Good question. I’ll try to respond in two parts.

From what I understand, Tamoxifen is usually prescribed for pre-menopausal women. An AI is generally prescribed for those who are post-menopausal (natural or surgical menopause). I say this knowing one or two post-menopausal women who are taking Tamoxifen. I don’t understand the nuances as to why some women are prescribed some things and others not.

In my case, being around menopausal age but still menstruating up until my second chemo round, my doctors did not indicate that one pathway of an anti-estrogen strategy was better than the other. Tamoxifen was the first thing they brought up. When I shared my concerns around my specific risks taking Tamoxifen, then the possibility of an oophorectomy + AI was offered.