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    Prostate Cancer and Prostatic Disease (2013) 16, 226–232 & 2013 Macmillan Publishers Limited All rights reserved 1365-7852/13 www.nature.com/pcan REVIEW Selective estrogen receptor modulators for BPH: new factors on the ground M Garg1, D Dalela1, D Dalela1, A Goel1, M Kumar1, G Gupta2 and SN Sankhwar1 As the current management of BPH/lower urinary tract symptoms by traditionally involved pharmacological agents such as 5alpha- reductase inhibitors and a1-adrenoceptor antagonists is suboptimal, there is definite need of new therapeutic strategies. There is ample evidence in literature that suggests the role of estrogens in BPH development and management through the different tissue and cell-specific receptors. This article reviews the beneficial actions of selective estrogen receptor modulator (SERM) and ERb- selective ligands, which have been demonstrated through in vitro studies using human prostate cell lines and in vivo animal studies. SERMs have anti-proliferative, anti-inflammatory and pro-apoptotic mechanisms in BPH, and also act by inhibiting various growth factors, and thus represent a unique and novel approach in BPH management directed at estrogen receptors or estrogen metabolism. Prostate Cancer and Prostatic Disease (2013) 16, 226–232; doi:10.1038/pcan.2013.17; published online 18 June 2013 Keywords: selective estrogen receptors modulators; BPH; estradiol; estrogen receptor b INTRODUCTION relevant articles were selected for the discussion of role of SERMs in BPH in BPH is a common urological problem of aging males. It occurs in this review. about 10% of men below the age of 40 and increases to about 80% by 80 years of age.1 Clinical BPH is a benign enlargement of the prostate, which ESTROGENS AND ITS RECEPTORS: ROLE IN BPH results in voiding urinary difficulties that may, sometimes, Though BPH typically manifests in later stage of life when 2 significantly impair the quality of life in older patients.
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