@orienteer
Women’s endocrine systems naturally produce testosterone which is quickly converted into estrogen. The body makes female hormones even if we have diminished levels of estrogen due to menopause and/or surgical removal of ovaries. Our serum estrogen is likely very low but AIs block testosterone from being converted to estrogen. This starves cancer cells of that converted estrogen.
You’re right that side effects may be related to the AI drugs’ mechanism of action as much as the lack of estrogen. It’s kind of amazing that researchers found that cancer can feed on these very small amounts.
The struggle is real. And the decision we have to make about taking AIs is hard every single day.