SERMs represent a diverse group of molecules with varying levels of estrogenic 
agonist and antagonist activity in target tissues. SERMs have a long regulatory 
approval history and have been studied for a variety of therapeutic indications. 
The clinical effects of SERMs have been evaluated in a large number of phase 3 
clinical trials. Many of the available SERMs have proved to be effective as 
chemo-preventive agents and treatments for breast cancer and a number are useful 
for the prevention and treatment of osteoporosis. The endometrial effect of 
SERMs has been a key differentiator in clinical practice and a major hurdle for 
regulatory approval. The effect of SERMs in the vagina also represents a major 
distinction among different SERMs. This review summarized key clinical finding 
of SERMs in different target tissues.