Persistent cough after starting Anastrozole, how can I manage it?

Oh dear, @misa0527 that sounds just awful. It occurs to me that it might not be a side effect of Anastrazole but it might be an allergic reaction. This is the same reaction I have to sulfa.
Have you spoken to your primary about this?

@auntieoakley
I will take your suggestion and make an appointment with my primary physician. Since the Oncologist was the one to prescribe Anastrozole, I believe I should inform him about my coughing but since I got no answer, I will go to my primary doctor. I know my doctor will want to do all kinds of tests re the cough. To be honest I am not up to more tests and procedure. I know my body and all I want is for my Oncologist to help me manage my coughing so I can be around people during the day and sleep at night. Nobody 2ants to be around someone having fits of coughing post covid
After doing some research I found that YES a persistent cough has been reported as a side effect by many taking Anastrazole. The fact that it was not a side effect in the clinical trials it is not listed as a common side effect.
Thanks for your reply.

I have tried all 3 aromatase inhibitors, just under 1 year, changing due to severe headaches.
Anastrozle, Letrozole and now Exemestane. As soon as I started Anastrozole I developed a cough.
I have it during the night and when I first get out of bed in the AM. My cough actually sounds like bronchitis but I don't have it during the day. I have reported this to numerous doctors...everyone listens to my lungs and makes no comment, so I am "assuming" my lungs are clear.
There is no question in my mind it is due to the AIs. These drugs have an unending list of possible side effects.
It seems those of us who are posting here are reporting many different side effects...take your pick.
And, for me, complaining to my breast oncologist is always the side effect that gives me the most pain, and affecting my quality of life which are severe, persistent headaches. For you it's the severe, persistent coughing. If it's not one thing...it's another. But for lots of women taking the AIs it is like taking a MVI daily. Bless them! So fortunate to tolerate the AIs so easily. What to do? We are between a rock and a hard place. We simply plow through it all or some of us just give up on the AIs. And hope for the best.
Wishing the very best for everyone in their personal situations. It can be beyond difficult.

Persistent cough evidently is linked to low estrogen in menopause, unfortunately many doctors don’t consider that the side effects of an AI would mimic the menopause low estrogen state. I don’t understand why they can’t make the obvious connection.

“Cough hypersensitivity syndrome is a clinical problem characterized by a long-lasting, treatment-resistant cough - either spontaneous or to stimuli that do not cause cough in otherwise healthy people (Morice et al., 2011). A demographic survey of more than 5000 presentations with chronic cough showed that women attended specialized cough clinics twice as frequently as men and the hypersensitive cough prevalence increases in this cohort in the postmenopausal period of life (Morice, 2013). According to a study on postmenopausal women, chronic cough belongs to one of the postmenopausal symptoms and the mechanisms of such complications remain unknown (Ziller et al., 2022). A newer longitudinal study of the northern European population described that the transition to menopause increases respiratory symptoms, and even new-onset asthma has been described (Triebner et al., 2016).
https://www.sciencedirect.com/science/article/abs/pii/S1569904823000277)
“During menopause, allergic rhinitis (AR), non-allergic rhinitis and chronic cough may present with distinct features due to fluctuations in estrogen and progesterone, which can affect immune regulation, mucosal sensitivity, and airway reactivity. Approximately 33% of postmenopausal women report chronic cough lasting longer than eight weeks, even in the absence of pulmonary disease.
Chronic dry cough in menopausal women is often characterized by a non-eosinophilic, CD4+ T-cell–predominant airway inflammation, differing from classic allergic eosinophilic patterns and indicating a shift in inflammatory phenotype.”
https://www.frontiersin.org/journals/allergy/articles/10.3389/falgy.2026.1777688/full
I wish I had known this, and many other symptoms of low estrogen, when my mother was alive. She suffered through some chronic issues that the doctors just told her they didn’t know why.