Advise please, switched from Letrozole to Exemestane


My breast cancer was oestrogen positive 8/8, 3 tumours, grade 3. Faulty BRAC1 found.

following breast surgery, I started on Zoladex and Tamoxifen for 1 year. Then I had my ovaries removed and I was put on Letrozole. I found my hot flushes intensified almost immediately as well as shedding hair! As time went on my joint pain seem to get worse each month, really painful over night. So 2 weeks ago the oncologist switched me to Exemestane as he said some people get less joint pain with this.

Has anyone been switched to Exemestane instead of being on Letrozole? How has you found it? When did you notice the difference? I’m feeling more anxious and moody but not sure whether 2 weeks in with the medication change means it’s too early to put it down to this?

Any advice appreciated. Xxxx

@Hope213  @My situation is different from yours but I started on Letrozole and had hot flushes and the arthritis in my joints became worse. I was then switched to Examestane but the side effects didn’t change I’m afraid. For the last 10 months I have been on Tamoxifen. 

I guess it’s worth a try as everyone is different and you may find it suits you better. Good luck, fingers crossed.  


Hi Hope213,
I was switched from Letrozole to Exemestane as the Letrozole caused episodes of severe shortness of breath after 2 weeks on it. I struggled on for 3 months. It took 2 A&E admissions & a CT scan of the heart to show all was clear. No one picked the cause of the SOB up. I reread the packet leaflet & spotted 1:1000 people can experience this. When I spoke to my surgeon & oncologist, neither had heard of it!  But oncologist switched me exemestane. The SOB has gone, but a few weeks in I’m getting some muscle aches in forearms, thighs, stiffness in fingers in mornings, knee discomfort on bending down & getting up, painful left hip, worse at night in bed & stiffness after sitting for short periods. My memory has also deteriorated, hubby noticed too. I was a fit 61 yr old before diagnosis of stage 2 lobular BC in January 22.  I was mountain biking & rowing. Now I’m just managing short walks. Life has radically changed. It’s all a bit pants really isn’t it. So grateful to be alive though & hoping symptoms will improve after a few months as body adjusts more to it, or is that wishful thinking I do hope things improve for you too. 


I started on Tamoxifen and had pretty bad side effects from that (same as cited by others in other posts on the forum). So my doctor switched me to Letrozole. For me, it was the worst one. I had to stop taking them after just two days. I got such severe headaches and felt so ill, I couldn’t stand it. So next the doctor put me on Exemestane, and it’s been the easier of the three to put up with, although the side-effects are still  a lot to put up with. I’ve noticed a difference with less joint paint, although there is a little achiness mainly around ankles in the morning but it wears off.

It seems very much that different people will have different experiences with these treatments. The only thing you can do is try and see which one causes less problems for you. I’ve heard that a different brand can even make a difference.