Menopause and SERM drugs

Question 1

ospemiphene

Answer 1

• SERM
• used for painful intercourse and vaginal dryness
• AGONIST at ER in vagina, ANTAGONIST on ER in breast
• risk of hot flashes, DVT, endometrial hyperplasia

Question 2

clomiphene

Answer 2

• SERM
• used for infertile anovulatory pts
• blocks estrogenic negative feedback in the HPO axis, leading to increased GnRH stimulation of ovaries
• ONLY used for up to 3 cycles due to multiple pregnancies

Question 3

bazedoxifene

Answer 3

• TSEC (SERM w/ CE)
• treat vasomotor symptoms in pts who are intolerant to progestin
• ANTAGONIST of ER in breast and uterus
• risk of hot flashes, DVT, endometrial hyperplasia