Which of the following is a SERM used in menopause management?

• A. Raloxifene
• B. Letrozole
• C. Calcitonin
• D. Estradiol

Answer: (A)

A SERM is a tissue-selective estrogen receptor modulator—it can act like estrogen in some tissues while blocking estrogen in others. Raloxifene fits this pattern in menopause management because it acts as an estrogen-like effect on bone, helping to maintain or increase bone density and reduce fracture risk. At the same time, it blocks estrogen receptors in breast tissue, which lowers the risk of developing breast cancer, and it has minimal stimulation of the uterus, avoiding the endometrial concerns seen with some other therapies. This combination makes it useful for postmenopausal osteoporosis prevention and breast cancer risk reduction.

The other options aren’t SERMs. Letrozole is an aromatase inhibitor that lowers overall estrogen production, not a SERM. Calcitonin works through a different mechanism to affect bone metabolism. Estradiol is estrogen therapy, not a SERM, and it does not have the same tissue-selective receptor activity.