I'm also pre-menopausal and my oncologist offered me the option of an AI with monthly injections to shut down my ovaries, as I also didn't have chemo (genomic testing did not recommend it) and this is the slightly more effective option. So definitely talk to your oncologist.
Also, the most recent research I could find - and my oncologist confirmed this - is the most effective treatment has been shown to be switching off tamoxifen at 5 years and onto an AI for a further 5 years. So that's some other food for thought.
I've only been on tamoxifen for 2 months, but I did have a hysteroscopy, d&c and ablation due to persistent low iron approx 12 months ago. It was such successful! I went from 7 day periods to 1 day with noticeable spotting plus a day either side with maybe a touch of colour. This hasn't changed so far. I know the 'risk' of needing a repeat ablation in a few years varies due to age - at 45, there is not much risk as my body is getting ready to pack up the baby making shop! But I'm not sure if the tamoxifen will change that. I may switch to an AI earlier if it seems to.
