Any pre-menopausal women taking both Lupron and Femara?

Binc

I met with my new MO today to discuss hormonal therapy. My cancer was 100% both er and pr+ (also her2+, but that's not really relevant to this question) so needless to say, my MO couldn't emphasize enough the importance of hormonal therapy for me. I am 42, so she's recommending monthly Lupron shots to shut down my ovaries along with taking Femara daily for at least 2 years. I'm hoping to hear from anyone who has experience with this combination. My MO said the Lupron takes a month to kick in, then I can expect to experience menopausal symptoms- hot flashes, night sweats, joint pain, etc. She also said that the side effects would calm down after about 6 months. I know each person's experience is different, but I'd like to hear from people,who have actually been through it as opposed to what my doctor says. Do,the side effects really calm down after a while? Also, is weight gain preventable? My head is spinning right now. I'd welcome input from anyone who has been down this road. Thanks!

Binc

Anyone?

voraciousreader

I took Lupron shots for almost two years and tamoxifen. I was closer to menopause when diagnosed. I had very mild symptoms. Just curious why you are doing Femara rather than Tamoxifen?

Binc

Thanks for the response! Blood clots and strokes run in my family. Femara carries less risk of this than Tamoxifen. Still weighing my options. I still may end up doing Tamoxifen but MO suggested the Lupron/Femara combo as an alternative. She did warn that the other side effects would be more severe with that combo than taking Tamoxifen alone. . . Glad to hear your symptoms were mild!

momica111

I have been on Lupron/Femara regime for 6 months (I've had 7 injections).  I am 50 and pre-menopausal and could not tolerate the Tamoxifen side effects.  I am on the 7.5 mg dose monthly and my oncologist has not ordered any hormone level tests.  My periods ceased in the first month on the drug.  The Lupron kicked in at about two weeks and I had a couple of major meltdowns but since then I've actually be very even emotionally and without the normal PMS symptoms.  I actually am feeling pretty good on this drug.  The plan is to do it for one year and then come off to see if my ovaries kick back in or if I'm in natural menopause.  I get hot flashes and maybe am experiencing a little more fatigue when working out.  My concern is how long is it safe to be on this medication.  This is an off-label use for the drug so I'm not sure anyone knows.  My main concern is bone loss.  I'm curious what dose other's are being prescribed.  There is a 3.25mg dose that is used monthly for endometriosis.   Never thought I'd be praying for menopause to happen.

momand2kids

did it for about 3 years.... couldn't take tamox, was pre-meno---got monthly shots and took femara--- I found mostly that lupron made me "neutral" so I did not get agitated over things at work, etc.  I do feel like I could not remember things as well-not sure if that was lupron or femara.... went off lupron in June 2012 I think.. wanted to see if I was "done"-- still on femara until June 2014... 

It is hard to tell if side effects were lupron or femara--mostly in the beginning joint stiffness (managed by exercise), vaginal dryness (I am now a regular user of replens, and loss of libido--that one was tough-- I have to work harder at it--I am hoping that will re-emerge after the end of femara....

didn't really have alot of hot flashes or emotional meltdowns.... I guess everyone is different... good luck....

YoungTurkNYC

Hi,

I was diagnosed at the age of 40, and I went with the salpingo-oophorectomy/Femara route.  I have been on this regimen for approximately 6 months now, and other than very mild hot flashes and joint pain (due to Femara), it has been quite manageable.  I know you were asking about Lupron, but from a side effect perspective, an oophorectomy might be similar.

momica111

Still wondering what the appropriate dose of Lupron is.  I just switched oncs and the new doc is going to use the 3.25 mg dose vs. the 7.5 mg dose.  Can't seem to find out what dose anyone else is getting.  Please respond with what dose you are receiving, thank you! I will be seeing the new Onc for my first injection of the lower dose on 2/5 so will see what his rationale is.  I'm all for taking the lowest dose possible to shut down the ovaries.

