Concerned about the side effects of anastrozole

@jkcares25 in light of the major study published today in uk about the relationships between menopause symptoms and dementia I too am concerned. For those of us on long term AIs we are having the equivalent of ‘menopause on steroids’! What does this almost total loss of oestrogen for many years augur for us? I too have a strong history of female family dementia ( six out of seven paternal aunts all developed it) does this mean that in trying to save us from cancer we are being steered towards dementia? Serious urgent further research needed here! The increasingly apparent downsides of these drugs were never clearly spelt out to me at commencement of treatment. In fact it is fair to say they were almost trivialised! I am very angry at the quite blasé attitudes of some of the medical professionals I have had contact with , and as a retired nurse even more so.

@reflector75 Thank you for your reply. It's true. When I confronted my PA, she said their job was to make sure that breast cancer didn't return. According to the book, it's more likely for a breast cancer survivor to die of heart disease than of cancer. I am glad you are researching it, too. The definition of "cure" for BC patients is that we are alive 5 years later. That's not how most of us define cure. The research saying outcomes are better than 20 years ago are faulty as it's discovered earlier these days, so it appears as though they are more successful when it hasn't changed significantly. What good will it do if we lost our minds earlier since we deprived our brain of estrogen and cholesterol? I pray for all of us to find the best solution for our health and longevity.

More candour is needed ,
it is interesting that when professional themselves ( though I would never wish this upon anyone!) become patients themselves or close family do how opinions change.

@reflector75 can you share the link for the UK study? I haven't seen it yet and am very interested in reading it. I would greatly appreciate it. Thank you.

@vegada Hi,
The info I have is as follows:
DOI: 10.1017/50033291725102845
Zuhisdorff,K et al Emotional and cognitive effects of menopause and hormone replacement therapy’.
Published in Psychological Medicine Jan 27 2026.

It makes the link between the brain effects seen in reduced oestrogen secretion and some of those also seen in Alzheimer’s.

@reflector75 Nice comprehensive current study! Thanks for the info. I've inserted the link below to the full report, scroll down past the abstract. And included a link to the charts showing results.

Please note in their results section they do list issues with the data (although they did a better job collecting information than I usually see in these studies!)
* They did not collect data on whether participants had depression or other mental health issues (dementia was excluded) before taking HRT. They note that the data shows higher mental health issues with HRT most likely because participants already had depression/other. In the UK the guidelines for managing depression for postmenopausal women says to try HRT.
* They did not collect data on which type of HRT was used. (Sigh!)

My takeaway IMHO: Data shows what we know, that pre-menopausal women function somewhat better than postmenopausal. HRT does not seem to improve depression or anxiety at the population level**. There is some difference in cognitive abilities (with/without HRT) but there may not be much difference. Their post hoc data, where they really compare specific differences, shows no "significant" changes in cognition. I'd need to see the post hoc data to see how this affects results.

Emotional and cognitive effects of menopause and hormone replacement therapy
Published online by Cambridge University Press: 27 January 2026
https://www.cambridge.org/core/journals/psychological-medicine/article/emotional-and-cognitive-effects-of-menopause-and-hormone-replacement-therapy/E9D94A6EB0B8A3C03113A93D34A99FD0
Data charts only
https://www.cambridge.org/core/journals/psychological-medicine/article/emotional-and-cognitive-effects-of-menopause-and-hormone-replacement-therapy/E9D94A6EB0B8A3C03113A93D34A99FD0
**Population level: this study looks at the results of a large group, a population. That's good. But individual results may vary. Meaning, HRT may lift your depression if you were feeling low because your skin was thin/more wrinkled, lost of hair, loss of interest in sex - because these are specific issues that concern you, but not necessarily everyone in the study "population". Again, IMHO, In My Humble Opinion based on my level of understanding.

@triciaot yes I agree . I think though that this study highlights the need for more research into the long term effects of near total oestrogen suppression on mental functions and possible dementia. Those of us on AIs are experiencing lack of oestrogen way below menopausal levels. There needs to be more long term data available on this.

So I met with the doctor and told him all the side effects I was having and he suggested a different prescription. I have had it filled, but still struggling with the decision of taking it. I tried to set up a appointment with my surgeon but turns out he is out of the country. I have a doctor apt coming up in two weeks with a new oncologist that I will discuss the pros and cons. At this point I think I will give the new medication a chance, but if I have as many side effects as the last on, I will discontinue.

Drug sensitivity runs in the family. Not to mention I already have sensitivity to some drugs, foods, MSG and food preservatives. I understand the concept of why I need to take the medication, but struggle with how the side effects make me feel and for 5 years?.

I really feel for anyone who is going through all the physical and mental struggles. Just dealing with hearing you have cancer is mind blowing by it's self. I think we have to ask questions and make the decision on what we feel is best for our own personal situation. I really wish the best for everyone. And prayers to everyone that is going thru this.

@peggydobbs
Thank you Peggy for the information. I will ask my doctor about the Oncotype test at my next appointment. Great to know.

I’m 8 months in to taking letrozole (excessive fatigue), currently anastrozole (1 mo.) Have been experiencing intermittent side pain so both PCP and Oncologist recommending I get CT scan. PCP discovered some unusual heart palpitations so now having to wear heart monitor to see what’s happening. Also BP is going up and cholesterol high. I’m scheduled for lumpectomy or mastectomy mid-March. At this point I’m highly suspicious about taking these drugs afterwards. Was trying to avoid mastectomy but now may just say remove it and from there take my chances as I’m reading of lots more issues and it’s now being further discussed as to its possible future use in treating BC. At 79 I am thinking about just taking my chances w/o taking it post surgery. Taking 5-10 years when that’s probably all the time I have left and don’t want to constantly be fighting side effects. JMO