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Medical Video: SERM - Selective Estrogen Receptor Modulators
Cells in the body have different types of estrogen receptors depending on the structure. Selective estrogen modulator is an agent that binds to estrogen receptors and can act as an agonist or anatagonist, for example estrogen receptor modulators act as antagonists in breast estrogen receptors and agonists in bone and uterine estrogen receptors. Selective estrogen modulator also blocks estrogen in breast cells which can activate estrogen in other cells, such as bones, liver and uterus. In addition, the ethrogen modulator serves to increase bone density and reduce the risk of osteoporosis.
Selective estrogen modulator is a reaction of breast tissue antagonists used in the treatment of breast cancer. The growth of breast cancer depends on the growth of estrogen which can protect the bone structure in women. Therefore, selective estrogen modulator is useful for preventing osteoporosis after menopause.
Some types of selective estrogen receptor modulators, namely
- Tamoxifen in pill form (called tamoxifen citrate; brand: Nolvadex); tamoxifen in liquid form (brand: Soltamox)
- Evista (chemical name: raloxifene)
- Fareston (chemistry: toremifene)
How does the estrogen receptor modulator work?
Selective estrogen modulator works by regulating receptors in breast cells. If the selective estrogen receptor modulator is an estrogen receptor, then there is no gap for cells to enter estrogen. The estrogen signal makes cells unable to grow and multiply.
Estrogen stimulates the development of both endogenous and exogenous breast cells and will involve the pathogenesis of breast cancer. Tamoxifen and selective estrogen receptor modulators will emerge as anti-estrogen agents that can be used for breast cancer. Tamoxifen is the standard of use because it is made to identify tumors and is a treatment with the right strategy so that patients can survive. The success of tamoxifen shows a 50% reduction in side effects within 15 years after diagnosis. But the large number of side effects in the use of tamoxifen causes many contributions in morbidity and mortality. Engineering medicine has also produced several side effects. Raloxifene can be an option because in addition to preventing osteoporosis, reloxifene can provide benefits for breast cancer patients. Raloxifene is also recommended as a prevention of breast cancer in women who have experienced menopause.
What are the side effects of elective estrogen receptor modulators?
Side effects of selective estrogen modulators are usually the occurrence of blood clots, strokes, and endometrial cancer. If the patient will use tamoxifen or selective estrogen receptor modulator treatment, then inform the doctor in advance if you are a smoker, have a history of blood clots, and a heart attack. Immediately consult a doctor also if you have symptoms like the following:
- Sudden headaches
- Unusual bleeding in intimate organs
- Vision becomes blurred
- Tingling or numbness in the face, arms and legs.
- Pain or pressure on the pelvis
- Difficulty breathing
- Swollen feet and pain
- Chest pain
- Dizzy
- Coughing up blood
There are some side effects that are common in selective estrogen receptor modulators that may be experienced by patients, namely
- Leucorrhoea
- Mood swings
- Fatigue
- Sweat at night
- Feeling heat in the body
What things should be considered?
The use of raloxifene must be stopped three days before surgery and during recovery. Selective estrogen receptor modulators should not be used in patients who are allergic to drugs, are pregnant, or breastfeeding because these drugs can interfere with fetal growth. Patients must also use non-hormonal contraceptives such as the use of I.U.D or condoms.
Other information that must be obtained by the patient is information about how long it takes to use this contraception if it has experienced blood clots.
