To investigate the stereoselectivity in human metabolic 3-reduction of tibolone. Twenty healthy Chinese female volunteers were given a single oral dose of tibolone (2.5 mg), and serial blood samples were collected after treatment. The plasma concentrations of the two pharmacologically active 3-hydroxyl metabolites of tibolone, 3alpha-hydroxyl-7-methyl- norethynodrel (3alpha-HMN) and 3beta-hydroxyl-7-methyl- norethynodrel (3beta-HMN) in plasma were determined by using a validated liquid chromatography-mass spectrometry (LC-MS) method. The apparent elimination half-life (T(1/2) of 3alpha-HMN was 1.43+/-0.52 h, and that of 3beta-HMN was 1.53+/-0.60 h. Maximum plasma concentrations (C(max)) were found to be 8.75+/-4.36 microg/L for 3alpha-HMN and 3.59+/-1.81 microg/L for 3beta-HMN. Areas under the plasma concentration versus time curve (AUC(0-t)) were 26.30+/-12.14 microg.h(-1).L(-1) for 3alpha-HMN and 9.89+/-4.93 microg.h(-1).L(-1) for 3beta-HMN. Stereo-selective differences exist in the pharmacokinetics of tibolone metabolism in humans.