Cancer In contrast to premenopausal women, in whom most of the estrogen is produced in the ovaries, in postmenopausal women estrogen is mainly produced in peripheral tissues of the body. Because some breast cancers respond to estrogen, lowering estrogen production at the site of the cancer (i.e. the adipose tissue of the breast) with<unk> s has been proven to be an effective treatment for hormone-sensitive breast cancer in postmenopausal women.<unk> s are generally not used to treat breast cancer in premenopausal women because, prior to menopause, the decrease in estrogen activates the hypothalamus and pituitary axis to increase gonadotropin secretion, which in turn stimulates the ovary to increase androgen production. The heightened gonadotropin levels also upregulate the<unk>  promoter, increasing<unk>  production in the setting of increased androgen substrate. This would counteract the effect of the<unk>  in premenopausal women, as total estrogen would increase. Ongoing areas of clinical research include optimizing adjuvant hormonal therapy in postmenopausal women with breast cancer. Although tamoxifen (a SERM) traditionally was the drug treatment of choice, but the ATAC trial showed that<unk>  gives superior clinical results in postmenopausal women with localized estrogen receptor positive breast cancer. Trials of<unk> s in the adjuvant setting, when given to prevent relapse after surgery for breast cancer, show that they are associated with a better disease-free survival than tamoxifen, but few conventionally-analyzed clinicals trials have shown that<unk> s have an overall survival advantage compared with tamoxifen, and there is no good evidence they are better tolerated. Gynecomastia<unk> s such as testolactone have been approved for the treatment of gynecomastia in children and adolescents. Ovulation induction=== Ovarian stimulation with the<unk>  letrozole has been proposed for ovulation induction in order to treat unexplained female infertility. In a multi-center study funded by the National Institute of Child Health and Development, ovarian stimulation with letrozole resulted in a significantly lower frequency of multiple gestation (i.e., twins or triplets) but also a lower frequency of live birth, as compared with gonadotropin but not with clomiphene.
Aromatase inhibitor
Antiandrogen
5α-Reductase inhibitor
Antiestrogen
N-Terminal domain antiandrogen
Selective androgen receptor modulator
Selective estrogen receptor degrader
Selective androgen receptor degrader