Connect
← Return to Aromatase Inhibitors: Did you decide to go on them or not?
Discussion
Aromatase Inhibitors: Did you decide to go on them or not?
Breast Cancer | Last Active: Sep 22 2:13pm | Replies (1230)Comment receiving replies
There is so much information here, it's hard for me to process everything.
I had stage 1 and lla plus 2 areas of ductal hyperplasia all in both breasts. Had a bilateral mastectomy in May 2025. Started Anastrozole 1 mg. in June. Just had my bone density test. At age 68 all was normal, now at age 70 I have osteopenia in my left hip. Is it the AI after only 3 months or a natural occurrence?
I have headaches daily. Very annoying. B/P systolic can not get below 140 despite being on 3 B/P medications and 2 recent dose increases. Oncotype was 14, no chemo indicated, no radiation. I am also a heart patient and this drug surely is potentially dangerous with my heart condition but my cardiologist gave the go ahead for me to go on it. Just some joint aches, nothing major. Some skin itching & redness also. The headaches are my main issue plus watching my blood pressure. I thought Tamoxifen was only for pre-menopausal women. Is this an option for me? My breast oncologist said no 3 months ago. Will be seeing her next week. Lots of thoughts here, but confused as to the way to go. This is my first post-op visit with her since starting the AI. Anything I should focus on during my visit with her? Thanks so much...
Replies to "There is so much information here, it's hard for me to process everything. I had stage..."
My oncologist encouraged tamoxifen when I made it clear no AIs. She was unhappy I would only agree to 5 mg Took it for 3 weeks. Had BP issues so my BP med was increased. I couldn’t get rid of a low level HA so I stopped it. I think about trying it again but I feel like it is poison for me. I am 70 so if I were younger maybe I would persevere. I had a recurrent IDC of L breast 22 years after mastectomy. Oncotype score was 8. MDs didn’t recommend radiation.
@briarrose
I had Letrozole for few months. First came the aura headache every week along with dull pain in the head, then a full blown migraine that woke me up at night and lasted a few days. Now I switched back to Exemestane which gives me mild petechiae. I don't think all the side effects come from lower estrogen. They could be the reactions to inactive ingredients in the drugs. Try to see if switching to Exemestane would help. I can put up with joints/muscles pain, but headaches are terrible! You're a tough one. I can't stand headache every day. I only take Exemestane every other day to prevent severe petechiae. I hope once my body is used to the drug, the petechiae will go away and I can take it every day. Best wishes to you.
Connect
Tamoxifen may not be recommended for postmenopausal women for various health reasons including risks for:
-Uterine cancer, a history of PCOS, possibly the number of years of estrogen including early menarche and HRT, endometriosis, any sign of uterine hyperplasia
-Deep vein thrombosis, a history of any thrombotic events or health issues related to thrombosis
-while tamoxifen can be cardio-protective in some areas, I think there are other heart conditions may be an issue
-it’s affect on the hypothalamus-pituitary-adrenal axis, prior health concerns in this area may increase risk of problems
Research shows tamoxifen induced risk for uterine cancer and DVT is low if health history indicates the original risk (prior to tamoxifen) is low.
AIs do have a little better outcome than tamoxifen for postmenopausal women and are recommended as a first line med by most doctors, but I felt the little higher risk wasn’t enough for me to take an AI with my health history. My oncologist gave me the choice for either.
My two cents on headaches, is that estrogen modulates the quality of our vascular system and very low, or high, estrogen may be a factor in vascular headaches.
I had headaches with the higher dose of Tamoxifen. My theory is it was causing vasodilation in my brain or meninges (tamoxifen can act as an estrogen agonist, promoting action in the brain). Although I do not have daily headaches with the lower dose, I now need to use a nasal spray antihistamine (vasoconstrictor) in the spring and fall when air pressure systems change and allergic inflammation abounds. Again, my theory, is that my vascular system is no longer supple (part age, part tamoxifen messing with estrogen) and I have to counteract the effects of the med.
It’s important to have your doctor evaluate the risks of tamoxifen vs AI. They can compare health history, current risks of developing disease. And then - how does hormone treatment affect your individual health status.
It is very confusing when we try to figure out what is best for us. Some of us have diabetes, autoimmune diseases, heart disease, neuropathy, adrenal insufficiency, polycystic disease, thyroid issues . . . the list goes on. All these factor into how a hormone therapy may affect us.