Tamoxifen V Letrozole

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Hi everyone...sorry this is going to be long winded. So I started tamoxifen in jan 2021, periods stopped straight away. I was 51 but no menopause symptons and regular periods. Then sep 2022 I had a one off bleed then it happenend again.

Had investigation and I had polyps removed, lining is thickening but gynecologist was not concerned. All biopsies came back fine. I saw oncologist in November who mentioned possibly switching to letrozole and zoladex. But when talking about side affects said if I stay on Tamoxifen theres a risk of uterine cancer, if I stop all meds theres a risk of recurrence and if I switch to letrozole theres a risk of osteoporosis and basically its my choice.

However because everything was ok and I felt like I know where I am on Tamoxifen it was agreed that I could stay on T for another 3 months. Anyway I had another bleed in December. Oncologist now seems to think its ok to stay on Tamoxifen but again said its up to me but isnt really giving me any guidance. She is calling me after my follow up gyne appointment tommorow to see what I should do.

Id rather stay on Tamoxifen as the side affects appear to be less however Im scared incase it causes other issues.

Anyone else had experience of this?

Beatthebreast over 2 years ago

I didn't have the exact same choice as you but before I started hormone therapy, they offered me a choice of tamoxifen or zoladex plus exemestane. I was mid-40s and so pre-menopausal. I asked which was better and they said both the same for mortality rates, but the zoladex route has less chance of recurrence, so I chose that.

I have a biphosphonates infusion every 6 months just now to help against osteoporosis, but I also naturally do a lot of strength stuff for my bones anyway. Currently going through a bit of a running lull, but hoping to get back to it when I feel a bit more energised in early Spring - another thing to keep my bones healthy.

I don't think any choice has fewer side effects, they are just different, and none are that great. If you are OK on tamoxifen, then that sounds like the right thing for you. But if you're going to be constantly worrying about uterine cancer because of the bleeding, then it may be better to switch to something that will definitely stop your periods.

I know zoladex is used for endometriosis so it may be that it also helps with the polyps and thickening as it will switch off your ovaries completely.

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Tamoxifen V Letrozole