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Deborah,
Once you hopefully overcome the side effects you mentioned using the advice in previous replies in this thread, you should be concerned about the longer term potential threat of weakening bones. So have at least your annual bone density test done. Even better would be to monitor more frequently the trend in bone resorption with the help of urine (or serum) test for NTx (Ntelopeptide) or Ctx markers or some other markers.
Femara is a very potent estrogen suppressor which in some cases leaves so little as to make undetectable the serum levels of estrogen.
If you respond well to the drug you should have tumour markers way down in 3 to 6 months
If you cannot live with the side effects ask your onc if it is feasable to reduce the dosage (oncs usually don't like it because they lack data on the efficacy of reduced dosages unless they are willing & able to find the detailed clinical trial regimens )
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