[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Selective oestrogen receptor modulators (SERMs)](https://durgical.com/en/pharmacology/classes/selective-oestrogen-receptor-modulators/) › Ospemifene

# Ospemifene

## SERMs?

Selective oestrogen receptor modulators (SERMs)

## Pregnancy: contraindicated?

Intended for women after menopause; it may harm a fetus and is not used in pregnancy or breastfeeding.

Oral SERM that acts like oestrogen on the vaginal lining. For painful intercourse and vaginal dryness after menopause; risk of clots and endometrial cancer.

Updated Nov 1, 2026

## Quick facts

**Group**
[Selective oestrogen receptor modulators (SERMs)](https://durgical.com/en/pharmacology/classes/selective-oestrogen-receptor-modulators/)

**Target**
Oestrogen receptor (ERα)

**Used for**
Painful intercourse

**Key effects**
Hot flushes · Vaginal discharge · Muscle spasms

**Monitor**
Any abnormal vaginal bleeding

**ATC**
G03XC05

No doses: the clinician sets them by the current guideline.

On this page

- The basics Mechanism of action
- Indications
- Adverse effects
- Pharmacokinetics
- Memory aid

- Clinical What the labels mean

- Safety Contraindications
- Key interactions
- What is monitored
- Administration and safety
- Pregnancy and breastfeeding
- Nursing care

- Study Test yourself

- Connections Connections

## Mechanism of action

Ospemifene is a selective oestrogen receptor modulator. On the vaginal lining it acts like oestrogen, so the thinned, dry tissue of menopause becomes thicker and moister and intercourse hurts less. Its oestrogen-like action can also thicken the endometrium, and like other SERMs it raises the risk of blood clots.

- Ospemifene binds the oestrogen receptor
- In the vagina it acts like oestrogen
- The lining thickens: less dryness and pain

## Indications

- Painful intercourse (dyspareunia) and vaginal dryness from menopause. [Genitourinary syndrome of menopause (atrophic vaginitis) →](https://durgical.com/en/conditions/genitourinary-syndrome-of-menopause/)

## Adverse effects

### Common

- Hot flushes
- Vaginal discharge
- Muscle spasms
- Increased sweating

### Serious (rare, important)

- Endometrial thickening and endometrial cancer
- Deep vein thrombosis, pulmonary embolism and stroke
- Severe allergic reactions with swelling of the face or throat

## Contraindications

- Known or suspected cancer, or undiagnosed abnormal vaginal bleeding (generally not used)
- Previous stroke, heart attack or blood clots (generally not used)
- Pregnancy

## Key interactions

**St John's wort**
Interacts with ospemifene and is not started without medical advice.

**Grapefruit**
May change ospemifene levels; it is discussed with the doctor.

## What is monitored

- Any abnormal vaginal bleeding, investigated promptly
- Signs of clots and stroke
- Cardiovascular risk factors: smoking, blood pressure, lipids, diabetes

## Administration and safety

- Oral tablet once a day with food, at about the same time.

## Pregnancy and breastfeeding

Intended for women after menopause; it may harm a fetus and is not used in pregnancy or breastfeeding.

## Nursing care

- Ask about cancer, abnormal bleeding, stroke, heart attack, clots (personal or family), smoking, lupus and liver disease before starting.
- Teach to report any vaginal bleeding at once.
- Teach the signs of a clot or stroke: leg swelling or pain, chest pain, sudden breathlessness, slurred speech, one-sided weakness.

## Pharmacokinetics

**Absorption**
Oral tablet once a day, taken with food.

**Metabolism**
St John's wort and grapefruit can interact with it.

## Memory aid

OSPEmifene OPENS the way: an oestrogen-like SERM for the vagina — but, like all SERMs, think clots, and like oestrogen, think endometrium.

## Test yourself

Think of the answer, then tap the question to see it.

## For which menopausal symptoms is ospemifene used?

Painful intercourse (dyspareunia) and vaginal dryness.

## Which two serious risks appear in the ospemifene warning?

Endometrial cancer, and stroke and blood clots.

## A woman on ospemifene reports vaginal bleeding. What should happen?

It is reported to the doctor at once and investigated, because ospemifene can thicken the endometrium.

[Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/ospemifene/)

[More Pharmacology questions →](https://durgical.com/en/practice/?f=pharmacology)

## What the labels mean

**Pregnancy: contraindicated**
Intended for women after menopause; it may harm a fetus and is not used in pregnancy or breastfeeding.

## Connections

## Related drugs 3

- [Raloxifene](https://durgical.com/en/pharmacology/raloxifene/)
- [Tamoxifen](https://durgical.com/en/pharmacology/tamoxifen/)
- [Clomifene](https://durgical.com/en/pharmacology/clomifene/)

## Related conditions 1

- [Genitourinary syndrome of menopause (atrophic vaginitis)](https://durgical.com/en/conditions/genitourinary-syndrome-of-menopause/)

[← Back to the class: Selective oestrogen receptor modulators (SERMs)](https://durgical.com/en/pharmacology/classes/selective-oestrogen-receptor-modulators/)

Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: [Ospemifene: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a613039.html) (MedlinePlus (U.S. National Library of Medicine), 2025); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=G03XC05) (WHO Collaborating Centre for Drug Statistics Methodology, 2026).

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Representative model, for educational purposes only.

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License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/ospemifene/