Why are dosages for estrogen suppression drugs one-size-fits-all?

I refused AI after my chemo and radiation for a 2mm tumor removal. That was 5 years ago and so far I am cancer free. My menopause was o miserable emotionally, I knew I didn't want to go through that again.

I don’t understand why they don’t test estrogen levels and avoid over dosing people unnecessarily. Someone on this site shared a study showing leteozole had a 48 hour life and taking it every other day kept estrogen away and reduced toxicity. It was a study out of the university of Arizona but it was small and the treatment protocols weren’t adjusted. I plan to speak with my oncologist about it. But I recall other women posting that they started taking it every other day to reduce symptoms.

As for bones, start lifting weights. You can Google exercise for bones and you will get a lot of ideas if you want to do it at home. I also do yoga for stretching joints and breathing and walking.

Stay active and move your joints. I too am 71, I started leteozole a year ago and have more stiffness than ever in my knees and I have arthritis in some places in my body. I had slight osteoporosis in my hip but I won’t go on more medications so I walk and lifer weights and have adjusted my diet. My DO agrees with my plan - doesn’t like the drugs that treat osteoporosis.

I think these AI meds are a blessing and a curse. They may prevent cancer from returning but they affect the quality of your life. My cancer was stage 1A without lymph node involvement and I had bilateral mastectomy last February with clean margins. I was told even with letrozole my cancer has an 8% chance of returning. It is a hard decision but there are women who decide not to take them at all. There are days I wonder about that approach.

Hang in there everyone. Now I have four more years to go. I will see whether switching to another AI med is something my oncologist would like to do. I hear they all have the same side effects. She chose Letrezole because it is the choice for invasive lobular breast cancer which was the kind I had. So again I find myself hesitant to try something else. I feel stuck between doing the best thing and feeling my best.

Docs will often prefer to switch AIs rather than dose adjust for side effects because they prefer to stick with approved doses. I'm also in Kisqali where starting dose is 600mg daily. Because of neutropenia, dose was reduced to 200mg. Since we all metabolize meds differently and may be taking other meds that slow metabolism, my 200mg may lead to same concentrations as 600mg in someone else. I was diagnosed at stage 4 with lobular carcinoma and have been at this dose for 3 years. Fingers crossed.