Livial

Order Livial (Tibolone) HRT Tablets Online

You can order Livial tablets online from our UK registered online pharmacy and doctor service. After completing a short assessment on our website, your order will be passed to our UK registered doctors for review. If approved, our pharmacy team will dispense your medication and dispatch it to your chosen address.

What is Livial?

Livial is a brand name for the medicine tibolone. It is classed as a Hormone Replacement Therapy (HRT). It is used to relieve menopausal symptoms and can also be used to prevent osteoporosis in postmenopausal women. It is only prescribed to postmenopausal women with at least 1 year (12 months) since their last period.

Most HRT products contain oestrogen (oestrogen-only HRT) or a combination of oestrogen and progestogen (combined HRT). Livial is different from both types because it does not contain oestrogen or progestogen, it uses the drug tibolone.

How does it work?

The menopause causes a reduction of oestrogen in the body and this loss of oestrogen can cause menopausal symptoms such as vaginal dryness, night sweats, reduced sex drive, difficulty sleeping and hot flushes.

When Livial is taken, the active ingredient tibolone is broken down by the body into three different ingredients. These have a similar action to the hormones oestrogen, progesterone, and testosterone. 

Two of these ingredients act in a similar way to oestrogen and relieve symptoms by effectively replacing the lost oestrogen. The third chemical acts in a similar way to progestogen and testosterone. This helps to restore the hormone balance in the body.

High levels of oestrogen can cause thickening of the womb lining (endometrium) and subsequently increase the risk of womb cancer. Having progestogen (or a chemical that acts like progestogen) alongside oestrogen helps to protect against this increased risk.

Dose 

The dose for Livial is one tablet a day. Tablets should be taken at the same time every day. The foil packet for Livial is marked with the days of the week to make it easier to remember.

If you forget to take a tablet, take it as soon as you remember unless it is 12 hours late. If you are more than 12 hours late, skip the tablet and take a tablet the next day as normal. Do not take a double dose.

Alternatives

Other types of HRT include:

• Gels
• Vaginal rings
• Vaginal creams
• Skin patches
• Vaginal pessaries

Our doctors are able to prescribe a number of HRT treatments on our website:

• Kliovance
• Trisequens
• Provera
• Evorel Conti patches
• Evorel Sequi patches
• Elleste Solo
• Premarin
• Premique
• Elleste Duet
• Elleste Duet Conti

There is no direct alternative to Livial because it is unique in how it works. However, it is similar to taking a continuous combined HRT meaning if an alternative is needed a combined HRT product can be considered.

Does Livial cause weight gain?

Research has shown that women can gain weight during the menopause. HRT may also cause weight gain and the manufacturers of Livial suggest that weight gain is a common side effect of the medicine.

What are Livial tablets used for?

Livial is a Hormone Replacement Therapy (HRT). It is used to relieve menopausal symptoms and can also be used to prevent osteoporosis in postmenopausal women. It is only prescribed to postmenopausal women with at least 1 year (12 months) since their last period.

What are the side effects of tibolone?

There is always a risk of side effects when taking any medicine. 

Some common side effects associated with Livial include:

• Stomach pain
• Pelvic pain
• Abnormal hair growth
• Breast pain or discomfort
• Vaginal problems such as itching, thrush and irritation
• Vaginal bleeding or spotting

Vaginal bleeding or spotting is normal during the first 6 months of treatment but if it continues or begins after 6 months of taking Livial, you should contact your GP immediately.

A full list of side effects is available in the patient information leaflet.

How long can you stay on Livial?

Generally, women taking HRT should be reviewed after 3 months of starting treatment to assess their symptoms and the effectiveness of the treatment. HRT may need to be taken for a number of years but ideally, HRT should be used for the shortest possible duration to reduce the risk of side effects.

How long does it take for tibolone to start working?

The manufacturers of Livial suggest that relief of menopausal symptoms generally happens during the first few weeks of treatment.

Can I order HRT online?

Yes, you can order tibolone (Livial) online via our UK registered online pharmacy and doctor service. After filling out an online assessment form, our doctors will assess your suitability for Livial and issue a prescription if necessary. Our pharmacy team can then dispatch your medication.

There is always a risk of side effects when taking any medicine. 

Some common side effects associated with Livial include:

• Stomach pain
• Pelvic pain
• Abnormal hair growth
• Breast pain or discomfort
• Vaginal problems such as itching, thrush and irritation
• Vaginal bleeding or spotting

Vaginal bleeding or spotting is normal during the first 6 months of treatment but if it continues or begins after 6 months of taking Livial, you should contact your GP immediately.

For further information on side effects read the patient information leaflet.

There are a number of risks associated with HRT and patients should be aware of these before starting treatment. The following diseases are reported more commonly in women who take HRT compared to women who do not take HRT:

• Stroke
• Endometrial cancer 
• Heart disease
• Blood clots (venous thromboembolism)
• Breast cancer
• Ovarian cancer

Scientific research has suggested that taking HRT increases the risk of breast cancer. This increased risk depends on how long someone takes HRT. The risk of breast cancer returns to normal within around 5 years of stopping HRT.

The risk of developing blood clots with HRT use is up to 3 times higher than in women not using HRT. However, the increased risk of a blood clot is lower with Livial than with other types of HRT.

There is research to show that taking HRT or Livial can increase the risk of having a stroke. The increased risk is higher in women over 60 years old.

Women taking HRT should be regularly checked by their doctor to monitor treatment and side effects. The NHS website contains information on the symptoms of blood clots, breast cancer, endometrial cancer and stroke as well as information on the risks of HRT.

Before taking any medication, it is important to read the Patient Information Leaflet. You can find information leaflets for your medicines by typing them into the search bar at medicines.org, or by contacting us.

• Livial PIL

Other conditions and Livial

When completing our online assessment it is important you mention any medical conditions that you have.

Livial should not be used in these conditions:

• Endometrial hyperplasia (a thickening of the womb lining)
• If you have or have ever had a blood clot
• If you have or have ever had liver disease
• Unexplained vaginal bleeding
• Blood clotting disorders
• Recent angina, stroke or heart attack
• If you have or have ever had breast cancer
• If you have or have ever had cancer sensitive to oestrogens (such as womb cancer)
• If you are allergic to any of the ingredients in Livial
• If you are currently pregnant or breastfeeding

If you develop any of these during treatment you must stop taking Livial and discuss treatment with your doctor.

Interactions with other medicines

When filling out our online form, it is important you list any medicines you currently take. Livial should be used in caution with a number of medicines. These include:

• Blood-thinning medicines such as warfarin
• Anti-epileptic medicines such as carbamazepine, phenytoin, and phenobarbital
• Medicines to treat tuberculosis such as rifampicin
• A herbal medicine called St John’s Wort