Selective Oestrogen Receptor Modulators

Abstract

Postmenopausal oestrogen deficiency causes a wide spectrum of adverse consequences that may be prevented or reversed by hormone replacement therapy (HRT). However, acceptance of HRT and then long term continuation is poor. Many reasons are given for this poor acceptance but the two most important factors are the return of withdrawal bleeding and the fear of breast cancer. Thus an ideal therapeutic agent should produce the beneficial effects of oestrogen in non-reproductive tissue such as bone, without proliferative effects on breast and uterine tissue. Compounds that possess tissue specific oestrogen agonist and antagonist properties are described as selective oestrogen receptor modulators, or SERMs. A number of SERMs, including raloxifene and idoxifene, are currently undergoing phase III clinical trials with encouraging results. Their imminent use should provide a great advance in the management of the menopause.