What Can We Expect from Raloxifene in the Treatment
of Postmenopausal Osteoporosis: Gynaecological Point
of View
Chmel R., Rob L., Strnad P.
Gynekologicko-porodnická klinika, UK, 2. LF a FN v Motole, Praha, přednosta prof. MUDr. J. Hořejší, DrSc. |
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Summary:
Objective: Evaluation of positive properties and side effects of raloxifene treatment with respect
to its potential use as agent to improve women’s health and quality of life in postmenopausal
years.
Design: A review article.
Setting: Obstetrics and Gynaecology Department, Charles University 2nd Medical Faculty and
Teaching Hospital Motol, Prague.
Subject: Estrogen use may protect against osteoporosis and cardiovascular disease, but may increase
the risk of breast cancer in long-term treated women and also may increase the risk of
irregular uterine bleeding (in combination with gestagen in non-hysterectomized women) in perimenopause
and postmenopause. Drugs with tissue-specific estrogenic effects are termed selective
estrogen receptor modulators (SERM). Tamoxifen is the first SERM successfully used in the prevention
and treatment of breast cancer. Another SERM raloxifene is widely used in the prevention
and treatment of postmenopausal osteoporosis, especially in women without climacteric
complaints. Therapy with raloxifene increases bone mineral density, lowers serum concentrations
of total and low-density lipoprotein cholesterol, and does not stimulate endometrium and
breast. Evaluation of another potential positive effects (reducing size of uterine leiomyomas, etc.)
warrants further investigation.
Conclusion: Raloxifene can be used in postmenopausal women free of climacteric symptoms for
the prevention and treatment of postmenopausal osteoporosis with no increased risk of thrombosis
and with the advantage of positive side effects during the treatment.
Key words:
raloxifene, SERM, osteoporosis, endometrial cancer, breast cancer, postmenopause,
cardiovascular disease
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