Femara vs Tamoxifen

I am 47 too and I've been on tamoxifen for about 10 months. I do get hot flushes but they started after chemo and before the tamoxifen. Sometimes I wonder whether it is the tamoxifen that causes me to wake at 5am most days. But really I can't be sure tamoxifen is causing me any side effects. I guess I'm lucky in that respect.

I had one period in between finishing chemo last August and starting tamoxifen in January but none since. My oncologist thinks I'm menopausal and has suggested switching me to one of the aromatase inhibitors (AIs) like femara.  Apparently the AIs like femara are slightly better at preventing a recurrance of BC in post-menopausal women.

However, I am quite reluctant to switch over because tamoxifen isn't causing me any major problems and I don't like the sound of the side effects the AIs give you. Apparently it is very common for women taking them to have joint pain and stiffness. Brittle bones are also a risk.  Also, from what I've read, they leave you with no libido at all and can lead to vagninal dryness and atrophy, Yep, a shrivelled up vagina. Not very appealing is it.

The thing is the aromotase inhibitors block the production of estrogen in your body entirely. So the way I look at it, they are a fast track to old-ladyhood. I accept I'm getting older but I'm not ready for creaky joints and to lose my sexuality completely.  Taxmoxifen on the other hand allows you to keep your estrogen (or what's left of it at 47). It just blocks the estrogen from feeding any stray cancer cells that may be left in our bodies.

Look I may be wrong Nick cause I haven't actually tried an aromotase inhibitor. Maybe they're not as bad as I fear. And I guess if it was a choice between dying of cancer and taking AIs I would certainly take them. But while I have the option of tamoxifen, I'm sticking with that. Of course tamoxifen does pose the small risk of uterine or endometrial cancer so there is no easy answer to this question.

Good luck with your decision. Janet.