Drug & supplement interaction

Androstenedione + Tibolone

Tibolone brand name: Livial.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Androstenedione has a moderate interaction with Tibolone. Theoretically, androstenedione might increase the effects and adverse effects of estrogens.

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Androstenedione and Tibolone

Here is the interaction we found between these two, with the evidence behind it.

Moderate

ESTROGENS

Why this applies to Tibolone

Tibolone falls under ESTROGENS — the group Androstenedione interacts with.

Theoretically, androstenedione might increase the effects and adverse effects of estrogens.
Androstenedione is a precursor to estrogen and seems to increase estrogen levels. However, androstenedione is converted to estrogen only in low estrogen environments. Patients taking estrogen do not have low estrogen levels because of the estrogen treatment. Therefore, androstenedione is unlikely to be converted to estrogen in these patients. However, until more is known, use with caution or avoid using.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the gist for tibolone (Livial), which works partly like estrogen in the body. Since androstenedione is a building block your body can turn into estrogen, the worry on paper is that stacking the two could add up to too much estrogen-like activity. That might mean more of tibolone's known effects, things like breast tenderness, fluid retention, vaginal bleeding or spotting, or headaches.

In real life, this is a theoretical concern based on how these compounds behave, not something proven in studies. Your body mostly converts androstenedione to estrogen only when estrogen levels are low, and tibolone keeps them up, so the actual risk is probably small. Still, androstenedione carries its own real risks. Please check with your pharmacist or doctor before combining them.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Broeder CE, Quindry J, Brittingham K, et al. The Andro Project: physiological and hormonal influences of androstenedione supplementation in men 35 to 65 years old participating in a high-intensity resistance training program. Arch Intern Med 2000;160:30
  2. Leder BZ, Longcope C, Catlin DH, et al. Oral androstenedione administration and serum testosterone concentrations in young men. JAMA 2000;283:779-82. PubMed
  3. King DS, Sharp RL, Vukovich MD, et al. Effect of oral androstenedione on serum testosterone and adaptations to resistance training in young men. A randomized controlled trial. JAMA 1999;281:2020-8. PubMed
  4. Brown GA, Vukovich MD, Martini ER, et al. Endocrine responses to chronic androstenedione intake in 30- to 56-year-old men. J Clin Endocrinol Metab 2000;85:4074-80. DOI
  5. Brown GA, Vukovich MD, Martini ER, et al. Effects of androstenedione-herbal supplementation on serum sex hormone concentrations in 30- to 59-year-old men. Int J Vitam Nutr Res 2001;71:293-301. PubMed
  6. Leder, B. Z., Leblanc, K. M., Longcope, C., Lee, H., Catlin, D. H., and Finkelstein, J. S. Effects of oral androstenedione administration on serum testosterone and estradiol levels in postmenopausal women. J Clin Endocrinol Metab 2002;87(12):5449-5454. PubMed
  7. Judge LW, Bellar DM, Hoover DL, Biggs D, Leitzelar BN, Craig BW. Effects of acute androstenedione supplementation on testosterone levels in older men. Aging Male. 2016;19(3):161-167. PubMed
  8. Badawy MT, Sobeh M, Xiao J, Farag MA. Androstenedione (a natural steroid and a drug supplement): a comprehensive review of its consumption, metabolism, health effects, and toxicity with sex differences. Molecules 2021;26(20):6210. PubMed
  9. Pang Q, Jia A, Al Masri MK, Varkaneh HK, Abu-Zaid A, Gao X. The effect of androstenedione supplementation on testosterone, estradiol, body composition, and lipid profile: a systematic review and meta-analysis of randomized controlled trials. Hormones (Ath PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Androstenedione Also Interacts With Other Medications

Androstenedione has 40 moderate known drug interactions in our database — the Tibolone one above is one of them. If you take anything else, check it against the full list below.

Moderate 40 No known interaction 2,790 (incl. Tibolone)
Taking anything else?

Check Another of Your Medications Against Androstenedione

Covers the 2,830 medications we’ve checked against Androstenedione. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Tibolone

This page covers Androstenedione only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Tibolone page lists 80 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Grapefruit (major), Aletris (moderate), Alfalfa (moderate) and Andarine (moderate).

By severity: 2 major · 62 moderate · 16 minor.

From our pharmacist’s overview on the Tibolone page

“Grapefruit is the risk I would learn first with tibolone (Livial), a hormone therapy used for menopause symptoms. Grapefruit can raise estrogen levels in the blood, magnifying both the drug's effects and its side effects, and it shares major status with activated charcoal, which soaks up medications in the gut and can blunt tibolone's…”

Reviewed by 2 · Jul 18, 2026

Open the Tibolone interaction page

One more smart check

Taking Androstenedione as Part of a Dietary Supplement Product? Check It for Interactions

We hold 4 real supplement products containing Androstenedione, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Androstenedione. Your product may carry other ingredients that interact with Tibolone too, on top of Androstenedione — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Androstenedione and Tibolone Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Androstenedione
Steady interest

#1,153 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Tibolone
Steady interest

#2,815 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Androstenedione

What is Androstenedione?

Androstenedione
  • Muscle building
  • Athletic performance
  • Boosting testosterone
  • Anti-aging
  • Increasing libido

Androstenedione is a prohormone that the body can convert into testosterone and estrogen, but studies have not shown that taking it reliably builds muscle or improves athletic performance. It carries real risks, is a controlled substance in the United States, and is banned in nearly all sports, so most people should avoid it.

Read the full Androstenedione monograph & all interactions
Keep checking

Other Drugs & Androstenedione

Browse every other medication we’ve checked against Androstenedione — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
40Moderate
0Minor
2,789No known interaction
40 Moderate 2,789 No interaction
Moderate

40 interactions

No interaction 2,789 drugs checked — show the list

We also checked Androstenedione against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,789 medications checked with no known interaction — see the full Androstenedione list.

See the full Androstenedione interactions page
See every supplement checked against Tibolone, ranked by severity
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Keep exploring
Androstenedione monograph › Uses, safety, and every drug interaction in one place Tibolone supplement interactions › Every supplement checked against Tibolone, ranked by severity Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Androstenedione and Tibolone Together: Common Questions

Can you take Androstenedione with Tibolone?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Androstenedione and Tibolone interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Tibolone and Androstenedione?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.