Detailed definition
Raloxifene (Evista) is a second-generation SERM with bone-agonist and breast-antagonist activity. It is FDA-approved for prevention and treatment of postmenopausal osteoporosis and for reducing the risk of invasive breast cancer in postmenopausal women at high risk. Bone effects are modest compared to bisphosphonates — DEXA gains of roughly 2–3% over 2 years and roughly 30% reduction in vertebral fracture risk, with less impact on hip fractures. Breast cancer risk reduction is roughly 50% in high-risk populations (STAR trial). Side effects include hot flashes (a frequent issue, ironic in a menopause-relevant drug), leg cramps, and increased VTE risk similar to oral estrogen. It does not increase endometrial cancer risk.
Why it matters in menopause
Raloxifene fills a specific niche: postmenopausal women with osteopenia/osteoporosis plus elevated breast cancer risk who want a single drug addressing both. It is not a fit for women with significant vasomotor symptoms (it can worsen them) or VTE history.
Related terms
Sources
External references: Wikipedia.