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Hormone therapy, osteoporosis, and cholesterol


my oncologist is prescribing hormone therapy (AI). I’m kind of opposed for 2 reasons. One of the reasons is that it can weaken bones, and I am already opteopenic. The second is that it can impact cholesterol, and I am already taking meds for cholesterol. Can anyone comment on their experiences? I am 76, just had a lumpectomy, and should be starting radiation treatment soon. My oncotype score was 17.


  • exbrnxgrl
    exbrnxgrl Member Posts: 4,830

    I have been on all three AI’s over the course of 12 years (I am stage IV). I had joint pain in quite a few areas but managed with OTC treatment. I coped quite well for a very long time (working almost that entire time as an elementary school teacher) so it wasn’t debilitating nor did it change my life much but, eventually the cumulative effect from over a decade on the drug really bothered me. The unusual part about this is that it is more common to have side effects diminish over time whereas for me it was the complete opposite. Yes, I do have osteopenia but it remains stable. Although there are known side effects to these drugs, individual reaction to them seems to vary widely.
    I stayed on them for 12 years because I was stage IV but had no progression after initial treatment. The reality is however, that no one really knows why I have not had progression. In November 2023, at my oncologist ‘s suggestion, I stopped taking them. I am still stage IV but on no treatment whatsoever.
    As far as your decision, that is entirely up to you. Many, including myself, suggest giving it a try and stopping if you experience side effects. The other thing that you might think about is how would you feel if you had a recurrence. We have members who have declined these drugs and had no recurrence as well as those who declined and did have a recurrence. Unfortunately, there’s no way to predict which way it might go so you need to feel comfortable with your choice. Take care

  • arose17
    arose17 Member Posts: 2

    thanks for your thoughts.

  • vlnrph
    vlnrph Member Posts: 490

    As a retired pharmacist, my perspective is the same as exbrnxgrl. At least start the aromatase inhibitor and see how it goes. Personally, I tried one from each class (letrozole & exemastane) over the course of a year but couldn’t tolerate either med. The joint aches and trigger finger that developed greatly impacted my quality of life, especially violin playing, so I quit.

    My mom didn’t do well on any of the 3 AI drugs she attempted to take. My bones were not a concern since I had been on tamoxifen. Should yours deteriorate further, oral tablets like Fosamax/alendronate or periodic injectables may help reverse damage or stablize their strength. You probably already take calcium with vitamin D and do weight bearing excercise.

    I also had a concern with cholesterol. Again, you won’t know how that will change until you’re taking the new prescription. Ask for a lipid panel after maybe 3 months. I had muscle cramps when we tried to push up my statin however 200mg of coenzyme Q daily kept that under control. Hopefully, your doctor can provide all the information you need to decide.

  • muska
    muska Member Posts: 224

    I have been on an AI for ten years. No impact on my cholesterol levels. Since you are already taking something for cholesterol, you should be ok.

    As for osteopenia they will monitor with regular DEXA scans and intervene if there’s a need.

    please talk to your oncologist about your concerns and your level of risk.