Tamoxifen vs Exemestane & Zoledex? Age 45

I’m really confused. Just had my last chemo cycle and need to decide which hormone therapy route to go down. Am 45, premenopausal. Oncologist and nurse raving about E&Z but already have dodgy joints and read that periods can return in 5 years if under 50 (which seems to defeat the purpose). Am veering towards Tamoxifen but recurrence rates slightly worse. 

I’m much better at being told what to do rather than making a decision. I think I’m overthinking this and getting into a state but would appreciate any advice from similar aged women. 

Many thanks, Debbie 

  • Hi Debbie - same age and new here... I found Tamoxifen caused fatigue and brain fog - especially during conversations and trying to be articulate. I'm currently on a med break as Anastrozole and Zoladax have caused me severe and ongoing muscle pain. It's 2 years since my double mastectomy and only now that I really feel disabled and overwhelmed by the verocity of the side effects. I wish I'd been better prepared emotionally. "Everybody reacts differently" seems to be a get out of jail card to dodge potential forewarning of discomfort.

  • It’s difficult to decide what’s best isn’t it? Interesting that you’ve had to stop both. I hope the break in meds is helpful and you can get back on it. I’m concerned about the muscle and bone pain too. 
    Feel like I need to pick my poison and give it a go and know there’s other options if needed. Just finding it much more stressful than it should be! 
    Take care and thanks for the reply x

  • Thanks Debbie, it's nice to connect. I've not heard of Exemestane. Yes it's an absolute mindfield. I'm awaiting a call tomorrow regarding pain management, but am also looking into medical cannabis, CBD treatment - I'll be raising that with my GP. My oncologist mentioned another injection beginning with P... Definately feel like researching to try take some control helps with mental health. It's really tricky being expected to make these enormous decisions. Good luck hun Slight smile here to chat anytime 

  • Hi DebbieB, I am 52 and had periods as normal last year before I started chemo. Once I started chemo my periods stopped but I hadn’t started my menopause. I was given tamoxifen when I finished my radiotherapy. I have been advised by my oncologist that he would look to swap me at a later date once I go into the menopause. I don’t know if my periods will start up again when I stop all meds after 5 years, but no one has mentioned they will.

    Wishing you all the best.

    Hugs from cuffcake x x x x x

  • Hi

    i was diagnosed at 46 and was having periods until I started chemo when they stopped . I had surgery a couple months after chemo and after surgery I was on tamoxifen for a couple months ( made me feel very low mood wise ) 

    My oncologist then put me onto Prostap injections and letrozole  as she felt they were more effective for me 

    I have had joint and bone pain but some brands are better than others re side effects 


  • I had the same choice at the same age and went for Z & E due to the risk of recurrence being lower, as you've said. I asked my oncologist a few times about periods coming back after 5 years and she said that given you will have had chemo and then 5 years of shut down ovaries until you're 50, then the chances of everything firing back up is very very low. At a time when they wind down anyway, it would take a lot to get going again! This was important to me - I really don't want to go through the menopause twice.

    You should also be able to have your ovaries removed after I think a year of being on zoladex. I had been querying this as you would need to make a case, but y oncologist convinced me that I was going to stay post-menopausal once treatment ends.

    I think either choice leaves you with some horrible side effects, so I went for the one that gave best long-term chances.

  • Thanks all. It’s really helpful reading your messages. Lots to think about and i have a phone call with oncology nurse on Thursday to discuss/decide. 
    Wishing you all well xxxx

  • That’s interesting about the ovary removal. I’m just at that funny age where I’m’young’ but have had children! X