AIs after hysterectomy?

maximummy, AIs can't stop the ovaries from producing estrogen conversely they stimulate the functioning ovary to produce more estrogen. Women with still functioning ovaries take ovarian suppression drugs, such as leuprolide Lupron or Zoladex plus aromatase inhibitors.
The best of good luck to you.

Hello! I’ve had a hysterectomy and I take Letrozole. Praise God it hasn’t bothered me. Praying for you! ♥️

After menopause estrogen doesn’t come from ovaries but mostly by fat cells that produce aromatase to convert progesterone to estrogen. That’s why old women like us are likely prescribed aromatase inhibitors. The reason we need to have bilateral salpingo oophorectomy surgery is that carriers of pathological BRCA2 mutation have an increased risk of developing ovarian cancer. It’s not to reduce estrogen. If your surgery is prophylactic, ie. you don’t have cancer and the surgery is to prevent cancer, you might not need AIs.
If I’m wrong, please correct me.

I had Stage 1a breast cancer in 2020 and I had a total hysterectomy in 2022. I have been on Anastrozole since 2020. Overall I have done fine on Anastrozole, however, I now have osteopenia which is a known side effect of AIs. So bone health can be an issue and I will likely end up with osteoporosis by the time I am off of them.

AIs are specifically for post menopausal PR+ breast cancer patients. Ovaries are not required for small amounts of estrogen in women. Aromatase in our bodies is responsible for the conversion of other hormones into estrogen. The inhibition of aromatase (AI) literally inhibits the peripheral estrogen synthesis in the body. The drugs block the natural conversion of testosterone and progesterone to estrogen. Even very small amounts of estrogen feed cancer cells dependent on estrogen to grow.

If there are cancer cells floating around in our bodies the AIs starve those cells.

Your oncologist should tell you what treatment is appropriate for your cancer/prognosis. Your treatment may be very different than those of us who have PR+ breast cancer without the BRCA gene. So please take everything you read here with a grain of salt.

@vegada

I’m have been on Anastrozole since 2023. It’s been hard but I am happy to read that you have made it through six years. It’s encouraging.

I have osteoporosis and am struggling with Fosamax. Do you take something to prevent osteoporosis? I was going to check with my doctor about trying a different medication or approach to treating the osteoporosis.

@vegada
I had breast cancer 2021, Chemo, Radiation. On Anastrozole since 2023, joint pain, hot flashes. Had a total hysterectomy in March 2026, so even less estrogen. Oncologist put me on Veozah, just slightly helps hot flashes, I'm always looking for help.

@dmr4ever I have not taken anything yet for Osteopenia. Managing bone issues and actually finding a solution feels almost impossible to me based on the research I have done. Today, I am focused on building muscle, ensuring I take sufficient calcium, vitamin D, collagen and protein. I don’t think it will be enough to reverse my osteopenia and I think the real answer may be to take HRT which oncologists will tell us we can’t because of our prior cancer. It's a quagmire and I am not sure what medicine, if any, that I will take in the future.

@sboston1 I have some hot flashes at night time and I just use a little fan and believe it or not, a cooling blanket that I purchased from Amazon that was a game changer for me. It keeps me cool all night and limits my hot flashes. Here is the link to the cooling blanket if you are interested that I highly recommend.
https://a.co/d/07Qw66vH

@myoga, seconding this. I had my ovaries/tubes removed after an ATM diagnosis (cervix, uterus was left because if something goes wrong there, it's easier to notice). I asked a few times about any hormonal effect I might notice and my gyn-oncologist reassured me that my post-menopausal little almonds were not doing anything of use. 🙂 And it's true, I've noticed nothing. She also said that if she could, she'd encourage all post-menopausal women to do the same to avoid ovarian cancer. I count one less thing to worry about as a definite up-side to having genetic testing!