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13 Tips to Help Manage Side Effects from Aromatase Inhibitors

I frequently get emails from dear readers and others about the dreaded drugs we love to hate, aromatase inhibitors. The topic is a common thread when subscribers share why they signed up for my newsletters. The two AI posts in the bottom corner of this page are my most commented on posts. These drugs are on the minds of a lot of breast cancer patients because these drugs suck!

You might want to read and download, Endocrine Therapy – Managing & Making Decisions About Your Aromatase Inhibitor Medication.

Women want validation, and they also want (and deserve) help managing the side effects of these drugs!

This is why I decided to write a post in which my goal is to share some ideas on how to manage the difficult side effects of these drugs that many women suffer from. If you have suggestions to add, please share them with a comment at the end of this post. Male breast cancer patients, you’re invited to share too!

Putting our heads together helps us all, right?

To learn more about aromatase inhibitors, read this post. Or visit a reputable sight such as cancer.net or breastcancer.org. Or of course, speak with your medical care team.

And yeah, about the latter…

Many women confide that their medical team isn’t all that concerned or helpful when it comes to these particular side effects. Women often share that their symptoms are dismissed as not that bad, pretty normal, or par for the course due to normal aging.

I’ve heard all that too. And it’s annoying as hell!

It’s important to remember that most doctors are not dismissive or certainly don’t intend to be, so generalizations are not a good idea here either. But clearly, many women do not feel heard. Their concerns and side effect issues are not being addressed or even validated.

And that’s a problem.

This list of things to try in order to manage troubling side effects is certainly not all inclusive. Nor are these suggestions meant to be some big solution. They are merely ideas to consider trying. Who knows, one or two might help!

Tips to help manage side effects from AIs:

 1. Keep a journal of your issues.

Record every day or at least every week how you’re feeling symptom-wise. Documentation is super important. Docs love it. Write down what issues you’re having and be specific. Are your joints aching? Which ones? Exactly what activities are hard for you? Are you feeling depressed? Is your hair thinning? Is intimacy an issue? Are side effects impacting your ability to work?

When you have a doctor appointment, take your journal with you so you have “proof”. Oh, and perhaps consider keeping a separate journal where you can write down all your frustrations – unfiltered! Releasing them somewhere sometimes helps even if you’re the only one reading.

Need some journaling tips? Here you go.

 2. Exercise, even a little helps.

Trust me, I know it’s sometimes hard when your joints hurt and the mere thought of exercising makes you cringe. Try doing it anyway. Start off super slow. It might sound counter-intuitive, but exercise can help you hurt less.

Another commonly reported side effect of these drugs is fatigue. Too tired to exercise? I hear you. But exercise can help you feel less tired too. Really, it can. Sometimes the hardest part is getting started, am I right? Again, start slow. The key is to start.

Need some motivation tips? Click here.

 3. If you need to shed a few pounds, work on doing that. 

I don’t know about you, but I’m pretty sick of condescending, finger-wagging articles telling us to maintain a healthy weight and how it helps prevent recurrence etc. I mean, who doesn’t know this is important? Sometimes it’s not that easy especially when taking these drugs. I speak from experience. And yet, it’s important to try.

Don’t think about losing 25 pounds or whatever you think your number is – that number might be unrealistic anyway. Think in little increments. Five. Two. One. Better yet, don’t think about pounds at all. Just try to eat healthier, drink a lot of water and squeeze in some movement most days.

 4. Along with the above, invest in some good tennis shoes or walking shoes.

When my ankles starting acting up on anastrozole, I got myself some spendy tennis shoes, and it made a difference. Now I wear them whenever I need to walk a distance. Does this sometimes make me feel like an old lady? Yep. Whatever…

And flip flops – no need to give them up. Invest in better brands such as Born and Clarks. I have both and I love them. Last summer I was able to wear the latter while strolling on the River Walk in San Antonio all day long, they were that supportive. Without them, no way.

 5. If you’re having issues in the bedroom, get help. 

Many women talk about libido issues, vaginal dryness problems and the like. Get help. There are products and things to try. Ask for a referral. Do NOT be embarrassed. Okay, try not to be. Regardless, don’t let that stop you. There is help. And yeah, sometimes you do have to “force” yourself to get started in the bedroom, but usually it’s worth it. Relationships take work. After a cancer diagnosis, this certainly doesn’t get easier. Figure out what works for you and your partner. Talk to each other. Talk to a professional. And then talk to your partner some more.

 6. Take Tylenol or ibuprofen when planning to sit for extended periods. 

Before I go to a movie, get on a plane or get in the car for more than a couple hours, I take Tylenol. It helps me be able to stand up later without wincing.

 7. Don’t think about five years or ten years on the darn pills.

It’s overwhelming to think like that sometimes, am I right? Try thinking in shorter increments such as three months, your next oncology appointment, the holidays or whatever.

 8. Take a break.

I’ve done this more than once. It helped. And now there’s research saying it might actually be a good idea for some women.

