Which selective estrogen receptor modulator (SERM) is approved for treatment of postmenopausal osteoporosis?

• A. Tamoxifen
• B. Raloxifene
• C. Toremifene
• D. Ospemifene

Answer: (B)

Raloxifene is approved for treating osteoporosis in postmenopausal women because it acts as an estrogen receptor agonist in bone, which helps reduce bone turnover, maintain or improve bone mineral density, and lower vertebral fracture risk. At the same time, it behaves as an antagonist in breast and endometrial tissue, which provides breast cancer risk reduction without stimulating the endometrium. Other SERMs are used for different indications: some target breast cancer risk or treatment and can stimulate endometrial tissue, while others are for genitourinary symptoms, not osteoporosis. This combination of bone benefits with reduced estrogenic stimulation of breast and uterus makes raloxifene the go-to SERM for postmenopausal osteoporosis.