Initially I felt that I was just put on the “AI’s are the current guideline directed therapy for post menopause” flight, here’s your boarding pass (prescription) get on with it.

For me it was helpful to discuss all medication options and potential side effects vs benefits with my oncologist.

I have osteoporosis and high cholesterol, both can worsen with AI’s, but Tamoxifen may actually help prevent bone loss and it doesn’t affect cholesterol (but it can cause blood clots and uterine cancer among other side effects). I asked my oncologist to walk me through the benefits/side effects/risk of recurrence of each med, based specifically on me … my tumor characteristics, Oncotype, family history, osteoporosis, cholesterol, etc.
In conjunction with the oncologist I was able to make an informed decision to try Tam.
I took 20mg of Tam and after 6 weeks developed severe leg cramps, she lowered my dosage, and smooth sailing since.

I think windyshores and Miriam are spot on — try the meds, talk to your doctor, and change or stop if your quality of life tips out of balance.