Egarter 1996.

Methods	Randomised controlled trial
Participants	129 women with physiological menopause (for ≥ 12 months), mean age 53 years
Interventions	Tibolone 2.5 mg/d Oestradiol 2 mg + medrogestone 2 × 5 mg/d for 12 days/mo For 6 months
Outcomes	Unscheduled bleeding, severity of menopausal symptoms (hot flashes, insomnia, vaginal dryness)
Notes	Data on unscheduled bleeding reported in a graph but number of events unclear Timing: not reported Location: Austria Multi‐centre: 5 sites To register severity of climacteric symptoms, a modified Kupperman Index was used
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	No information provided
Allocation concealment (selection bias)	Unclear risk	No information provided
Blinding of participants and personnel (performance bias) All outcomes	High risk	Open label
Blinding of outcome assessment (detection bias) All outcomes	High risk	Open label
Incomplete outcome data (attrition bias) All outcomes	High risk	Participants lost to follow‐up: 19.4% in tibolone group, 34.6% in combined HT group
Selective reporting (reporting bias)	Unclear risk	Study protocol not available
Conflict of interest	Unclear risk	Not reported