Hi @mazzabayes this is a decision many of us struggle with. I will be 69 in five weeks so roughly at the same stage of life as you. I have taken Letrozole for two years (of 5) but with some self-determined breaks during that time. I am lucky, I’ve never had the joint and muscle pain that you have had on it or hot flushes (never had those during menopause so I guess it figures) but I do get very bad periods of fatigue and brain fog. I argue with myself every day during the fatigue, whether to just stop it. There is a very long list of pros and cons that I tediously go through during this argument but it all comes down to one thing - if I choose to not take the drug and was to develop secondaries, could I live with my decision? Additionally, if I decided not to take the drug, would this desired quality of life be negatively impacted by fear of secondaries? If I could answer yes to the first and no to the second then I’d choose to stop. If not, in your position, I’d choose to give Tamoxifen a try with the option of stopping later. There is a large percentage of women who do stop, particularly amongst those of us later in life - and I may well become one of them - so you would not be alone in that decision. Ultimately no-one can foresee the future so it comes down to how risk averse you are.
Here is a link to a long consideration of this point that you might like to dip in to. I wish you strength and luck in making this decision.