I started on letrozole mid 2017...so coming up to six years now. I have other pre existing joint, tendon, muscle and skin problems from systemic scleroderma, so it's hard to tell what's from which, but I can say (as does my rheumatologist) that any issues in these departments would have existed in any event, letrozole or not. I too have experienced vaginal dryness as well as some hair thinning but not to the extent that is a real problem....solutions can be found. A little of this and a little of that (plus getting the engine warmed up prior to driving...so to speak) have worked for me. Good luck with your ongoing treatment.