SERMs

Selective Estrogen Receptor Modulators (SERMs) are drugs that influence testosterone and various physiological processes. They lower 5-α reductase activity, increase total testosterone, increase sex hormone-binding globulin (SHBG) levels, and decrease p450 aromatase activity[1]. This makes SERMs potential treatments for conditions like male hypogonadism and idiopathic male infertility.

In male hypogonadism, SERMs like Clomiphene (Clomid) and tamoxifen (Nolvadex) increase testosterone and gonadotropin levels while preserving spermatogenesis[2]. They can effectively enhance testosterone levels and improve reproductive function in men with hypogonadism.

For idiopathic male infertility, SERMs have shown modest improvements in semen parameters and pregnancy rates[3]. However, the quality of these studies varies, and more research is needed[3].

SERMs also have potential benefits beyond reproductive function. For instance, raloxifene has shown renoprotective effects[4]. In the context of acromegaly, SERMs can modulate growth hormone secretion by blocking the effects of estrogen and testosterone[5].

References

  1. Bae, David, et al. “The Diagnosis and Treatment Of Osteoporosis In Men On Androgen Deprivation Therapy For Advanced Carcinoma Of The Prostate“. Journal of Urology, vol. 172, no. 6 Part 1,2004, p. 2137-2144.
  2. Krzastek, Sarah, et al. “Non-testosterone Management Of Male Hypogonadism: An Examination Of the Existing Literature“. Transl Androl Urol, vol. 9, no. S2, 2020, p. S160-S170.
  3. Tadros, Nicholas, et al. “Empiric Medical Therapy With Hormonal Agents For Idiopathic Male Infertility”. Indian J Urol, vol. 33, no. 3, 2017, p. 194. https://doi.org/10.4103/iju.iju_368_16
  4. Melamed, Michal, et al. “Raloxifene, a Selective Estrogen Receptor Modulator, Is Renoprotective: A Post-hoc Analysis“. Kidney International, vol. 79, no. 2, 2011, p. 241-249.
  5. Selek, Alev, et al. “Aromatase Enzyme Expression In Acromegaly and Its Possible Relationship With Disease Prognosis“. Endocrine, vol. 49, no. 1, 2014, p. 250-257.
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