Best wishes @KarenY for your treatment. I have been on letrozole since October 2019. I have had very little joint pain although one ankle is a little stiff in the morning. Like others i had a bone scan before commencing treatment which showed osteopenia probably as I'm post menopausal for at least 5 years. I take vitamin d and calcium on a daily basis and prolia injection every six months to reduce osteoporosis risk. The only side effect i do struggle with is vaginal dryness and libido issues which are also manageable