title: Effects of raloxifene on cognition, mental health, sleep and sexual function in menopausal women: a systematic review of randomized controlled trials.
abstract: OBJECTIVE
  Raloxifene has been used as therapy for osteoporosis and ER(+) breast cancer prevention in menopausal women. However, its effects on cognition and climacteric syndrome are controversial. This study reviews the relevant studies and reaches a comprehensive conclusion.
  
  
  METHODS
  We retrieved thirteen electronic databases, read the titles and abstracts to exclude ineligible articles, and then read the full text and references to form a basis for decisions using the inclusion criteria. If full text was not available, we asked the author for a copy of the article. After the data were extracted and recorded, the research quality was evaluated by two authors using the Jadad score and Cochrane handbook.
  
  
  RESULTS
  We found seven eligible studies. The design, evaluated items, questionnaires and scales were heterogeneous. The design quality was fair as evaluated by the Cochrane Handbook. We found that 60 mg/day raloxifene could improve verbal memory, and 120 mg/day raloxifene produced a 33% decrease in the risk of mild cognitive impairment and also lowered the risk of Alzheimer's disease. There was not enough evidence to state if raloxifene had any effect on depression, anxiety, sleep, sexual function, vasomotor symptoms, but significantly worsened menstrual symptoms.
  
  
  CONCLUSIONS
  Raloxifene may have some benefit for cognition, but it is not significant effect on anxiety, depression, sleep, sexual function, vasomotor symptoms and worsens menstrual symptoms. This drug is safe for treating osteoporosis and preventing breast cancer in menopausal women, but it is not suitable for patients who have any arterial stenosis or thrombophilia.
authors.affiliation: Department of Neurology, Liyuan Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Z D
authors.initials: ZD
authors.lastname: Yang
authors.forename: J
authors.initials: J
authors.lastname: Yu
authors.forename: Q
authors.initials: Q
authors.lastname: Zhang
mesh_terms: D000544:Alzheimer Disease / Q000517:prevention & control; D003071:Cognition / Q000187:drug effects*; D003072:Cognition Disorders / Q000517:prevention & control; D005260:Female; D006801:Humans; D008568:Memory / Q000187:drug effects; D008593:Menopause; D008603:Mental Health; D020849:Raloxifene Hydrochloride / Q000494:pharmacology*; D060728:Reproductive Health; D020845:Selective Estrogen Receptor Modulators / Q000494:pharmacology*; D012890:Sleep / Q000187:drug effects*
chemical_list: D020845:Selective Estrogen Receptor Modulators; D020849:Raloxifene Hydrochloride
keywords: Climacteric syndrome; Cognition; Menopause; Raloxifene