Why letrozole?

Hi All

I,m 43, had mastectomy, chemo and rads and was told that i was going to start tamoxifen, but instead was started on Letrozole about 8 weeks ago because unknown to myself i,ve already gone through early menopause.

From reading other threads, i get the impression that even if we’re post menopausal after treatment we’re still put on tamoxifen first for 5 years then switch to letrozole, unless there are secondaries involved. Has anyone else gone straight onto Letrozole after treatment for primary Bc having never been on any other hormone treatment and if so do you know the reason for this? I know that i have a high chance of recurrances and i suspect that this maybe why?

I hope that,s all come out legible lol

Any info or opinions would be very appreciated

Thanks Maria x

Hi Maria

I had chemo suregery rads and herceptin, and was put onto letrozole for 5 years. My understanding is that tamoxifen is used pre menopause and the AIs of which Letrozole is one is for post menopause. I well could have that wrong but I’m sure it was what I was told.


I started on Arimidex, another AI and switched to Aromasin (a third AI) because of the side effects. I was never on Tamoxifen as I was told that Tamoxifen was for pre menopausal women.

Good luck

Hi Maria,

Was it dr m who put you on letrozole? Can’t recall if your treatment was Oldham or north Manchester. Thought it was Oldham though. Did he do a test to check if you were post menopausal? He told me that if my periods still aren’t back this time next year (2 years almost post chemo) then he will do blood test to check if I am post menopausal and if I am then he will change me to an AI instead of tamoxifen. My understanding is also that tamoxifen is for pre menopausal, AIs for post menopausal . Hope you’re feeling ok


Hi Maria
In response to your query. I was grade 3, stage 2,oestrogen positive and in nodes 5/14cancerous. Had lumpectomy and node clearance, chemo ,then radiotherapy. Wss initially on tamoxifen, and then once post menopausal (due to zoladex, and then oophrectomy) was put on letrozole.
Like others have said, I think they put you on letrozole once you are post menopause. That was all 3 and a half years ago,when I was 37. I’m now a bit older and wrinklier, but am still on letrozole and doing fine.
All the treatment seems to be working well for me, I hope it will for you too

Thanks everyone for your replies

Vickie - had treatment at Oldham but am under North Manchester , was told i had had the blood test at the same times as blood for chemo, said i was def post menopausal.

I was just worried about it because i can barely stand in a morning and every bone hurts as well as putting on a lb in weight per week. Hair is still patchy as well. Was kinda hoping i could go on Tamoxifen. Still managing to keep up the running for now lol - will just have to see how it goes.

Other than that i,m great thanks

Meggars - do you mind me asking how you are on these pills. I feel like i’ve aged 20 years over night

Maria x

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Hi Maria
I have been fine on letrozole, but I was fine on tamoxifen, don’t think I have noticed any side effects.
I do have to take weekly alendronic acid and daily calcium tablets because of risk of osteoperosis, these did give me side effects initially, but ok now.Will you need these bone strengthening tablets too?
I also did running, but recently fell while running, am black and blue, was lucky I didn’t break any bones! am gonna stick to walking from now on.
Hope this helps
Meg x

Hi Maria

I went onto Letrozole after surgery and chemo- started at the same time as I started rads. I’m post menopausal too. Started on 31st May and haven’t really noticed side effects yet, just maybe a little constipation so have upped the fibre intake. I’m taking calcium and vitamin D tablets as Letrozole is tough on the bones. Having a bone density scan too.
Also having hot flushes, but I was having those before anyway.

I took Tamoxifen immediately after diagnosis (Sept) for two and a half months as I was going on holiday for two weeks (in Nov) and they didn’t want to do the surgery before I went. The hot flushes were worse on the Tamoxifen.


That’s really encouraging because i started around the same time as you, so it must mean that not everyone gets bad Se,s and it’s worth trying something else if you do. i,ve also started calcium and vit D. Think i,m going to talk to Bc nurse like norberte suggested - thanks norberte

Maria x

Hi meggars

sorry i missed your reply there. Yes i do alot of walking too, but i,m finding that i,m not that flexable anymore either - i really do need to change these tablets - i don’t think thy’re right for me.

Do you know whether it’s ok to take glaucosamin, whilst on letrozole?

Maria x

Hi Maria,
Not heard of that drug, so no idea, sorry.
Regarding side effects, i’ve not really noticed any side effects with the drugs I take. However, I do get quite stiff joints. I’ve always put this down to getting old, but maybe its the concoction of medication I’m on!
Do you live in Manchester?
Meg x

Hi meggars

Yes i,m in Chadderton. You a manchester lass?

Maria x

Hi maria,
well nearly,I’m from Wigan
Meg x

I was put on Letrozole (aka Femara) at age 57, after chemo, MX, rads and was told it was for 8 years. I felt really ill whilst taking it but persevered for about 4 months because I didnt know what was the reason for feeling so ill after all the treatment. It was the surgeon who put me on it and when I saw the onc from Christys, I told him how I ached all over and was nauseous every day and he sort of scratched his head and said he hadnt understood why the surgeon had chosen Letrozole in the first place and would I like to try Tamoxifen. The difference was amazing, I started to feel as if there was light at the end of the tunnel, the only possible drawback is a bit of a weight-gain. I think its a matter of personal preference, however the GP was real glad I was changed over, Letrozole costs the NHS about £ 80 a month, Tamoxifen about a fiver.
Good luck everyone, love Mags, a fellow Manc now living in Spain

I’m on Letrozole (since March) and have had minimal side effects apart from the hot flushes. I can’t have Tamoxifen as I’ve suffered from DVT.
Apparently the chemists have terrible trouble obtaining Letrozole because people are getting it over here and sending it abroad, my chemist told me just yesterday that there’s people out there obtaining false prescriptions to obtain it, how the hell can anyone make out to have cancer is beyond me, a sore throat, headache or whatever to obtain antibiotics/pain killers, but cancer, amazing.

I was told by my breast consultant that for women who are ER+ they recommend two years of tamoxifen first, then a switch to aromatase inhibitors after that for those who are definitely post-menopause by then. Apparently research has shown that there is a benefit from taking one then switching to the other, rather than going straight onto AIs, even if you’re already post menopause.

From the reading around I’ve done it looks like the other possible benefit of this approach is that the Tamoxifen strengthens your bones before hitting them with AIs that can weaken them.

Sarah x

hi all

Sarah, what you have said is exactly what i understood and this was the reason for my original question. i was even getting a bit paranoid - thinking that my consultant hadn’t told me everything ie i have secondaries. My consultant does tend to be a bit full on and tells you exactly how it is( which is good in the main) but i do always have a few shaky days after seeing her.

I,m not having any trouble getting the Letrozole. I phoned up the chemist about this and he has taken over my prescription so that he can order it in advance. When i was looking into Letrozole i did keep happening on sites for body builders. Apparently, they take this as well as tamoxifen(what ever they can obtain). It helps get rid of the boobs they develope from taking steroids. Bloody great isn’t it! We,re trying to keep ours and they’re trying to get rid and nabbing our medication too .

hi manc mags from spain - where about are you, my inlaws live in Pillar on the costa Blanca

Thanks all for your responses

Maria x

Hi Maria,
We come under Orihuela Costa, you leave the N332 at Campoamor then its a couple of miles further on, I know Pilar very well, whats the name of their urbanisation? Hasta luego, Mags x

Hi again Maria,
we spent our first 9 years in Chaddy, we lived on Rydal Avenue which is off Chadderton Park Road, are you close by?