How to Cope with Side Effects of Aromatase Inhibitors

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Anne Kelly, MSN, NP

Anne Kelly, MSN, NP

Aromatase inhibitors (AIs) are some of the most effective treatments for post-menopausal women with hormonally sensitive breast cancer, such as estrogen-positive breast cancer. Compared to tamoxifen, AIs like Arimidex, Aromasin, and Femara are less likely to cause blood clots or raise the risk of endometrial cancer. The drug also helps reduce the risk of recurrence.

However, AIs often come with side effects, including joint discomfort, bone loss, hot flashes and vaginal dryness. Anne Kelly, MSN, NP, a nurse practitioner for the Breast Oncology Program in the Susan F. Smith Center for Women’s Cancers at Dana-Farber, provides some advice on how patients can cope with some of the symptoms of AIs:

Joint discomfort – While on an AI, women may experience discomfort in hands, wrists or knees. If the AI is causing the pain, it will typically occur bilaterally, or on both sides of the body. To prevent joint discomfort, Kelly encourages patients to “keep moving” and stay active. The exercises do not have to be time-consuming or complicated; walking, yoga, or even just taking an extra flight of stairs can be effective.

Bone loss – If a patient is taking an AI, nurses and physicians will monitor her bone density with regular tests. To help prevent bone loss, Kelly encourages patients to incorporate light weightlifting and strength exercises into their workout routines.  Kelly also recommends patients take calcium supplements and vitamin D to help maintain bone health. Read this blog post for tips on how to get started with an exercise routine during cancer.

Hot flashes – In addition to helping with joint discomfort and bone loss, exercise can also help with hot flashes, Kelly says. Patients should also pay attention to what triggers the hot flashes (stress, alcohol, spicy food, or caffeine are often/sometimes  involved/the cause/to blame?) and avoid those triggers as much as possible. Dressing in layers can also help, Kelly says.

Vaginal dryness – It may be uncomfortable to talk about, but it is important for women to discuss vaginal dryness with their physicians. Kelly recommends women use vaginal lubricants on a regular basis, not just during intercourse, to avoid urinary tract infections and other genital issues. Although these side effects can be uncomfortable, it is important to remember that all patients react to AIs differently, Kelly says. Once a patient is off the AI, the symptoms will go away.

If  you, or a patient you know, are experiencing any of these symptoms, discuss them with a physician or care team. For more information on breast cancer treatments, visit the webpage for the Susan F. Smith Center’s Breast Oncology Program.

2 Comments:

  1. Great tips for managing side effects of AIs. Vitamin D has been demonstrated in clinical studies to have significant impact on bone pain, myalgias and arthralgias. In patients whose serum vitamin D levels are optimal prior to commencing AI therapy, side effects of AI are significantly less. Another study found concurrent supplementation of vitamin D with Arimidex produced notably reduced muscle and joint pain compared to placebo.

  2. This is great information. I have been taking tamoxifen for 3 years now but recently found an EIN polyp so I have stopped taking the drug for now and am having a hysterectomy. I wasn’t too happy about possibly taking an AI drug but maybe it won’t be as bad as I thought. I currently take Vitamin D supplements daily. We’ll see what my oncologist recommends after my surgery. Thank you for this information.

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