Suppressed menstruation in pre-menopausal patients. Reversible cystic ovarian swelling. Discontinue treatment if hypercalcemia occurs. Monitor patients taking coumarin-type anticoagulants. Increased incidence of endometrial changes including hyperplasia, polyps, cancer & uterine sarcoma (mostly malignant mixed Mullerian tumours). Patient receiving or having previously received Tamoxifen who report abnormal gynaecological symptoms, especially vag bleeding, or who presents w/ menstrual irregularities, vag discharge & symptoms eg, pelvic pain or pressure. Patients at risk of thromboembolism. Stop treatment 6 wk before surgery or long-term immobility. Avoid concomitant use w/ CYP2D6 inhibitors. Lactation.