WHAT ARE SERMS?

WHAT ARE SERMS? SERMS are used as hormone replacement therapy for menopausal women. SERMS are different from traditional Estrogen and Progesterone combinations currently prescribed.

SERM stands for:

S-Selective

E-Estrogen

R-Receptor

M-Modulator

Does that help? Probably not. This means that SERMS act LIKE estrogen on some parts of the body and NOT like estrogen on other parts of the body. So think of them as “partial estrogens”

The details do matter-

SERMS act LIKE estrogen on

Skin and hair-SERMS can help prevent wrinkles and hair loss*

Bones- SERMS strengthen bones and help prevent brittle bones

Bloodstream- SERMS, like estrogen, lower cholesterol. SERMS, like estrogen also “thicken” the blood and it makes it slightly more likely to clot

Brain - SERMs can reduce hot flashes for some women because the brain thinks they are estrogen*

Vaginal tissue-SERMS help thicken up thinning vaginal tissue, helping with issues like chronic vaginal irritation, painful sex, and frequent UTI.

Dementia Risk-SERMS seem to decrease dementia risk. Some studies show estrogen increases dementia risk.

Uterus-Raloxifene(Evista) and bazedoxifene (Duavee) are neutral(Evista doesn’t stimulate) or block (Duavee blocks) estrogen in the uterus. This means these two SERMS don’t increase the risk of uterine cancer like estrogen can. This is really important, because it means you don’t have to take progesterone with SERMS.

*Data is not consistent in all studies

Therapy.

Sources:

1. Selective Estrogen Receptor Modulators and Bone Health.Goldstein SR. Climacteric : The Journal of the International Menopause Society. 2022;25(1):56-59. doi:10.1080/13697137.2021.1936485.

2.Use of SERMs for Treatment in Postmenopausal Women.Pinkerton JV, Thomas S. The Journal of Steroid Biochemistry and Molecular Biology. 2014;142:142-54. doi:10.1016/j.jsbmb.2013.12.011.

3.A Pharmacological Review of Selective Oestrogen Receptor Modulators. Goldstein SR, Siddhanti S, Ciaccia AV, Plouffe L. Human Reproduction Update. 2000 May-Jun;6(3):212-24. doi:10.1093/humupd/6.3.212.

4.Selective Estrogen Receptor Modulators: A Look Ahead.Mitlak BH, Cohen FJ.Drugs. 1999;57(5):653-63. doi:10.2165/00003495-199957050-00001.

5.An Overview of Current and Emerging SERMs.

Komm BS, Mirkin S.The Journal of Steroid Biochemistry and Molecular Biology. 2014;143:207-22. doi:10.1016/j.jsbmb.2014.03.003.

6.Selective Estrogen Receptor Modulators in Clinical Practice: A Safety Overview.Ellis AJ, Hendrick VM, Williams R, Komm BS.

Expert Opinion on Drug Safety. 2015;14(6):921-34. doi:10.1517/14740338.2015.1014799.

7. Effect of Selective Estrogen Receptor Modulators on Metabolic Homeostasis.Xu B, Lovre D, Mauvais-Jarvis F.

Biochimie. 2016;124:92-97. Doi:10.1016/j.biochi.2015.06.018.

8. SERMs: Current Status and Future Trends.

Morello KC, Wurz GT, DeGregorio MW.

Critical Reviews in Oncology/Hematology. 2002;43(1):63-76. doi:10.1016/s1040-8428(02)00022-7.

9. Evista. FDA Drug Label.

Food and Drug Administration