What Are Selective Estrogen Receptor Modulators?
Written by Ben Bunting: BA, PGCert. (Sport & Exercise Nutrition) // British Army Physical Training Instructor // S&C Coach.
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Selective estrogen receptor modulators (SERMs) are nonsteroidal drugs that work as antagonists or agonists to the estrogen receptor.
These drugs are often prescribed to treat or prevent breast cancer. They can also regulate menopausal symptoms.
SERMs are nonsteroidal compounds that function as agonists or antagonists for estrogen receptors
The diverse class of nonsteroidal compounds known as selective estrogen receptor modulators (SERMs) is comprised of a broad variety of compounds that selectively bind and activate estrogen receptors (ERs) in tissues.
These drugs differ from estrogens in both potency and specificity, and their mode of action is highly tissue-specific.
This allows them to provide estrogenic effects in the targeted tissues while avoiding adverse effects associated with estrogen receptors.
The mechanism of action of SERMs is complex and depends on a number of factors. For example, SERMs have different affinities for the different subtypes of the ER.
Once bound, they induce specific conformational changes in the ER and influence its ability to dimerize.
In addition, SERMs are able to affect the binding of co-factors. These co-factors can either directly bind the ERE or a transcriptional motifs on the ER.
Most of these nonsteroidal compounds target the ligand binding domain (LBD) of the human ERa protein.
For example, 17b-estradiol and tamoxifen bind to the same site on helix 12 of the ERa molecule, but they bind to different conformations of H12. Aside from targeting the LBD, most other SERMs target the ERa active site pocket.
These compounds can also be used as antiestrogens. The antiestrogenic action of SERMs is associated with their ability to bind to the ERb receptor. These estrogen receptor modulators are also known to have antiproliferative effects.
Clinical indications for SERMs
Selective estrogen receptor modulators (SERMs) work by inhibiting the actions of estrogen on breast cancer cells. SERMs bind to the ER receptor and induce specific conformational changes.
These changes are important for the dimerization of the ER, which affects its binding to co-factors. In some cases, the ER-SERM complex can bind directly to the ERE or to other transcriptional motifs.
Bone health
Although SERMs have been in clinical use for almost half a century, recent research has focused on newer agents with improved clinical activity and reduced side effects.
In addition, newer agents are being investigated for their potential role in osteoporosis. These new agents have been shown to reduce serum cholesterol levels and improve bone mineral density.
These compounds are tissue specific and differ from each other in their biological effects.
Their development has significantly extended the scope of estrogen-related therapy and has positively affected treatment for a range of diseases.
They are also being used to prevent osteoporosis and to maintain beneficial serum lipid profiles in postmenopausal women.
Because SERMs target different tissues, they can have different side effects in the same patient. Further research on these drugs may reveal how they work in different tissues and prevent or reverse certain side effects.
Breast cancer
SERMs have advantages and disadvantages, depending on which type they are used for. The drugs are not recommended for every type of breast cancer and should be used under the guidance of a medical professional.
The risk-benefit ratio must be considered carefully before SERMs are prescribed.
Although research on these drugs is limited, they have been shown to reduce breast cancer risk in some women.
Tamoxifen, for example, has been used for over 30 years as an anti-estrogen, and it is effective in reducing breast cancer risk in some women. It also maintains bone density in postmenopausal women and lowers circulating cholesterol.
For women with high-risk breast cancer, tamoxifen is the anti-estrogen of choice. It is one of the few drugs approved by the FDA to reduce the risk of breast cancer.
The use of SERMs is a promising prevention strategy for hormone-sensitive breast cancer. Among the first generation of SERMs, tamoxifen reduced the risk of invasive breast cancer by 30% to 40%. It also reduced the risk of death from breast cancer in women before menopause.
They regulate menopausal symptoms
Selective estrogen receptor modulators (SERMs) are an important class of pharmaceutical agents that are known to regulate menopausal symptoms.
They bind to the estrogen receptors in the body and can have either estrogen agonist or antagonist properties, depending on the compound and target tissue. The receptors are found in the brain, ovary, breast, bone, and liver.
A well-designed SERM would also have beneficial effects on the cardiovascular system and vasomotor system.
Selective estrogen receptor modulators can treat symptoms of menopause and help prevent postmenopausal osteoporosis.
These drugs also improve bone density and reduce hot flashes, vaginal atrophy, and bleeding. These agents also have fewer side effects than estrogen-based treatments.
Although SERMs can have both agonist and antagonist effects, research shows that they are not optimally balanced. Some of their side effects include an exacerbated vasomotor response and an increased risk of breast cancer.
Is the research into SERMs limited?
The study of SERMs in women with breast cancer has shown encouraging results. These drugs are able to decrease ERa expression and reduce mortality from the disease.
Their pharmacology is also quite interesting. They can be used to treat a variety of breast cancer conditions, including early-stage disease.
Although SERMs are not pure antiestrogens, they are ER agonists in some tissues and ER antagonists in others.
The ER conformations of these compounds are tissue-specific and affect gene expression. As a result, the use of SERMs for VMS treatment is not yet widespread.
The study has also identified some of the possible side effects associated with SERMs. Although there is no reliable way to assess these risks, there are some guidelines that can help guide physicians and patients.
For example, women who are at increased risk of developing cancer should be informed about all potential risks and options.
In addition, women should also be given a risk communication tool that helps them understand their risk. Using a simplified frequency tree or risk calculator can help.
The results of the study also suggest that SERMs are appropriate for postmenopausal women.
SERMs have been shown to lower the risk of vertebral fractures and maintain bone mineral density (BMD). However, these drugs are not without side effects and should be used with caution.
Conclusion
Selective estrogen receptor modulators (SERMs) are a class of compounds that is primarily used for treating health conditions related to estrogens. These include infertility, osteoporosis and menopausal symptoms.
SERMs are a group of nonsteroidal, synthetic compounds that are designed to act as an estrogen-antagonist or an estrogen-agonist in different tissues.
The pharmacology of selective estrogen receptor modulators is based on binding to the estrogen receptor, which is an important protein in the body.
As a result, SERMs activate the body's estrogen receptor, resulting in varying conformational changes. This results in a mixed agonism/antagonist profile that affords beneficial estrogenic actions in target tissues.
However, they also have the potential to have adverse effects on the body. SERMs can be associated with a variety of health conditions, including thromboembolic events and carcinogenesis.
Some SERMs affect estrogen receptors in the breast and uterus, but others have a more mixed effect on multiple tissues. This has led to a better understanding of the mechanisms of action for these compounds.
In some cases, SERMs can inhibit cancer growth in post-menopausal women. In addition, they can reduce the risk of vertebral fractures in postmenopausal women. They have also been shown to improve bone mineral density (BMD) in postmenopausal cisgender women.
Several SERMs can provide significant benefits for people who are at high risk for developing breast cancer. A number of SERMs are FDA approved for the treatment of breast cancer, genitourinary syndrome of menopause, and osteoporosis.
