Dear @Suwal, there is often not much you can do to avoid side effects. The reasons some people get them and others don't are very far from clear. Eat healthily, exercise, keep as positive as possible which may all help deal with any side effects you do get, but may not stop them. Arthritis type pains are common with Femara but in nearly 6 years I have never had any. I have vaginal atrophy though! Which may be in part (now, not in the beginning) attributable to age. Discuss and ask your medical team for relief from any difficult side effects, which may or may not help, but always worth trying. Best wishes.