The most important problems associated with HRT and selective estrogens receptor modulators are increased risk of thromboembolic , cerebro and cardiovascular events , but they differ in their cancer risks >>>>
Estrogens only HRT increase risk of endometrial cancers ( so used after hysterectomy ) .
SERM like tamoxifen used in ttt of breast cancer , but it increases risk of endometrial cancer .
SERM like raloxifen is used in ttt of osteoporosis ( reduce spine fracture only) , but as his brother , increased the risk of endometrial cancer .
In contrast to the above , combined HRT increased the risk of breast cancer and reduces risk of endometrial cancer .
HRT is no longer needed for primary or secondary prevention of osteoporotic fractures .