Selective estrogen receptor modulators and phytoestrogens: New therapies for the postmenopausal woman

Estrogen deficiency in the postmenopausal woman results in numerous symptom atic and asymptomatic manifestations, including vasomotor symptoms, osteopo rosis, heart disease, bladder and vaginal symptoms, and cardiovascular dise ase. Estrogen replacement therapy is associated with amelioration of these problems but has attendant risks. A newer class of drugs, the selective est rogen receptor modulators, provides both estrogen agonist and antagonist pr operties, depending on the target tissue, This article discusses the mechan ism by which selective estrogen receptor modulators may vary in their end-o rgan effects and reviews the clinical studies associated with these compoun ds. Phytoestrogens are widely used in the United States, but little informa tion is available regarding their potential long-term effects.