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Background and aim <p>Depression, anxiety, and mood disorders are common in women. Tibolone, acting as both estrogen and progestin, has shown conflicting effects in hormone therapy. This first meta-analysis of RCTs assesses Tibolone’s impact on these conditions in women.</p> Methods <p>Two reviewers independently searched Scopus, PubMed/Medline, Web of Science, and Embase up to 22 May 2024. Using the DerSimonian and Laird random-effects model, weighted mean differences (WMD) with 95% confidence intervals (CI) were calculated. Risk of bias was assessed using the Cochrane tool, and evidence certainty was rated using the GRADE approach.</p> Results <p>Eight articles were included in the meta-analysis. Tibolone significantly reduced depression scores (WMD = -5.335, 95% CI: -9.144 to -1.525, p = 0.006), with high heterogeneity (I² = 99.8%). Greater effects were observed in trials ≤6 months. Anxiety (WMD =-1.489, CI: -3.271 to 0.294, <i>p</i> = 0.102, I² = 99.1%) and mood (WMD = -0.719, CI:-1.805 to 0.366, <i>p</i> = 0.194, I² = 76.6%) scores showed non-significant reductions.</p> Conclusion <p>Tibolone significantly improved depressive symptoms in women, with non-significant trends in anxiety and mood. However, due to high heterogeneity, risk of bias in some studies, and limited number of trials for anxiety and mood outcomes, findings should be interpreted with caution.</p>

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The effect of Tibolone treatment on depression, anxiety and mood in women: a meta-analysis and systematic review of randomized controlled trials

  • 期刊论文

  • 发表日期：

    2025年10月22日

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  • Li Dong,
  • Yi Gang Wang,
  • Ming Zhang,
  • Mingxing Hu,
  • Qi Yuan,
  • Xi Cheng,
  • Kousalya Prabahar,
  • Guanghai Wang

摘要

Background and aim

Depression, anxiety, and mood disorders are common in women. Tibolone, acting as both estrogen and progestin, has shown conflicting effects in hormone therapy. This first meta-analysis of RCTs assesses Tibolone’s impact on these conditions in women.

Methods

Two reviewers independently searched Scopus, PubMed/Medline, Web of Science, and Embase up to 22 May 2024. Using the DerSimonian and Laird random-effects model, weighted mean differences (WMD) with 95% confidence intervals (CI) were calculated. Risk of bias was assessed using the Cochrane tool, and evidence certainty was rated using the GRADE approach.

Results

Eight articles were included in the meta-analysis. Tibolone significantly reduced depression scores (WMD = -5.335, 95% CI: -9.144 to -1.525, p = 0.006), with high heterogeneity (I² = 99.8%). Greater effects were observed in trials ≤6 months. Anxiety (WMD =-1.489, CI: -3.271 to 0.294, p = 0.102, I² = 99.1%) and mood (WMD = -0.719, CI:-1.805 to 0.366, p = 0.194, I² = 76.6%) scores showed non-significant reductions.

Conclusion

Tibolone significantly improved depressive symptoms in women, with non-significant trends in anxiety and mood. However, due to high heterogeneity, risk of bias in some studies, and limited number of trials for anxiety and mood outcomes, findings should be interpreted with caution.