Letrozole and vaginal atrophy

Hello everyone,

I would welcome any suggestions or advice anyone may have on managing one of the side effects of Letrozole, ie vaginal atrophy. I have had this since having an early menopause at 40, I am now 72.

I was using vagifem which controlled the symptoms but when I was diagnosed with HER positive breast cancer in late 2019 the oncologists told me I could no longer use this as it could affect the efficacy of Letrozole in preventing the body producing oestrogen. I was prescribed Letrozole for 10 years, I have been taking it for over a year and my symptoms of vaginal atrophy are now so bad my quality of life is low and I am in constant pain and discomfort day and night. I have used all the normal remedies such as Replens and Yes which don’t help. It has been suggested by my breast care Nurse that I could take a Letrozole “holiday” and/or use Vagifem sparingly but I have yet to get this confirmed by an oncologist as I need to be re referred and everything seems to take so long. 
I would welcome other peoples experiences of this and whether anyone has moved to alternative drugs such an Tamoxifen or any other suggestions which could make life more bearable.

Thank you for reading this, look forward to any comments or suggestions.


I too have vaginal atrophy, started menopause at 49 after hysterectomy and ovaries removed. Was diagnosed with oestrogen driven breast cancer end of 2020 and put on letrazole. I’m 55. I have been lucky in that a have been allowed a 6 week break from letrazole, it was offered to me by breast cancer nurse and a decision was made same day to allow it. I’m in the North East. I’ve been off 4 weeks and can only say it’s made a slight difference, still having problems. Was on hrt prior to my diagnosis and really miss it!  Do feel for you and don’t know why you have to have a referral just to stop pills for 6 weeks, perhaps try again. Hate the thought it’s something we have to live with, has changed my life too. 

We are all different though and I hope coming off letrazole really helps you.

sending hugs and best wishes


I am on tamoxifen but also have vaginal atrophy and have been living with painful sex and general dryness and soreness for 3 years.

Having had hormone positive breast cancer in 2016 i was told oestrogen cream and HRT were both were a no no. Ive tried all the usual creams and gels but nothing worked. 

Then out of the blue an advert popped up on facebook for Vagivital. Its a non hormone gel to be used every night for 12 weeks. Its not the cheapest but I have been using it now for 10 weeks and can see a massive improvement.

Its by no means back to how things were pre cancer but I can now have sex without being in pain.

Hope this helps xx

I’ve now come off Letrozole in favour of Exemestane, but the vaginal dryness etc is still an issue. 

The best solution I’ve found is Replens MD moisturiser (which is hormone free) and Superdrug’s own Lubricating Gel. 

Some of the others actually stung as they were inserted, which didn’t bode well! 

Hope that’s helpful x