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Livial is a non-hormonal tablet for women going through the postmenopause.

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This page was medically reviewed by Dr Daniel Atkinson, GP Clinical Lead on August 02, 2022. Next review due on August 01, 2024.

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What is Livial?

Livial is a HRT treatment that helps to tackle menopausal symptoms. It’s also a second line tablet for osteoporosis, which can develop in the first couple of years after the onset of the menopause.

Livial is sometimes referred to as Tibolone, the active ingredient in the tablet. It’s a treatment that’s only suitable for postmenopausal women who haven’t had a period for one year or more.

How does Livial work?

It works by imitating oestrogen and progesterone, which are naturally occurring female hormones in the body.

Livial is a little different from combined HRT treatments like Indivina and Evorel Conti, or oestrogen only options such as Estradot, as it doesn’t contain actual oestrogen and progesterone hormone replacements. Your body instead breaks down the active ingredient, tibolone, to make these hormones.

When you experience the menopause, the levels of oestrogen in your body start to drop, and this can trigger various symptoms, including vaginal dryness and discomfort when you’re having sex, trouble sleeping, hot flushes, night sweats and depression or anxiety. Tibolone, the active ingredient in Livial, makes up the oestrogen deficit, and helps to bring these symptoms under control.

What’s the difference between Tibolone and Livial?

Tibolone is the generic version of Livial (which is the branded treatment), so it works in the same way in the body. Only the packaging that it comes in and the tablets themselves may look different.

Because it’s a generic product, it’s usually cheaper than Livial. It might also contain different non-active ingredients, like the tablet’s film coating. Otherwise though, the two medications are essentially the same.

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How to use Livial

You should not take Livial if you’ve had your period within the last 12 months. If you’ve never used HRT before or you’ve had a hysterectomy, you can use Livial straight away.

One tablet should be taken daily. Each strip of pills comes with the days of the week marked on them, so you can keep track of what you’ve taken.

It’s likely that you’ll be prescribed the lowest dose of Livial at the start of treatment to minimise the risk of side effects and possible toleration issues. If needed, this can be increased over time to find the right balance for you.

If I miss a Livial dose, what should I do?

If you forget to take a Livial tablet and it’s within 12 hours of its scheduled dose, simply take it as soon as you remember. After 12 hours, the tablet can be skipped and you can just carry on taking it as you normally would.

You should never take two tables to make up for a missed one as this can cause severe nausea and vomiting.

How long does it take for Livial to work?

It usually takes a few weeks for any HRT medication to provide noticeable relief from your menopausal symptoms, and a little longer for it to become fully effective.

Our clinician will usually recommend waiting three months to see if you’re getting the benefits you should from the treatment, during which time the dosage can be adjusted. It might take a little patience, but you should get there eventually.

Medically reviewed by
Dr Daniel Atkinson
GP Clinical Lead
on August 02, 2022.
Meet Daniel  
This page was medically reviewed by Dr Daniel Atkinson, GP Clinical Lead on August 02, 2022. Next review due on August 01, 2024.

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FAQ: Livial

Have something specific you want to know about Livial? Search our info below, or ask our experts a question if you can’t find what you’re looking for.

Is Livial suitable if you’re over 60?

Women over the age of 60 can take Livial, as long as there are no other factors that might prevent its safe use. These could be other medications that interact with Livial or health issues, whether related to the menopause or not.

Livial has been associated with a slight increase in strokes and heart disease in women over the age of 60, although these risks are very low. On the other hand, it’s also thought there’s a reduction in bone fractures and breast cancer among women who take it longer term.

If you’re concerned about side effects and increased health risks when taking Livial, drop our clinician a message.

Livial ingredients: how are they different from other HRT treatments?

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.

What is Livial 2.5mg?

Livial is only available in one dosage, 2.5mg, so if you find you are having issues tolerating it, another type of HRT might be recommended.

There are many types of HRT that are prescribed depending on what stage of the menopause you’re at. There are also a range of doses for your individual needs. With a little help from our clinician, we should be able to find one that works well for you.

Is Livial suitable for the perimenopause?

Livial is not prescribed to treat symptoms of the perimenopause, which describes symptoms that you experience when you’re in the middle of the hormonal changes that occur during this time of life.

It can only be prescribed to treat the postmenopause. Unlike other HRT, you don’t need to take a progesterone alongside it as it doesn’t increase the risk of cancer if you haven’t had a hysterectomy. The postmenopause is defined as being free from menstrual bleeding for at least 12 months.

Does Livial cause weight loss or weight gain?

Weight gain and bloating are among the more common side effects for Livial, but it’s still very much a minority of patients that report it. Weight loss is rarely reported, although it isn't unheard of.

But what is the evidence for weight changes while taking tibolone? The picture isn’t clear, but there’s strong evidence to suggest that weight changes are related to the menopause, rather than triggered by the medication itself.

If you’re noticing any weight changes that concern you, get in touch with our clinician and they can advise you.

Can Livial cause depression?

Depression and mood changes have been reported as rare symptoms for Livial, so it is something you should be aware of before taking it.

On the other hand, studies have shown that Livial can improve symptoms of depression associated with the menopause, too.

In truth, there’s no way to guarantee how anyone will react to any medication. While it’s important to be aware of the risks associated with your treatment, it’s unlikely you’ll have any issues with depression from taking Livial.

Why should I buy Livial online with Treated?

Treated offer convenience, reliability and support. This begins from the moment you order Livial online and continues through an aftercare service that allows you to speak to us about any issues you’re having with the condition or treatment.

We’ll recommend treatments for you to choose from based on your health, you pick your medication, and how often you’d like us to deliver it to you. You can change, pause or cancel your subscription at any point.
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