postmenopausal....maybe

Gerri · 04-25-2008, 07:31 PM

I just got back from seeing my onc and really hope I can get some feedback from some of you. I have been taking Tamoxifen for almost two years now (the beginning of May) and have been getting my levels tested every three months to check my menopausal status. Well, the latest results are in and the numbers have finally changed but are a bit confusing: Estradiol 1.2 (Postmenopausal), LH 16.4 (Postmenopausal), FSH 15.3 (Not Postmenopausal). So, with 2 out of 3, am I in menopause or not? My onc put a call in to the endocrinologist but is waiting to hear back. She thinks that the FSH level is the most important one but wanted to get the endo's opinion. I really want to switch to an AI so will probably get the injections if needed to give me that final push. When I do switch to an AI I am considering going with Femara. My onc says that it probably doesn't matter but she suggests Arimidex based on past studies. I based my choice on the new info out on Femara. Any ideas on this?

I would really appreciate any thoughts or suggestions anyone has to offer.

All my best,

karen z · 04-26-2008, 06:22 PM

Gerri,
I was 53 when I got diagnosed in 2005 but not yet menopausal. Although my last period was during my first chemo cycle (July 05) and, despite my age, my oncologist kept me on tamoxifen for a full two years and checked my levels at least twice during that time. My doc had heard several stories at conferences about women regaining ovarian function after being switched to an AI and he wanted to be absolutely certain that I was truly postmenopausal before moving me from tamoxifen. So, he was very cautious about that move, although very aggressive with my main treatment (herceptin in 05 for stage 1). I do not know whether this helps or not. I am now on Femara- seem to be doing o.k. with it so far.
Best,
Karen

PinkGirl · 04-26-2008, 06:35 PM

Hi Gerri,
I too started out peri-menopausal and took Tamoxifen.
I was only on it 4 months and then switched to an A.I.

My onc. made the decision based on my blood work. I
was in full menopause after my chemo treatments and
kept having blood work to see if I was staying there.

I guess I would wait and see what the endocrinologist
has to say. Good luck with all of this. I take Arimidex
and have not been told by my onc. that Femera is
better. I will ask about that at my next appointment.

karen z · 04-26-2008, 06:54 PM

Hi Gerri and PinkGirl,
I think that there is definitely some variability regarding the tme frame for moving from tamoxifen to an AI, for patients in our position. My doc told me up front that he would definitely give me tamoxifen for one year (another doc I interviewed told me that that is also what she would do) and then my guy decided to go longer. My bloodwork indicated postmenopausal status after chemo but he wanted to make sure that the levels stayed that way for some time out that he was comfortable with....and I think he was definitely influenced by conference stories. I agree with PinkGirl's advice that you will need to see what the endocrinologist says. Also, by the way, at the time that I moved to an AI (a few months ago) my doctor told me that I could take either Femara or Arimidex- that they were both very good. So, I did not go with one or the other because he thought it was better.
Take care.
Karen

Gerri · 04-26-2008, 08:26 PM

Hi Karen and PinkGirl,

Thanks so much for the input. All along I have been fine with being on Tamoxifen but lately I have seen a few studies that say women who have mild hot flashes don't do as well on Tamoxifen as women who have more severe flashes. I am a warm flasher at best and wonder if that means I am a poor metabolizer. Now that I am so close to menopause I just want to make the switch. Hopefully the endocrinologist will say that my counts are good and I won't have to have the injections. My onc's original plan was Tamoxifen for two years and then switch to an AI for three years, providing I was in menopause. It looks like it is going to work out just as she planned. I will probably start with Femara and see if I can tolerate the side effects, if not I will switch to Arimidex. Thanks again.

Take good care,