Tetracyclic heterocompounds as estrogen receptor modulators

The disclosure is directed to heteroatom containing tetracyclic derivatives of formula (I), wherein the variables are as defined in the specification, pharmaceutical compositions containing them, their use in the treatment and/or prevention of disorders mediated by one or more estrogen receptors and processes for their preparation. The tetracyclic derivative compounds of formula (I) are useful in the treatment and/or prevention of disorders associated with the depletion of estrogen such as hot flashes, vaginal dryness, osteopenia and osteoporosis hormone sensitive cancers and hyperplasia of the breast, endometrium, cervix and prostate endometriosis, uterine fibroids, osteoarthritis and as contraceptive agents, alone or in combination with a progestogen or progestogen antagonist.