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Related Experiment Video

Updated: Nov 6, 2025

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Selective oestrogen receptor modulators (SERMs) for endometriosis.

Maaike Ht van Hoesel1, Ya Li Chen2,3, Ai Zheng2

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The Cochrane Database of Systematic Reviews
|May 11, 2021
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Selective oestrogen receptor modulators (SERMs) show uncertain effects on pain relief for endometriosis. A single study indicated faster pain return with raloxifene compared to placebo, necessitating further research.

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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.