Tibolone has anti-inflammatory effects in estrogen-deficient female rats on the natriuretic peptide system and TNF-alpha

► Estrogen-deficient state promotes increased pro-inflammatory cytokines and impairment of the natriuretic peptide system. ► Increased IL-6 and TNF-α, in addition to decreased ANP levels, contributes to increased cardiovascular disease. ► We demonstrated that tibolone reduces serum TNF-α levels and increases plasma ANP levels. ► The anti-inflammatory effects of tibolone may prevent cardiovascular disease in the long-term.