tamoxifen then femara

kristen8594 · 09-23-2008, 08:13 AM

Hello, I have been a member for a while but do not post much. I have learned so much just from reading all the post, its such a wealth of information.
I have a question I am hoping someone can help me with. I have been on tamoxifen for 5 years, I am 47 years old. I haven't had a period in almost 2 years and even then not much of one for the last 5 years. My oncologist wants me to wait three months to be sure I don't get my period back after ending with tamoxifen and before beginning femara. My doc says that because of the 5 years on tamox she wants to be sure I am post meno ( the blood test showed meno but tamox can through things off) before starting the femera. I am worried about two things. One....not being on anything and two...side effects for femera. Also if I should get my period back where does that leave me??
Any information anybody can give me on their experiences would be very helpful. I am glad I have the option to be starting a new drug, but am fearful at the same time. Should I be worried about not being on anything for three months? Does anybody have any helpful information on side effects?
Thanks for all your help!
Kristen

Becky · 09-23-2008, 08:26 AM

First - it only takes 3 weeks for Tamoxifen to be out of your body. That said, your onc may want to wait a couple of weeks after that to see what goes on with your blood work. I am sure they are running LH, FSH and estradiol (do not let them forget estradiol as it is the most important reading). If your bloodwork shows that you are not quite in menopause yet, you can ask for Lupron or Zoladex shots that will shut down your ovaries so you can take Femara. You could also contemplate an oophorectomy.

Femara or any AI can cause side effects. Since you have been reading this board for almost 3 yrs, you have seen that many women on this board had side effects (mostly joint pain) that was relieved when switching to another AI. Therefore, if you have alot of joint pain on Femara, try Arimidex or try Aromosin.

As for being off Tamoxifen for 6-12 weeks, I wouldn't worry about it one second. Tamoxifen (and also the AIs) give sustained protection for yrs after you stop using them. This is documented. Being off won't make a difference so rest easy about this.

Discuss chemical shut down of the ovaries with your onc. Also be watchful if you are postmenopausal. Make sure you get bloodwork on the AI after 3 months (unless you get the ovaries shutdown chemically or surgically) as AIs can cause ovaries to come to life (this happened to me which is why I got my ooph (among other reasons)). This does NOT mean it will happen to you but I feel we are all here to learn from each other's experiences. I was almost 47 at the time.

Cheers

Gerri · 09-23-2008, 10:34 AM

I was pre-menopausal at dx (age 52 - no menstural cycle due to partial hysterectomy) so my onc put me on Tamoxifen and checked my levels periodically. Last April two of my levels had changed indicating menopause but my Estradiol remained in the normal range. My onc consulted with the endochrinologist at the center and she recommended that I be tested with the Anti Mullerian Hormone test - apparently more accurate than the standard test. The test had to be sent out and took almost a week to get the results. The test confirmed that I was in menopause. I switched to Femara and have done well with it. I do have some aches and pains but nothing that I wasn't experiencing with Tamoxifen. I still don't have overwhelming hot flashes but do get very warm a few times a day - a little more than when on Tamoxifen. Now I am wondering about Becky's comment regarding being tested again. I'll have to pull out my results from the AMH test and do a little research.

Be sure to have a bone density test when you start your AI. My onc wanted to delay mine six months because she said that Tamoxifen strenghtens bones. I asked her for one after three months and found that I have osteopenia. I will now get Zometa every six months. I have found that sometimes, no matter how smart our doctors are, we still need to watch out for ourselves.

Good luck.