From the Editor

Professor and Director, Division of Reproductive Endocrinology, Department of Ob/Gyn and Women’s Health, Albert Einstein College of Medicine, Bronx, New York

WHAT WOULD BE THE PERFECT selective estrogen receptor modulator (SERM) for a menopausal woman? First, it would have to be effective at symptom relief—and function like estrogen. Second, it would have to antagonize estrogen action in the uterus and breast and function as an antiestrogen. Oh, and it also needs to be osteoprotective! It would probably also be beneficial if it did not induce liver protein synthesis, thereby avoiding some of the clotting complications of estrogen therapy. And, of course, it should prevent vaginal atrophy. An extra bonus would be maintaining the vasodilatory effects of estradiol on the coronary vasculature.

Is it possible to achieve this perfect blend with a single compound? This issue of Menopausal Medicine features 3 articles that provide the answers: yes, maybe, and no. Drs Hall and McDonnell provide the scientific background that describes the search for this perfect SERM. They are so inspiring, it makes you feel as if this seemingly impossible dream can be realized. Dr Clark provides an overview of SERMs that are available or in development, giving a practical overview of what’s out there and providing us with a definite “maybe” that a near-perfect SERM may be on the way. Finally, Dr Pickar describes a different strategy: instead of searching for the perfect SERM, he shows how an existing SERM can be complemented with estrogen to produce the desired effects. I hope you find this issue as enjoyable and educational as I did!

Sexuality, Reproduction & Menopause ©2008 Quadrant HealthCom Inc.