Hi
I started Letrozole November 23 after having a mastectomy & DIEP reconstruction Sept 23. I’m 58 & had been through the menopause.
The side effects from letrozole started within a couple of weeks & were tiredness, random joint pain & awful hot flushes.
After 6 months the only side effect I had was the hot flushes but they were intense, waking me every 2 hours in night & frequent through the day & evening.
I decided to see if there were any recommendations on here - good move.
I initially tried Fluoxetine but the nausea & feeling like i was going to faint was grim.
A chat with my GP resulted in him saying try Sertraline but 1/2 dose for 1st week or so. After 4 days I had a day where I felt sick all day, but since then I’ve not had nausea.
After 8 days of 1/2 dose I went to full dose, after 4 days of full dose the hot flushes started to ease.
I’ve been on them just over 2 weeks & no longer have night hot flushes, the day/eve ones are definitely easing.
I’m posting this in the hope it will help someone else.
Laura x x
Hi Laura,
Thanks for posting this, all info re: hot flushes and night sweats useful.
I had pretty intense & frequent hot flushes after stopping HRT before masectomy. Was healing well from the surgery, but the sleep interruption/loss and day flushes made me feel like I would never have a quality of life, and I was particularly terrified of starting the Letrozole. My oncosurgeon prescribed Citalapram (low dose) and it worked well to alleviate the severity and frequency both daytime and nighttime. Since starting Letrozole now about 10 days ago, the hot flashes and sweating have increased a lot. I’m going for acupuncture tomorrow (a four week course, and if successful, get another four weeks on the NHS), and also hoping that the body “settles down” with the side effects which my onco said often happens after about four months.
I’m aware of a new drug, vezoah, which recently got FDA approval in the US, and I think is available here in the UK, although not on the NHS yet. The research I’ve read about it looks pretty good, fairly high efficacy (70-80% I think I recall), so I hold onto this as a ‘last hope’.
But good to read you’re having what sounds like very good success on the sertraline! I’ll put that on my list of questions/possibilities after giving the acupuncture a good go.
Thanks for sharing and hoping others with info might share also.
all the best,
Gail 
@gailtea I started letrozole in Oct 2022; the hot flushes stopped after 5 months; but now the hot flushes are back… sigh…
How frustrating that the hot flushes are back for you Siggi. Mine from letrozole were far more extreme than the ones I had during menopause.
Hope yours either settle again or you can get something to help. L x