Hi Angie,
I am 49 too and I have been on tamoxifen for two and a bit years. Recently I had a pelvic ultrasound which found thickening of the uterine wall which is quite common on tamoxifen I'm told. As a result of this I was sent off for a D&C ie to have the lining surgically scraped out.
I am just wondering why you can't take tamoxifen after a hysterectomy given that it has a deleterious effect on the uterus anyway. You would no longer have the thickening problem to worry about or the risk of uterine or endometrial cancers.
I understand that aromotase inhibitors like arimidex are slightly more effective in reducing the risk of BC recurrence in post-menopausal women (as I am myself now) but tamoxifen is still an effective treatment even after menopause and it doesn't give you all the aches and pains. I know some people do have unpleasant symptoms on tamoxifen but I've found it to be fine so when my oncologist suggested switching to an AI after my periods stopped I opted to stay on tamoxifen. She seemed fine with that.