What risks are associated with SERMs?

• A. Hair loss and dry skin
• B. Blood clots, stroke, and uterine cancer
• C. No side effects
• D. Improved muscle strength

Answer: (B)

SERMs act as estrogen receptor modulators, showing estrogen-like effects in some tissues and anti-estrogen effects in others. This mixed action leads to key safety concerns: they can increase the risk of forming blood clots, which can cause deep vein thrombosis, pulmonary embolism, or even stroke. In tissues where they act like estrogen, such as the uterine lining with drugs like tamoxifen, they can stimulate the endometrium and raise the risk of endometrial hyperplasia and cancer. Because of these clinically important effects, the combination of clotting risks, potential stroke, and uterine cancer risk best captures the main safety issues associated with SERMs. Hair loss and dry skin aren’t the primary risks, there isn’t an overall assumption of no side effects, and improved muscle strength isn’t a known major SERM risk or benefit.