 9. Find others to commiserate with.

Vent here on this blog! Or find another online space where you can be frank. Face-to-face support groups can be helpful. Or not. Depends on your group, I guess. Having some place safe to vent helps. Plus, it takes some of the load off those closest to us.

10. Wear head covers.

If you’re like me, your hair might be disappearing. (Except for those annoying hairs on our faces, right ? WTF!) Get yourself some caps, hats, scarves or even a wig. I never wore caps before cancer. Now I wear them all the time. Besides hiding my hair, they provide good sun protection for my face. I need it. I’ve had a skin cancer diagnosis too. Ugh…

11. Check and monitor your Vitamin D level.

Following chemo, mine was super low. Getting adequate amounts of Vitamin D is important. Low levels can contribute to bone/joint pain. We monitor mine now and yes, I take a supplement.

12. Consider switching drugs.

For whatever reasons, I could not tolerate Arimidex – anastrozole. My body just said, no. I switched to Aromasin – exemestane and I’ve done better. I still hate it, but I’m doing better.

13. Do not suffer in silence.

If you remember nothing else from this post, remember this one. Never suffer in silence. Just do not. You have a right to be heard. You deserve validation, and you also deserve help in managing side effects from a medication that your medical team is prescribing for you. And of course, you have the right to stop taking these meds if you so choose. The decision is yours and yours alone.

I hope one or two of these suggestions help. If I think of more, I’ll add to this list, so check back now and then.

Now, I can’t wait to hear what your suggestions are.

Share away!

You might want to read and download, Endocrine Therapy – Managing & Making Decisions About Your Aromatase Inhibitor Medication.

If you’re on an AI or some other medication, what are your most bothersome side effects, and are you getting validation and help in managing them?

What tip(s) would you add to this list?

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13 Tips to Help Manage Side Effects of Aromatase Inhibitors

 

 

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Christine Onofrey

Sunday 30th of June 2019

Nancy, A million thanks for this blog!!! I’ve been on anastrozole for a little over 4 months. Hot flashes were a problem for me. I talked to my doctor and she prescribed oxybutynin. It works like charm!

Best Regards,

Christine

Nancy

Thursday 11th of July 2019

Christine, You're very welcome. Thank you for taking time to comment. I'm glad you've found something to help with the hot flashes.

Janet Person

Friday 28th of June 2019

Between my medications from my oncologists and naturopathic meds to help with the side effects from the western medicine, I take almost 2 dozen pills a day. My way of dealing with the side effects from the AI type drugs (and other western meds, is to not read the pages of possible side effects as I am the kind of person that reading about side effects can become a self-fulfilling prophecy. Instead I try to visualize what each drug is doing for my body. For my AI-type estrogen blocker drug, Letrizole, I imagine that drug moving through my body with keys locking out the estrogen. I find if I can put a positive spin and visualization on what the drugs are doing I am more likely to take them, less likely to be resentful and angry about having to take them even though they are doing their job and I have no further disease progression and some of my mets are decreasing. I do have some side effects, but they are not nearly so bad as what other people seem to experience, so I am very grateful. Sleep is probably my biggest challenge and i have just resigned myself to taking sleeping pills and melatonin as it is way easier than doing the nightly battle with insomnia. Fatigue is another challenge, but my blood tonic (Shi Quan Da Bu Tang) from the naturopath helps immensely.

Jody Fleming

Wednesday 26th of June 2019

I have bounced between exemestane and anastozole. Mostly because of costs. However I found no difference in my side effects. I have also found that exercise has helped a lot for the aches mostly in my legs. My biggest issue was finding something to deal with terrible hot flashes. Doc put me on Effexor. It was horrible! It wasn’t making any difference and it took me almost 2 months to get off of it. Very addictive to some people. Now I’m on gaberpentin and I sleep like a baby. Finally! If you can’t sleep you are miserable all day. After a year I think I’m finally on meds that are working.

Nancy

Thursday 27th of June 2019

Jody, I'm so glad you have finally figured out what works for you. Hope you keep sleeping like a baby!

Renee Haberman

Wednesday 26th of June 2019

I have been on Arimidex for just over two years now and I have recently found a Tumeric creamer that has really helped with the joint pain. Turmeric Superfood Creamer made by Laird Hamilton ( the big wave surfer). This has helped me so much along with daily exercise as well. You can purchase it through his website or Amazon.

Nancy

Thursday 27th of June 2019

Renee, I think exercise is key. Thank you for sharing what works for you.

Carol A Miele

Saturday 2nd of March 2019

I've been on letrozole (Femara) for 8 yrs & will be on it till it stops working as I have MBC. i also have osteoarthritis in most joints. My oncologist recommended Glucosamine w/Chondroitin & MSM, Vit D3 14,000 IU's p/wk (my blood levels were low) & Magnesium 200 mg daily (my blood levels of Mg were also low). All of these have helped to reduce joint discomfort greatly. The advice to keep moving is the best thing you can do! Thanks Nancy for this valuable topic.