Letrozole or Tamoxifen, which should I choose?

FormerMember
FormerMember
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My consultant has given me the choice as to whether I start on Letrozole or Tamoxifen, and I wondered if anyone had any suggestions or advice regarding side effects? Obviously I don't want any side effects but I'm particularly worried about vaginal pain, itchiness or atrophy. Thanks!

  • FormerMember
    FormerMember
    1. Hi I have been on tamoxifen since November I do seem to be having some side effects. Hot night sweats in regular sleep, cramp in my feet and legs which made me collapse. But everyone is different. 
  • Hello ,

    Sorry you find yourself here - however, you are in the company of a great bunch of Fruit Loops as we are better know as.

    I can't say 'which' is the best, what I will say is look at each in its over right and see what seems best for you.  I believe there are for's and against on both.

    With regards to side effects again I think each of us reacts differently, plus the brands can have different additives, colourings, etc that can possibly give off different side effects to different people.

    Add to this what the tablet is actually doing (I'' take about Letrozole here, as I have not had Tamozifen) .... I believe the tablet is taking the oestrogen 'out' of our bodies ..... literally 'ageing' our bodies over the course of a few weeks - so we will have new aches and pains, stiffness, joints hurting etc our bodies are having its lubricants taken out - so this part (in my opinion) is an effect - not a side effect.

    This said many take supplements to help ease a lot of this and sometimes we are able to get by without noticing or not having any effects.

    I hope this helps..... a little x

    I'm hoping this makes sense - only my mind says one thing and my fingers type whatever they like x
  • FormerMember
    FormerMember
    1. Hi I have been on tamoxifen since November I do seem to be having some side effects. Hot night sweats in regular sleep, cramp in my feet and legs which made me collapse. But everyone is different. 
  • Are you pre or post-menopausal? I was pre and was offered a similar choice (though ovary suppression and exemestane as the Aromatase Inhibiter rather than letrozole). After a long discussion with the oncologist, I chose the ovary suppression/AI as that had the best outcome for non-recurrence.

    Everyone reacts differently to the medication but they told me it would take around 6 months for things to settle and that was about right. I get some pain but it quickly goes away with activity, I have had more joint inflammation than usual, but I have horses and I run so all of that took its toll on my body anyway - joint and muscle pain was never unusual for me. I've also gone into menopause so that was sudden and intense with the zoladex implant. Unfortunately, atrophy has happened for me but it is easing and there are loads of non-hormonal creams you can try. I think mine was made worse as I also went through chemo and that is not good for those things either. 

    I figured I was going to go through menopause anyway, so many of the side effects I would get naturally sooner or later.

    AIs can cause joint and bone pain and tamoxifen has other side effects.

    I think they often offer tamoxifen for a few years before switching in post-menopausal women now.

    What does your oncologist say about them both in terms of benefits and risk?

  • FormerMember
    FormerMember in reply to WhatHappened

    Thanks. Yes, I keep trying to imagine what I'm going to look like in a year having oestrogen suddenly stripped from my body - it's the opposite of what most beauty products are trying to do! 

  • Hi

    Ive been on Tamoxifen for 5 years and was expecting to be moved to Letrozole last month, but still not menopausal so can’t swap. I discussed the different scenarios with the oncologist, and she did say that Tamoxifen is much better tolerated than Letrozole , and 20% of women have side effects with Letrozole which caused them to stop taking/swap to Tamoxifen. Most women are fine on either , but don’t tend to come on these forums as they have nothing to be on here for, so don’t feel that it is all inevitable that you will have issues. What swung it for me is that Letrozole can cause oesteoperosis, and you will need to take calcium supplements and have scans etc, I am now very much over being monitored and so am sticking with the Tamoxifen.

    Have a chat with your oncologist and BCN about what they would do ?

    jo x

  • FormerMember
    FormerMember in reply to Beatthebreast

    Thanks for your reply. I was peri-menopausal when I started chemo and haven't had a period since, so this is why they don't know which to give me, but I think I'll choose tamoxifen, only because I read scary stories from other women about Letrozole, but with the awareness that in fact side effects can be very similar! No one has mentioned Aromatase Inhibiter to me, maybe I should ask them?

    The consultant really underplays the risk element, but I've looked on my PREDICT to see how much benefit I'll get and it is quite significant (although it does say I'm more likely to be dead in 15 years than alive whether I take it or not)

    I always seem to panic a bit at the start of a new treatment, and with this one, the idea of taking a medicine every day for 10 years has made me delay starting! 

  • Hi I am on Letrozole for the past 4 weeks my biggest side effect is fatigued. But I have just picked up another dose of Letrozole by a different manufacturer and these are making me feel worse aches and pains wish they would gives us the same medication as this is really disruptive. 

  • Hi 

    I'm on anastrozole and 6 weeks in and cautiously hopeful the side effects are starting to lessen.  All the aromatase inhibitors ( of which Letrozole is one) take the oestrogen out of the body whereas Tamoxifen prevents it reaching breast tissue I believe

     I am not getting hot flushes/ brain fog etc as I think my body is used to low oestrogen..main issues for me are increased joint pain and stiffness and weirdly  a dry throat 

    I was 12yrs post menopausal having gone through the menopause at 45 so was wary of having tamoxifen due to the very slightly increased risk of endometrial cancer but all the meds have potential issues so it is an individual decision based on your specific situation. I already had osteoporosis in my spine only so was already living with that without it impacting on my physical activities or lifestyle. In any even I wasn't offered tamoxifen just anastrazole 

    Best wishes with the rest of your treatment xx

  • Hi. I’m the same as you. I was given the choice as I was started on tamoxifen as they were not sure if post menopausal. However I am but still on tamoxifen. I will change to letrazole at some point Information desk persont they are not bothered when. It’s up to me Information desk person   However I will say take tamoxifen at night before bed it saved having side effects during the day. I got a bit light headed with it but that’s all and changing the time taken has really helped.