Objective: Hormone replacement therapy (HRT) may increase the quality of menopausal women life. In this study we have evaluated the effects of Tibolone on the endometrium for three years and compared them to those observed in HRT patients and controls. Methods: The study was carried out on seventy post-menopausal patients; of these 32 received tibolone, 2.5 mg per day, 22 went through HRT (17 beta-estradiol, 50 microg twice a week with oral dydrogesterone, 5 mg per day) and 16 were not treated. All the patients underwent aspiration cytology in order to assess the basal conditions of the endometrium; this examination was repeated after 3 years. Results: After three years the rate of atrophic endometrium was 90% in the women who were being treated with tibolone and 60% in the patients who were receiving HRT, while the proliferative endometrium was respectively 10% and 40% (p<0.005). Conclusions: Tibolone treatment is safe for the endometrium. The use of continuous combined HRT requires a closer endometrium surveillance.
