Decisions

My understanding is that tamoxifen works for both pre-menopausal and post-menopausal women. It blocks any eostrogen in our bodies from "feeding" the cancer cells. Aromatase inhibitors only work when you are post menopausal. Once your ovaries are no longer producing eostrogren, AIs can prevent any other eostrogen being formed in your body (by fat cells I think). So tamoxifen lets you keep some eostrogen circulating in your body after menopause. This eostrogen helps keep your bones stronger and joints healthier (among other things).

However, AIs apparently reduce the risk of recurrannce in post-menopausal women slightly more than tamxofen does. Also, AIs don't carry the small increased risk of edometrial/uterine cancer associated with tamoxifen. So there are pros and cons with both treatments.

Despite not having had a period for a year now - making me menopausal - I have decided to stick with tamoxifen because it is not causing me any major side-effects and I feel that at 47 I want to hold onto whatever eostrogen I have left. I am scared that AIs will be a fast-track to a sexless old-age with brittle bones and achey joints. While my onocologist has suggested switching to an AI she was not particularly concerned when I said no to it.  Perhaps I will switch when I am a bit older but for now I am okay with tamoxifen. Good luck with your decision Michelle, I hope all goes smoothly for you.