Selective modulation of postmenopausal XXXX : cutting the Gordian knot of hormone replacement therapy with @entity0 .

@entity1 @entity172 @entity9646 @entity0 @entity1420
BACKGROUND: @entity9646 replacement therapy (HRT) has proven and presumable benefits for @entity1 desiring postmenopausal health preservation. Among HRT-associated risks, the fear of @entity0 intimidates @entity1 and physicians contemplating hormonal treatment and limits long-term compliance. Identifying effective alternative medications that are not associated with @entity0 or that even may prevent its development would be a major advance. METHODS: This article discusses the clinical perspective of HRT and selective @entity172 receptor modulators (SERMs) in light of the molecular and cellular mechanisms of @entity172 and @entity1420 action on the breast. Emphasis is placed on the potential of selective receptor modulation as the future of postmenopausal treatment. RESULTS: Current epidemiologic evidence suggests that HRT is associated with a small but substantial increase in the risk of @entity0 , and combined @entity172 - @entity1420 regimens further increase this hazard. Ample biologic data support this clinical association and propose multiple molecular mechanisms for the effects of @entity172 and @entity1420 on breast cells. SERMs are a novel class of drugs that demonstrate @entity172 agonistic and antagonistic actions in a tissue specific manner. SERMs act by binding the @entity172 receptor and selectively modulating its effect on gene transcription at target tissues. CONCLUSIONS: SERMs offer an alternative to HRT that can successfully circumvent the intimidating side-effect of @entity0 . Further insight into the molecular mechanisms of SERM action may enable the development of agents with improved target-tissue selectivity. Identifying selective modulators with unique pharmacologic properties would facilitate the creation of individualized treatment for the postmenopausal @entity1 according to her particular predisposition for menopause-related morbidities and her overall clinical profile.
