Selective estrogen receptor modulators: Women's panacea for the next millennium?

The purpose of this review is to assimilate relevant experimental and clini cal information available on selective estrogen receptor modulators with re spect to their potential use as agents to improve women's health in the pos tmenopausal years. In addition, the mechanisms of action of these drugs are outlined. Selective estrogen receptor modulators represent an exciting gro up of antiestrogens that possess agonist action on bone, lipids, and lipopr oteins and antagonistic action in the endometrium and breast. Thus in theor y these drugs may preserve bone density and reduce the risk of osteoporotic fracture and coronary heart disease at the same time that they lower the i ncidences of breast and endometrial neoplasms. Short-term data with the use of raloxifene suggest that bone is preserved and lipid profiles are less a therogenic. Long-term studies are needed to determine whether raloxifene or other selective estrogen receptor modulators are associated with any decre ase in the risk of breast or endometrial cancer.