It should be noted, however, that the risk for this condition is still extremely low. Only women with a previous history of thromboembolism or other risk factors for it should avoid HRT for this reason. Liver Disease Complications. Estrogens do not damage the liver, but they metabolize more slowly in women with diseased livers, this can result in an increased effect of estrogen. One study suggests that the use of unopposed estrogen more than doubles the risk of Raynaud's phenomenon, which affects circulation in the hands and feet, causing changes in skin color and sensation, including tingling, coldness, or numbness.
Tamoxifen is the best studied and has been used to both treat and protect against breast cancer.
It increases the risk for uterine cancer, however, in some women. Raloxifene is actually the first SERM to be approved for preventing spinal fractures and may protect against breast cancer without increasing the risk for uterine cancer. Droloxifene is an investigational SERM that also appears to protect against bone loss without increasing cancer risks. It should be noted that any beneficial effects of the SERMs on the heart or central nervous system are still unclear. It should be noted that most SERMs do not relieve menopausal symptoms, and some exacerbate them.