ACOG practice bulletin. Selective estrogen receptor modulators. Number 39, October 2002 (replaces Committee Opinion Number 224, October 1999).

Selective estrogen receptor modulators (SERMs) are synthetic compounds that bind estrogen receptors and produce agonistic activity in some tissues while acting as estrogen antagonists in other tissues. Although referred to collectively, their effects in different organs (eg, endometrium, urinary tract) are far from uniform. Much confusion exists about the indications for their use and the effects of these compounds. The purpose of this document is to review the use of SERMs for breast cancer risk reduction and skeletal protection as approved by the U.S. Food and Drug Administration (FDA).