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Urogenital effects of selective estrogen receptor modulators: a systematic review.

Abstract Selective estrogen receptor modulators (SERMs) include a relatively large number of compounds, each with different profiles of estrogenic/antiestrogenic actions on the genital tract. The aim of this review was to systematically evaluate all the available data from randomized, controlled studies on the effects of these compounds on pelvic organ prolapse and urinary incontinence.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title climacteric : the journal of the international menopause society
Publication Year Start




PMID- 16390753
OWN - NLM
STAT- MEDLINE
DA  - 20060106
DCOM- 20060228
LR  - 20071115
IS  - 1369-7137 (Print)
IS  - 1369-7137 (Linking)
VI  - 8
IP  - 3
DP  - 2005 Sep
TI  - Urogenital effects of selective estrogen receptor modulators: a systematic
      review.
PG  - 214-20
AB  - OBJECTIVE: Selective estrogen receptor modulators (SERMs) include a relatively
      large number of compounds, each with different profiles of
      estrogenic/antiestrogenic actions on the genital tract. The aim of this review
      was to systematically evaluate all the available data from randomized, controlled
      studies on the effects of these compounds on pelvic organ prolapse and urinary
      incontinence. METHODS: Literature searches were performed using three
      computerized databases to identify the result of all randomized, controlled
      trials performed with SERMs having any effects on pelvic floor as an outcome. A
      manual search was performed on all related articles. RESULTS: We have identified 
      only one randomized, placebo-controlled trial specifically designed to assess the
      effect of raloxifene and tamoxifen on the urogenital tract. Most of the data on
      genitourinary effects of various compounds derive from either questionnaires or
      adverse events reported during phase III clinical trials. Both tamoxifen and
      raloxifene appear to increase the incidence of pelvic floor prolapse in one
      trial, although this was not apparent from the licensing studies data for either 
      of the drugs. Raloxifene does not appear to increase the incidence of urinary
      incontinence. Levormeloxifene and idoxifene, on the contrary, were noted to
      increase uterine prolapse and incontinence during phase III trials that
      prematurely terminated. No data are available on the genitourinary effect of
      toremifene and on the newer SERMs currently undergoing phase III trials:
      basedoxifene, lasofoxifene, and arzoxifene. CONCLUSION: Contrary to their effects
      in bone, SERMs do not have a class-specific effect on the genitourinary tract. In
      fact, compounds that are more estrogenic on the uterus such as levormeloxifene
      and idoxifene also increase the risk of prolapse and incontinence. SERMs can
      adversely affect the pelvic floor and incontinence but data from urodynamic
      studies are not yet available. Data on prolapse are contradictory. Given the
      increased incidence of prolapse and incontinence observed in several licensing
      trials, more focused research on the effect of these molecules on pelvic floor
      function is needed.
FAU - Albertazzi, P
AU  - Albertazzi P
AD  - Centre for Metabolic Bone Disease, University of Hull, Hull, UK.
FAU - Sharma, S
AU  - Sharma S
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Climacteric
JT  - Climacteric : the journal of the International Menopause Society
JID - 9810959
RN  - 0 (Selective Estrogen Receptor Modulators)
SB  - IM
MH  - Clinical Trials as Topic
MH  - Endometrium/*drug effects
MH  - Female
MH  - Humans
MH  - Leukorrhea/chemically induced
MH  - Osteoporosis, Postmenopausal/prevention & control
MH  - Selective Estrogen Receptor Modulators/*therapeutic use
MH  - Urinary Incontinence/*chemically induced/epidemiology
MH  - Uterine Prolapse/*chemically induced/epidemiology
MH  - Vagina/*drug effects
RF  - 35
EDAT- 2006/01/05 09:00
MHDA- 2006/03/01 09:00
CRDT- 2006/01/05 09:00
AID - N54872253848869P [pii]
AID - 10.1080/13697130500117946 [doi]
PST - ppublish
SO  - Climacteric. 2005 Sep;8(3):214-20.

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