Have you been on Tamoxifen AND Zolpadex AND Letrozole?

I don't have experience of all those drugs but I was offered a choice of hormone therapy (I'm mid-40s and was also pre-menopausal). I could either have tamoxifen or zoladex/exemestane. As I went through chemo, we had to decide whether to start zoladex during chemo so that coming out of it, I would be post-menopausal and be able to have exemestane (similar to letrazole).

I asked which was the better option for long term outcomes and was told that either option has similar mortality rates but the zoladex/exemestane option was better in terms of recurrence. So I chose that.

I think in terms of side effects, everyone reacts differently and if you really don't get on with something, you can try something else. They are all pretty similar in that they are going to give you menopausal symptoms. Unfortunately, that is unavoidable, but there is plenty you can do to manage them and I have found that everything improves with time. I am almost a year on zoladex and almost 6 months on exemestane and they are fine. I have hot flushes/night sweats but significantly better than when I started on them. I get pain but that is always better with activity.