Tibolone (Amena): a one-tablet option for menopause, price in the Philippines

Prices checked October 2026. The Watsons listing does not state how many tablets are in a pack, and its title says "25mg" while the usage section says 2.5 mg. Tibolone tablets are labelled at 2.5 mg (UK label), so "25mg" looks like a typo, but confirm with the pharmacist. Ask the pharmacist for the pack count before working out a monthly cost. The cost calculator will update once it is confirmed.

The UK label lists one 2.5 mg tablet a day, preferably at the same time each day, with no separate progestogen added. Check the leaflet in your PH pack too.

Tibolone works like a continuous combined regimen in one tablet. That means:

• Only after at least 12 months without a period. The UK label says to start at least 12 months after your last natural period; started earlier, in perimenopause, it may cause irregular bleeding (Australasian Menopause Society). Women after surgical menopause can start straight away.
• No monthly bleed is expected. Some spotting in the first months is common. Bleeding that starts later, or continues after the first months, needs checking.
• Switching from other HRT: the UK label says to start tibolone the day after finishing a sequential regimen, or at any time if you are on a continuous combined regimen. Let your doctor plan the switch.

It helps hot flashes and night sweats (relief usually starts within the first few weeks, per the UK label), and it prevents bone loss about as well as standard HRT (Australasian Menopause Society). Some studies found better libido or sexual function than with placebo, though whether it beats standard HRT here is unclear. See low libido.

Your doctor decides whether tibolone suits you. The details above are from the label, not a prescription.

The UK label says tibolone should not be used if you have or had:

• Breast cancer. In a trial of breast cancer survivors (LIBERATE), the cancer came back in 15.2% of women on tibolone versus 10.7% on placebo.
• Womb cancer or another estrogen-dependent cancer
• Vaginal bleeding that has not been checked
• Untreated thickening of the womb lining
• A blood clot in a leg or lung, or a known clotting disorder
• A stroke, mini-stroke (TIA), heart attack or angina
• Liver disease, unless liver tests are back to normal
• Porphyria
• Pregnancy or breastfeeding

It is also not started until 12 months after a natural last period.

Stroke risk in older women. In a trial of women aged 60 to 85 with osteoporosis (LIFT, average age 68), a lower 1.25 mg dose of tibolone about doubled stroke risk (2.2 times placebo) while reducing fractures. Doctors are more cautious about starting it in women over 60 or with stroke risk factors such as high blood pressure, diabetes or smoking.

Side effects listed on the UK label include:

• Spotting or vaginal bleeding
• Breast tenderness
• Weight gain, and swelling from fluid (oedema)
• Lower tummy or pelvic pain
• Unwanted hair growth, acne
• Vaginal discharge, itching or thrush
• Headache, migraine, dizziness and low mood (reported in use after launch)

Bleeding that continues beyond 6 months of treatment, or starts later, should be checked.

Tell your doctor about any bleeding after the first few months, a breast lump, or signs of a clot or stroke.

Prices checked October 2026. A Cochrane review found tibolone works better than placebo but slightly less well than combined HRT for hot flashes, with less unscheduled bleeding than combined HRT. Its convenience is the main draw. For the breast cancer picture across HRT types, see Nakaka-cancer ba ang HRT?

Tibolone suits some women well and others not at all. Before you start, ask:

• "Has it been long enough since my last period for tibolone?"
• "Given my age, blood pressure and family history, is my stroke or breast cancer risk a reason to choose something else?"
• "How many tablets are in the Amena pack, so I can plan my monthly cost?"
• "What spotting is normal in the first months, and when should I call?"
• "How will we judge if it is working, and when do we review it?"

Bring a symptom diary from the weeks before your visit, and see talk to your doctor for a Taglish script.

• Estradiol gel with micronized progesterone or dydrogesterone
• Conjugated estrogens with a progestogen
• Non-hormonal treatments if hormones are not suitable

Compare regimens on HRT costs and the full overview on HRT for menopause.