Reviewing the Common Side Effects of Letrozole

By Stacie-Mullin

2 min read

If you have advanced breast cancer, you may wonder, "What is letrozole?" Letrozole, brand name Femara^®, is a hormone therapy drug that belongs to a class of drugs called aromatase inhibitors. Aromatase inhibitors work by lowering estrogen levels in the body. Letrozole is given to those with estrogen-positive breast cancer who have already reached menopause.¹

Sharing my side effects on letrozole

After having a conversation with my doctor, he informed me that those with lower stages of breast cancer may be on letrozole is up to 5 years, but the recommended duration for those with metastatic breast cancer can be the full length of their life. Since you can potentially be taking letrozole for a long time, it can be difficult when the medicine causes unwanted side effects. My side effects are hot flashes, joint pain, and bone pain.

As with most medicines, the list of side effects for letrozole is extensive, so I will just touch on the most common side effects and some ways I ease them. As always, check with your doctor before trying any over-the-counter medications, exercises, and supplements.²

Pain and aches in joints or muscles

This side effect is one of the most common complaints from people who take letrozole. Painful joints can affect movement and make it hard to participate in many activities. Ironically, you are in too much pain to move, but being stationary is worse. Once you do get up, you can barely walk.

But getting up and walking, doing stretches, and doing yoga are some of the best ways to ease joint and muscle pain. Do not stay stagnant. Move that body, and talk to your doctor about supplements and other options to help reduce pain.²

Menopause symptoms

Hot flashes, loss of libido, vaginal dryness, skin itching and dryness, sleeping disturbances – the list goes on. To help manage hot flashes, it is recommended you stay away from spicy foods, dress in layers so you can remove clothing if you soak through with sweat, and drink lots of water. I personally have a handheld fan that I take with me everywhere.^3,4

For skin dryness and itching, use a good cream or lotion specifically for dryness and itchiness. My favorite brand is Aquaphor. Sometimes I put it in the refrigerator and use it to cool down those hot flashes too. Speak with your gynecologist about the best lubrication and creams for vaginal dryness and loss of libido. Also, working with a physical therapist can help you learn pelvic floor exercises.

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Mood swings

Good ol' mood swings. Happy, sad, angry, content, crying over commercials on TV, or rearranging your house because you hate everything. The first thing I recommend is meditation, yoga, and professional therapy to help with all those moods. If those methods do not help you, there are medicines your doctor can prescribe. I prefer the natural route if I can, but I understand it is not always possible.

Pros and cons of letrozole

In conclusion, letrozole is one of those drugs that you hate to love. The side effects are brutal, but we know they help us live longer lives with advanced breast cancer.

What are some side effects you experience while taking letrozole, and in what ways do you find relief from them?

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The AdvancedBreastCancer.net team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

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Steph Millett Moderator & Contributor
Living for these tips. I love that you touched on vaginal dryness too! I feel like a lot of folks don't talk about it, but we NEED to! Sending you some love, friend <3
mrtl Member
I'll add brain fog where you find yourself staring at the wall for extended periods of time. Then there's the issue with extreme fatigue, as in, you can't stay awake more than 4 hours at a time. But the final problem was the carpel tunnel - so painful that I couldn't open nor close my hands when it hit that finally made me quit the drug. Crossing my fingers for the future but I couldn't take it after 15 months. 
1. Steph Millett Moderator & Contributor
 All of these things you’re listing here are such struggles. My heart goes out to you, friend! Neuropathy and carpal tunnel are such tough and tricky things to manage. I feel like I myself have good days and bad days. Sometimes I’ll forget about it, it stays away for so long, and then I drop something ten times and I get so frustrated. My heart is with you, sending you so much love. -Steph (team member)
Glenda Member
I would like to share what a few of us go through on aromatase inhibitors. Maybe about 4% of the women who take them have 0 quality of life on the drug. The oncologist calls it a sever neuropsychological response. The night sweats soaked my bed cloths and sheets. I was irrationally angry. My mind constantly raced. I couldn't sleep more then 2 hours a night. I couldn't remember anything. I couldn't focus. I wanted to hurt people. I finally no longer wanted to live because I did not like who I had become and my 1st oncologist told me I was making it up. I stopped the drug and became human again. When I became metastatic I saw a new oncologist. He was familiar with the crazy side effect and when it started again he put me on a high dose of antidepressant. It controlled the symptoms but I lacked energy and focus and felt like I was half living. When my oncologist retired, I switched to a different cancer center. My new oncologist talked to me about switching to fulvesterant. She was concerned with my poor quality of life. When my cancer came back it came back in the pleural of my lung. Although I am no evidence of disease right now, we know that cancer does not play fair. She wants me to be able to enjoy life and do things I love not just go through the motions. So far so good. The point of my sharing this is that aromatase inhibitors can be mentally and physically hard. Fortunately my joint pain is minimal and I have remained active. Please if your oncologist will not take your side effects seriously either as for a referral to palliative care of find a new oncologist. These drugs are hard and side effects can be lessened.