More selective drugs could give the benefits of hormone replacement without the health risks of conventional treatment.

There is increasing concern that the hormones estrogen and progesterone, used in hormone replacement therapy (HRT), may carry a number of risks to long-term health, such as cancer and heart disease. Yet HRT is valuable in treating menopausal symptoms, and protects against osteoporosis and maybe even dementia.

Researchers in the US have been surveying what we know of the risks of conventional HRT and comparing this with a 'new generation' of HRT, called the selective estrogen receptor modulators (SERMs). These are 'designer' drugs in the sense that they act on only certain tissues, not on others. Estrogen and progesterone, by contrast, act at many sites throughout the body.

For instance, tamoxifen is a SERM which can help protect against breast cancer (although it is not completely specific, for it still increases the risk of endometrial cancer). Raloxifene is a newer type of SERM which protects against both osteoporosis and breast cancer, without raising the risk of endometrial cancer. The goal of pharmaceutical research is now to make even better SERMs, which can offer women the protective benefits of HRT without the risks.

Source

Cancer 1st January 2003