Well - the Calm helped because it's basically magnesium. I took 4 gummies at night (for sleep & the constipation). Metamucil - I found some chocolate cookies that I could stand to eat, I'd eat 4 cookies a day. I didn't care for the powder in water. And Finally it got so bad I used Colace (2 to 4 tablets a day - the generic form). That really helped when the other 2 things were not moving things along. It didn't seem to matter how much water I drank or how much fiber I ate - it was never enough on it's own. The other thing that ticked me off - both my regular doctor & the oncologist acted like this was something trivial & waved me off. Same thing with the insomnia. I mean I got tired but Never sleepy. I'd lie in bed for hours awake. Sometimes I still do. The doctors do not realize these items really affect the quality of life. I meant to add - it took about 3 or 4 months on exemestane for my hand pain to go away, but it did. Went from a 7 to a 0 or 1.

@ram33 I take something I found online called "Emma". I asked my oncologist about the ingredients, (as well as an alterative medicine physician I visit), and they were both in favor of me taking it. The constipation dissipated and my digestion has honestly never been better. I've been on Exemestane for a year now, and feeling really good as far as digestion goes. Still some muscle stiffness and lack of sleep, but MUCH better than things were on either Anastrozole or Letrozole. This fight is not for sissies, but aren't we lucky there are way to beat cancer? The treatments are tough but temporary. So worth it! Hang in there.