Selective oestrogen receptor modulators (SERMs) for endometriosis

Area of Science:

• Reproductive Medicine
• Pharmacology
• Gynecology

Background:

• Endometriosis is a chronic, estrogen-dependent condition affecting women of reproductive age, causing pain and infertility.
• Current medical treatments aim to suppress the menstrual cycle to alleviate symptoms and reduce lesion size.
• Selective estrogen receptor modulators (SERMs) are explored as an alternative treatment by targeting estrogen receptors.

Purpose of the Study:

• To evaluate the effectiveness and safety of selective estrogen receptor modulators (SERMs) for managing endometriosis.

Main Methods:

• Conducted a systematic search of multiple databases and trial registers up to May 2020.
• Included randomized controlled trials (RCTs) comparing SERMs against placebo, no treatment, other medications, or surgery.
• Extracted data on pain relief, adverse events, quality of life, and recurrence, using standard Cochrane methodology.

Main Results:

• One small RCT (n=93) comparing raloxifene (a SERM) to placebo in post-surgical endometriosis patients was included.
• Evidence quality was very low; raloxifene showed a trend towards faster return of pelvic pain compared to placebo.
• Uncertainty exists regarding raloxifene's impact on pain relief, adverse events, quality of life, and recurrence rates due to sparse data.

Conclusions:

• Based on limited evidence from one small RCT, the effects of SERMs on pain relief in surgically treated endometriosis patients remain uncertain.
• The study was prematurely halted due to higher pain scores in the SERM group, suggesting potential inefficacy or adverse effects.
• Further research is required to definitively establish the role of SERMs in endometriosis management.