Selective estrogen receptor modulators, as well their related pharmaceutical compositions and methods of use, are provided herein. These estrogen receptor modulators include compounds that primarily exhibit estrogen receptor antagonist activity or primarily exhibit selective estrogen receptor antagonist and agonist activity, i.e., SERM activity, in specific tissue types. Particular embodiments provide compounds that behave as NeuroSERMs promoting neurotrophism and neuroprotection in brain tissue. These NeuroSERMs represent a subset of the modulators compounds provided herein that can cross the blood-brain-barrier and exert estrogen receptor agonist-like effects in the brain. The compounds should be useful for treating a variety of diseases, particularly estrogen receptor-mediated diseases and disorders, such as osteoporosis, breast and endometrial cancers, atherosclerosis and Alzheimer's disease.