momand2kids

Hi

I had monthly shots and I think they were 7.5

smrlvr

Momand2kids, my MO is hesitating to give me Lupron to kick me into menopause.  He does not want me to put any more chemicals into my body than necessary. I would rather be on arimidex as there have been studies it is better for ILC. So I am deciding whether or not I should push the Lupron.  Are there any side effects?  I am hoping chemo put me into menopause, but I have to wait a year to find out.

momica111

Hi smrlvr, the side effects of Lupron are typical menopause symptoms.  For me it's been hot flashes and like momand2kids, vaginal dryness and loss of libido.  The major concern is bone loss which according to my onc is over and above what one would normally experience with menopause.  Normally if you are pre-menopausal they would prescribe Tamoxifen before going to an aromatase inhibitor, at least that's my understanding.  Being 50 and unable to take Tamoxifen because of the side effects, I opted for the Lupron injections so I could take an aromatase inhibitor.  The other option was having the ovaries out, but the thought of having another surgery was just too much so I opted to try the Lupron.

momand2kids

side effects were hard to pinpoint because I was on femara and lupron-- but I noticed when I went off the lupron that my head was less fuzzy and I felt a little more emotion (lupron made me feel really neutral, which was not a bad thing!).  Now I just have the vaginal dryness and the loss of libido which I hope will lift some after I go off in May

momica111

I've now had 3 injections of the 3.75 mg subcutaneous dose of leuprolide (aka Lupron).  My new onc measured my estradiol level when we started the lower dose and we will be rechecking in another month to make sure the lower dose of the Lupron will keep my estradiol at menopausal level.  Still am feeling fine on this regimen of leuprolide to suppress the ovaries and Femara.  Hot flashes are not too bothersome however the vaginal dryness is becoming quite an issue.  My gyno suggested Estrace cream but that just seems ridiculous to me to use an estrogen cream when I'm trying to reduce estrogen in my body.  My onc said it was "permitted" but basically a quality of life decision.  I'm going to try some natural remedies first.

momica111

Here's an update on my Lupron and Femara regimen.  I'm into my 2nd year on Lupron.  I've had 15 total monthly injections and only 9 more to go.  I'm on 3.75mg monthly.  My estradiol numbers came back low so my Onc is comfortable with the lower dose.  Still experiencing typical menopausal symptoms, regular hot flashes which are manageable and vaginal dryness.  Using a vitamin E suppository and coconut oil for that and an organic water based lubricant for sex called "Yes"....funny, but the stuff works and has no silicone like some of the stuff you buy in the stores (find it online).  Over the last few months I've noticed an increase in hair loss and my nails which were already quite thin have gotten worse.  I've added a "hair & nail" formula to my supplement regimen.  Gonna let this ride for awhile then decided if I need to do something Rx for the hair loss.   Mood wise I'm pretty level but do have occasional emotional meltdowns in periods of stress.   Overall I believe I'm handling this endocrine therapy well with minimal side effects that are not having a huge impact on my life.  I work out at the gym and am feeling fit and healthy.  I'm still adjusting emotionally to my body which hasn't been easy and intimacy with my husband is strained.  Need to address that next.   One thing at a time!

momica111

I'm happy to report that I have had my final Lupron injection (2 years on the drug). Now I am wondering how it will be coming off the drug. I am 51 and hoping that I am in true menopause (or else the doctor will likely recommend oophorectomy). I experienced some real melt downs and mood swings when I started the medication so hoping this won't happen as the drug wears off. Anyone have any experience they'd like to share? I am still on the Femara and the plan is to stay on that for an additional 3 years for the 5 year total endocrine therapy.

momica111

Update on discontinuing Lupron after 2 years: I had my last injection the first week of April 2015. I am now almost 3 months out from that and have started experiencing ovary and uterine pain. This is similar to the pain I experienced when I was taking Tamoxifen during my first attempt at endocrine therapy. It has been going on for about a week. It feels as though my ovaries are trying to kick back on again and ovulate. I guess I will see what happens in a couple of weeks. Hoping that I don't start menstruating again (I'm almost 52) because my onc may recommend an oophorectomy after all. (I started on the Lupron to avoid that surgery). Anyway, the saga continues. Also experiencing headaches and feeling hormonal and anxious....just like the old PMS symptoms. My moods were quite level on the Lupron after the initial meltdowns. Stay tuned. I would love to know anyone else's experience discontinuing Lupron.

