 27(6):635-637; doi:10.1093/eurheartj/ehi724
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© The European Society of Cardiology 2006. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Does tibolone exacerbate atherosclerosis?

Thomas B. Clarkson*

Wake Forest University School of Medicine, Comparative Medicine Clinical Research Center, Medical Center Boulevard, Winston-Salem, NC 27157-1040, USA

* Corresponding author. Tel: +1 336 716 1570; fax: +1 336 716 1601.E-mail address: tclarkso@wfubmc.edu

This editorial refers to ‘The effect of tibolone and continuous combined conjugated equine oestrogens plus medroxyprogesterone acetate on progression of carotid intima–media thickness: the Osteoporosis Prevention and Arterial effects of tiboLone (OPAL) study’{dagger} by M.L. Bots et al., on page 746

The first 10% of the full text of this article appears below.

Tibolone is widely used in many countries (though not in the USA) for the treatment of post-menopausal symptoms and to inhibit post-menopausal bone loss. Tibolone's popularity likely reflects the observation that it equals traditional hormone therapy in the relief of hot flushes, vaginal dryness, and the prevention of bone loss and, in addition, appears to increase libido. The post-menopausal benefits of tibolone relate to the uniqueness of the metabolism of the parent molecule. In human and non-human primates, tibolone is converted to three metabolites. Two are weak estrogen agonists (the 3-alpha and 3-beta hydroxy metabolites). The third metabolite, the delta-4 isomer, is a molecule that binds both to the progesterone receptor and to the androgen receptor with progestogenic and androgenic effects.

Although tibolone has numerous benefits for post-menopausal women, it markedly lowers plasma concentrations of the HDL with consistent reductions of . . . [Full Text of this Article]


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Related articles in EHJ:

The effect of tibolone and continuous combined conjugated equine oestrogens plus medroxyprogesterone acetate on progression of carotid intima–media thickness: the Osteoporosis Prevention and Arterial effects of tiboLone (OPAL) study
Michiel L. Bots, Gregory W. Evans, Ward Riley, Karen H. McBride, Electra D. Paskett, Frans A. Helmond, Diederick E. Grobbee, and for the OPAL Investigators
EHJ 2006 27: 746-755. [Abstract] [Full Text]