Tamoxifen effects on menopause--associated risk factors and symptoms.

UNLABELLED: This study reviewed the available data on the influence of prolonged tamoxifen treatment on postmenopausal women. Tamoxifen might induce or increase vasomotor symptoms, such as hot flushes and night sweats, and occasionally cause vaginal discharge, irritation, and bleeding. Long-term use of tamoxifen by premenopausal women lowers total serum cholesterol and LDL-cholesterol, with a resultant reduction in cardiovascular mortality. In postmenopausal women, tamoxifen has a similar effect on serum lipids, but its cardioprotective effect has not yet been substantiated. Tamoxifen has a beneficial effect on bone density presumably through its estrogen agonistic effects. It has an antiresorptive action primarily on trabecular bone and to a lesser extent on cortical bone, thus preserving bone mass. Its long-term effect on the risk of osteoporotic fractures has yet to be proven. The authors conclude that prolonged tamoxifen treatment of postmenopausal women is associated with beneficial effects on serum lipid profiles and bone density; however, its effects on the morbidity and mortality from cardiovascular disease and osteoporosis and how it compares with the benefits of estrogen therapy remain to be determined by long-term comparative studies. TARGET AUDIENCE: Obstetricians & Gynecologists, Family Physicians. LEARNING
OBJECTIVES: After completion of this article, the reader will be able to be aware of the new indications for tamoxifen use prophylactically. To understand the various effects of tamoxifen on post-menopausal women and how they differ from the effects on premenopausal women.