Menopause: tibolone: practice question

A OBG question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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OBG · Menopause: tibolone

Sample item

A 55-year-old postmenopausal woman with hot flushes and low libido is prescribed tibolone. What is the characteristic of this drug?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. It has oestrogenic, progestogenic and androgenic actions and does not stimulate the endometrium

Tibolone is a synthetic steroid whose metabolites provide oestrogenic, progestogenic and androgenic effects, relieving vasomotor symptoms and improving libido and bone density without stimulating the endometrium, so no additional progestogen is needed. It is not advised in breast cancer survivors and increases stroke risk in older women. Unscheduled bleeding may occur in the first months.

Option by option

  • A. It has oestrogenic, progestogenic and androgenic actions and does not stimulate the endometrium (correct)

    Correct. It combines three steroid activities and spares the endometrium.

  • B. It is a GnRH antagonist

    It does not act on GnRH receptors.

  • C. It is a selective oestrogen receptor degrader

    It is not a receptor degrader like fulvestrant.

  • D. It is a pure oestrogen causing endometrial hyperplasia

    It is not a pure oestrogen and does not cause hyperplasia.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More OBG questions

Questions about this OBG question

What is the answer to this OBG question?

The best answer is A, It has oestrogenic, progestogenic and androgenic actions and does not stimulate the endometrium. Tibolone is a synthetic steroid whose metabolites provide oestrogenic, progestogenic and androgenic effects, relieving vasomotor symptoms and improving libido and bone density without stimulating the endometrium, so no additional progestogen is needed.

Why is "It is a GnRH antagonist" not the answer?

It does not act on GnRH receptors.

Why is "It is a selective oestrogen receptor degrader" not the answer?

It is not a receptor degrader like fulvestrant.

Why is "It is a pure oestrogen causing endometrial hyperplasia" not the answer?

It is not a pure oestrogen and does not cause hyperplasia.

What concept does this question test?

It tests Menopause: tibolone in OBG. It is not advised in breast cancer survivors and increases stroke risk in older women. Unscheduled bleeding may occur in the first months.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Menopause: tibolone?

Learn management algorithms as steps: PPH, eclampsia, ectopic pregnancy. Then use the flashcards and the other OBG questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.