U4iachic

Hello, I received my first injection today. I think I was a bit dizzy a few hours later. Either way my onco and I are arguing over ovary removal. He asked me to do this for 3 months and then if I fair well he will support me removing my ovaries....... I start an AI with the next injection in July. I'm a bit nervous and hoping there are some good experiences with this drug!

pboi

U4 - interesting that your MO is arguing with you about ovary removal. I wanted to try the injections first to see how I did before ovary removal, but my MO said if I was done with having kids, I should just remove the ovaries. Will do so next month and then start Arimidex. Which AI are you taking? I'm nervous about all of this too!

PB

U4iachic

Pboi, I took the Lupron shot, not too bad, yet. I will have Arimidex to start with. We will do that in a month at the next injection. I'm hoping things go smooth for you! All of these decisions are nerve wracking!

rgiuff

Pboi, you should tell your Med Onc that ovaries are not just there for getting pregnant. The hormones they produce do help many functions all over the body, even after menopause. If you want to try ovarian suppression instead, that should be your choice. Once they are gone, you can't put them back, but suppression could be stopped and tamoxifen taken instead if the menopausal symptoms become intolerable. Every Oncologist seems to have a different philosophy about how to do things, which is why you should do what you prefer, as you are the one who has to live with the choice.

terrij152

I just got my first lupron injection today. I haven't had a period since October 2013. I started on Femara for mets to my lungs and hip almost 3 months ago, but this weekend I started spotting. My MO doesn't want me to have my ovaries removed, he'd rather me do the monthly lupron injections. He said there are too many risks in the OR vs. doing a monthly injection.

momica111

Update on discontinuing Lupron: Well, it's been just over four months and no return of periods yet. However, like clockwork every four weeks I have the pelvic and ovarian pain, similar to what I used to experience during ovulation time. But still no periods. I had my estradiol level done and while I'm not as low as I was while on Lupron I am still pretty low. So hoping that I truly am in natural menopause. Time will tell. Meanwhile I am still taking the Femara and my naturopath has prescribed DIM to also help keep my estradiol level down. The headaches are gone as well as the mood swings that I experienced shortly after discontinuing the Lupron and I'm am feeling more even. Good news on my bone density. I had my two year follow up and there was no significant change in my bone density after being on Lupron for the two years. I've been taking a product called "Bone Up" that was recommended by my naturopath as well as doing weight bearing exercise on a regular basis. So glad my bones did not deteriorate. It's always nice to get some good news!

treelilac

I was reading about Lupron injections at home on some infertility treatment forum. I wonder if anyone here ever did the injections home? I guess the formulations of the drugs might be different enough to require a professional administration but still feel curious.

rozem

I did Lupron from Dec 2012 to June of this year. I went off 2x during that time and both times my period came back but I was only 42 a diagnosis so young for menopause. My mom didn't go into menopause until early 50s. I tried for Femeravand Arimidex after the SOFT studies came out couldn't tolerate either. Im back on tam and just stopped the shots ( unauthorized by my MO) to see if the ovaries are finally fried. Im goimg to be 47 in Dec. I'm hoping you're finally done because I really don't want to go back on the shots or have an OOPH. I agree that the ovaries are very beneficial and I'm very hesitant to give up mine. Its a different story of course if you are BRAC + or have a strong family history of breast or ovarian cancers - then they should come out

atanea

Hi,

I took Lupron/Zoladex shots for 2 years, stopped 6 months ago, I had a hard time, not so much the first year, but the second one. I'm taking Tamoxifen.

