i understand your concerns. This medication is used to treat painful sexual intercourse in women after menopause. Painful intercourse is a symptom of changes in and around your vagina, due to menopause. This drug is different from hormones (including estrogens and progestins). It works by acting like estrogen in some parts of the body.The medication belongs to a class of drugs known as selective estrogen receptor modulators (SERM). Hot flashes, vaginal discharge, muscle spasms, and sweating may occur. Many people using this medication do not have serious side effects. This medication may rarely cause blood clots (such as pulmonary embolism, stroke, heart attack, deep vein thrombosis). You may be at increased risk for blood clots if you are severely dehydrated, or have a history of blood clots, heart/blood vessel disease, heart failure, stroke, or if you are immobile (such as on very long plane flights or being bedridden). it is very unlikely that you will develop side effects like stroke or internal bleeding unless you have any predisposing condition that increase your risk of these complications. Take care!