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Livial is associated with a high amenorrhea rate.  
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Livial® (tibolone) is a first choice treatment for the relief of climacteric symptoms and prevention of osteoporosis in postmenopausal women as it regulates the estrogenic activity in a tissue-selective way. This results in desired estrogenic effects in tissues like the brain, bone and vagina, while avoiding the undesired estrogenic effects on the endometrium and the breast.
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