Aromatase Inhibitors: Did you decide to go on them or not?

On 20 mg Tamoxifen, the first few weeks I had warm flashes and more moody. My eyebrows thought they might want to be a unibrow 🙂 Extra brow hair grew more in between my brows (not a lot) and some above my natural brow. As the body adjusts to the change of hormones, it leans toward a higher level of testosterone - ergo the unibrow. It was easily tweezed away. By 6 weeks, I seemed to settle into difficulty with thermal regulation- no hot flashes, but if I overheated, like in a hot car, or standing in Texas summer heat, my body took a longer time to cool off. My hair thinned some. I was more likely to cry at sad movies. I do have a slight vaginal discharge, a thin milky-like substance. It is caused by an pH imbalance from the tamoxifen, it does not bother me. I have not had any vaginal infections. I do not douche.

Before the cancer, I had vaginal dryness, vaginal atrophy, and osteoporosis. After taking tamoxifen, the vaginal issues were reversed, no atrophy. Tamoxifen can act as an estrogen agonist (promotes estrogen like action) in other parts of the body outside of the breasts. With taking Reclast my DEXA scores at the hips have improved to osteopenia, my spine has improved but is at -2.5.

At 3 months on tamoxifen I started having headaches 24/7. Not migraines. My regular doctor went through every possibility for headaches, found nothing, and I had a brain MRI. The radiology report said they found nothing remarkable (thank you very much!!) But that was good news. I saw the neurologist on staff at the cancer center and the conclusion was that the tamoxifen was causing the headaches. I changed to 5 mg, and the headaches have gone away.
Interestingly, I’ve noticed more head hair growing in. I have this fringe most noticeable in front of my ears, about 5 inches long. That’s about the right length for the time I switched from 20 to 5 mg - when maybe the higher testosterone dropped.
I have not had any bone or joint pain on tamoxifen. I started on tamoxifen at age 68, three years ago.

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...

@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.

I'm following this thread. I took Arimidex for a year and a half and had sever side effects I switched to Exemestane and also had side effects. I'm now taking Tamoxifen and these have their own set! I'm seriously thinking of going back to Exemestane. Not sure yet. I'm waiting for some lab test results.

I took them for 6 months and the side effects were crippling. It has been 11 weeks now and I am clear headed, sleeping better, still have stiff joints and fingers not bending at all, but those are also side effects of radiation. I now take DIM plus, calcium, Vd3, selenium, Ve, garlic, and an immunotherapy vitamin. Have felt 80% better and improving every day. Went for mammo (1 yr) and ultrasound and should hear from Dr tomorrow. I will not put that poison in my body. It causes too many other issues. The starvation of all estrogen to the brain in that short time has now caused head tremors. No way.

I just do not understand the science of these pulls that cause terrible side effects!!!!!!!!!!!! what is the proof that cancer does not come back from these horror pills which cause more problems! I am stage Lumina 1A
Oncoscore (3)!!!!!! Slow growing tumor no lymph nodes I may just do radiation and skip these horror sounding pills! I start radiation this week

I just do not understand the science of these pulls that cause terrible side effects!!!!!!!!!!!! what is the proof that cancer does not come back from these horror pills which cause more problems! I am stage Lumina 1A
Oncoscore (3)!!!!!! Slow growing tumor no lymph nodes I may just do radiation and skip these horror sounding pills! I start radiation this week