ABSTRACT
Selective estrogen receptor modulators tamoxifen,raloxifene,and bazedoxifene reduce neuronal death through the mechanisms of anti-inflammation,antioxidant stress,and inhibition of glutamate excitotoxicity.They play a neuroprotective role in cerebral ischemia and may become a new neuroprotective agent for the treatment of ischemic stroke.
ABSTRACT
Post-menopausal women suffer from a plethora of problems like vasomotor symptoms, vulvovaginal atrophy (VVA), bone loss, and all this can be attributed to estrogen deficiency. The conventional treatment till date for these hormone deficient manifestations have been estrogen replacement therapy in hysterectomized female or a combination of estrogen and progesterone therapy in women with an intact uterus. The reason for adding progesterone is to protect the endometrium from estrogenic stimulation. The drawback with the combination therapy was irregular vaginal bleeding and breast discomfort, which led to the discontinuation of this therapy. The United States Food and Drug Administration, has recently approved a novel tissue selective estrogen complex comprising of conjugated estrogen (0.45 mg) and a selective estrogen receptor modulator, bazedoxifene (BZA) (20 mg) for the treatment of moderate to severe vasomotor symptoms and prevention of osteoporosis in nonhysterectomized post-menopausal women. This combination retains the benefits of estrogen on vasomotor symptoms, VVA and bone density along with the protective effect of BZA on endometrium and breast tissue. The results of clinical trials have been promising but what still needs to be evaluated is the long term safety of this pair on venous thromboembolism, stroke, and breast cancer.