I thought I was not going to have my period back after those shots and chemo, but 4 months later there it was, after 2 weeks of moderate pelvic pain, probably due to ovulation. Since then, I didn't had my period anymore, but it's probably coming near soon, as I'm starting to have pelvic pain again..unfortunately I believe it also make me have a big cyst, that appeared from nowhere, made my week a living hell, afraid of having ovarian cancer, fortunately it seems benign. Why can't my ovaries just be quiet..I don't want to have to take Zoladex or Lupron again, neither do an OOPH.

momica111

Atanea, that is very interesting because a week after my last post on 8/11 I ended up having a period, however I haven't had another one yet and would be a week late if I was going to be back on schedule. I'm still getting ovarian/pelvic sensations but not as bad as the first few months off the Lupron. My naturopath says that sometimes you'll get a surge and then perhaps the ovaries will be done. I checked with an oncologist at USC that I had gotten 2nd opinions from in the past and she said that there is no established limit for how long you can take Lupron for this use however I was really hoping the 2 years would be it. I don't think I want the surgery either. I just had labs drawn yesterday to check FSH and Estradiol so it will be interesting to see if I'm at menopausal levels or not. My question for my oncologist will be - at what level of Estradiol will it render the aromatase inhibitor useless. Perhaps you are lucky that you can tolerate the Tamoxifen. If I could have tolerated it I wouldn't have been put on the Lupron/Aromatase Inhibitor plan in the first place. Stay tuned.....

atanea

Hi momica11,

Thanks for the reply.

My estradiol levels where = 150 pg/ml, progesterone=5.17 ng/ml and FSH=4.93mUI/ml) 2 months ago, 2 days before period came. That was 2 months ago. Some days ago they were (estradiol=104 pg/mL, FSH = 8 mUI/ml) estradiol isn't low anymore, it used to be 10 - 20(with Zoladex/Lupron shots). I'm premenopaused again. I have done a lot of US lately and they can see that my ovaries have follicles evolving, so sooner or later period will come. I took Zoladex/Lupron shoots for 2 years at the same time I also took Tamoxifen, I thought the side effects I had during those 2 years were caused by Tamoxifen, but no, after the end of Zoladex shots, the most common SE went away. But then I started having uterus lining thickness, and now this cyst, I'm also getting worried if Tamoxifen is doing anything at all (besides getting my uterus lining thick, and maybe causing cysts ) because I don't really have any other side effects. I could return to those shoots, for more 3 years, but I decided against it, if I have to take Zoladex/Lupron shots again, then I will prefer to have an OOPH+hysterectomy, but then I will have to go for aromatase inhibitors? right?

Shouldn't you take aromatase inhibitors only if are certain you are pos-menopaused? I wouldn't mind go for aromatase inhibitors if that doesn't force me do a OOPH right now or taking those shots again, but they told me I couldn't because I was premenopaused again. I guess aromatase inhibitors are not that effective if you are premenopaused. I'm now confused. I'm curious of how will your onc answers the estradiol levels question.

momica111

Hi again Atanea, yes AI's are not used in premenopausal women.....I'm still taking it as we aren't sure if I'm close enough to being in menopause. Tamoxifen is also prescribed sometimes for post-menopausal women. I did horrible on Tamoxifen - uterine thickening and I felt super agitated and crazy so went off. Opted for the ovarian shutdown with the Lupron so I could take the AI. I'll be seeing my Onc next week and will see what he recommends after seeing my latest labs. Are we having fun with our hormones yet??

exercise_guru

I am in a position where I need to decide whether to have a hysterectomy and then go on arimidex ( Genetics involved) I am trying to decide if I should go on Lupron for a few months to make sure I can handle the side effects.

Has anyone gone off of Lupron and had an oophrectomy/hysterectomy? Did it change your symptoms?

pboi

I'm curious to know too. I've been on Lupron 3 months and will be getting an oophorectomy in about 2 1/2 weeks.

PB

fightergirl711

Bumping this - officially started Lupron today, Letrozole a month from now. We're starting out aggressive at first, see how it goes.