Exemestane and extreme fatigue

Hello @stephied welcome to connect. I also had an oopherectomy, and extended endocrine therapy. It is not easy, and good for you for getting this far. That being said, you should have an honest conversation about the fatigue with your doctor. I have learned that sometimes, the things we attribute to these drugs are in fact something else entirely.
I don’t know your age or other health history, but I was in my 30s when I started, I have come to understand that endocrine therapy accelerated the aging process considerably. So the issues an 80 year old woman might have, I started having in my 50s. The good news is that I made it to 60 and certainly would not have done without the treatments.
When I started having fatigue issues, my doctor initially tested my thyroid and said it was a little off so a little thyroid pill helped a ton. I can’t say what yours might be, but quality of life is important.
Are you comfortable talking to your doctor about this? Have you remained cancer free since 2016?

Hi there!

I am 54 soon to be 55. I have been cancer free since 2016. Knock on wood!

I am seeing my onco in June. We will revisit my meds in 2026 but I will talk to him about this next month.

I’m scared of stopping but also don’t know if I can continue like this. I am currently job hunting and honestly don’t know how I’d get through a 40 hour work week!

Thank you so much for replying. I’m happy you’ve done so well!

Stephanie

Going through some of the same. Lumpectomy June 2023 then chemo and radiation. On Anastrazole for 7 months but changed to exemestane in November 2024 due to side effects. Last visit (March 2025) he even noted I looked tired. So told him I am constantly tired, falling asleep in the middle of doing things, naps etc that I’ve never needed before. Also been gaining weight even though nothing else (diet and exercise) is unchanged and I’ve maintained static weight since the start of this until 8 weeks on exemestane. Thyroid was tested and normal several months ago, bloodwork otherwise looks ok, so the only answer I get is that I must be depressed because fatigue is a symptom of depression and I should seek therapy and try medications. I’ve reached the point where I’ll acknowledge something if specifically asked but don’t offer much anymore because it’s never a side effect of the medications so not something they need to treat. I think both problems relate to the exemestane because I was stable before it started but a, just told they’re not a side effect of the medications. So we just do the best we can with what we have. Don’t know that this helps but you’re not alone.

Thank you so much for your reply. I’m sorry for what you are experiencing. I believe fatigue is a side effect and, I, too, have been asked about my mood. I think the side effects most reported are released or noted. Like any other drug, there are always outliers. On top of Exemestane, I take prolia every 6 months and I also take Effexor every day. In fact, I’ve been treated for anxiety since 6 months after my oophorectomy because the anxiety never went away.

I’ve explained to my family doctor recently (on phone) how I am feeling. All of my bloods are good with exception of my triglycerides and sugar. I’ve never had a problem with these before. Admittedly, I’ve not been taking as good care of myself these last 6 months. I’m getting on top of things, though. I’m rambling now lol.