Hi Kerr Kerr, when I started Tamoxifen 5 yrs ago,I got terrible hot flushes, low mood and sleepless nights. I persevered but in the end I got prescribed 10mg of Endep which is a really low dose antidepressant. It was a huge help and enabled me to keep taking Tamoxifen. I know ladies who have no problems at all- you don't know till you try. What I would say is to have a liver function blood test and perhaps a pelvic ultrasound so that you have a baseline before you start this drug.As time goes on, Tamoxifen can affect your endometrium and liver and you wouldn't know it. I now have a fatty liver and my hair is thinning - another Tamoxifen side effect that isn't mentioned.On a positive note,it's very effective at preventing a bc recurrence. xx