Similarity of uterine mucosa changes in patients treated by raloxifen and tamoxifen.
BACKGROUND
Selective estrogen receptor modulators (SERMS) like Tamoxifen and Raloxifen are used for menopausal symptoms, prevention of cardio-vascular diseases, osteoporosis and mammary carcinoma. Tamoxifen acts as an estrogen inhibitor on the mammary gland, but stimulates postmenopausal uterine mucosa in about 25% of cases while decreasing the risk of osteoporosis.


RESULTS
In three menopausal women, 56, 79 and 62 years of age, we found uterine mucosal changes similar to what is found in Tamoxifen-treated patients. Using light microscopy and immuno-histopathological techniques, partly cystic mucosa with both atrophic and proliferating glands was found. Strong stromal proliferation was also seen with the typical sharp-edged form of stromal cells and mitoses. A strong ostrogen and progesterone reaction was revealed with immuno-histopathological techniques in both gland and stromal parts.


CONCLUSIONS
Taking into account the variable amount of different estrogen-receptor types in the uterine mucosa, we can not in the long run expect that no patient will react with estrogen-stimulation features on SERMs like Raloxifen. Further studies and thorough observations are needed to elucidate the true frequency of Raloxifen impact on the uterine mucosa.
Willèn
Roger
R
Department of Pathology, Sahlgrenska University Hospital, Göteborg, Sweden.
Willèn
Helena
H
Lindahl
Bengt
B
D000368:Aged; D005260:Female; D006801:Humans; D008875:Middle Aged; D009092:Mucous Membrane / Q000187:drug effects / Q000473:pathology; D011127:Polyps / Q000139:chemically induced / Q000473:pathology; D020849:Raloxifene Hydrochloride / Q000009:adverse effects* / Q000627:therapeutic use; D020845:Selective Estrogen Receptor Modulators / Q000009:adverse effects* / Q000627:therapeutic use; D013629:Tamoxifen / Q000009:adverse effects* / Q000627:therapeutic use; D014594:Uterine Neoplasms / Q000139:chemically induced / Q000473:pathology; D014599:Uterus / Q000187:drug effects* / Q000473:pathology
D020845:Selective Estrogen Receptor Modulators; D013629:Tamoxifen; D020849:Raloxifene Hydrochloride