I've been on letrozole since mid 2017. I've had the Femara brand as well as generic brands, at the moment the pharmacor Letrozole, and have not noticed any difference between the different generics, or between the generics and the branded femara. I have other medical conditions which have resulted in fairly severe joint pain and stiffness as well as having osteoporosis before starting the letrozole. I have a Prolia injection six monthly for that, and my figures have improved slightly from what they were in 2017. It's hard to tell whether ongoing joint issues are caused or exacerbated by the letrozole, but my feeling is that the ongoing deterioration would have occurred regardless. Other than that, I too have some, shall we say.. changes in my lady garden. It is no longer lush, but is now semi desert, with nary even a cactus in sight.