Managing the side effects of HT
There are many articles about how many women do not continue HT because of the side effects. Then there is this simplistic answer to "talk to your doctor" because there are ways to manage the side effects.
I am supposed to be in survivorship but I have significant side effects to hormonal therapy and this is amplified by removing of my ovaries. I have consulted 2 Mo's and my OB trying to solve some of these problems and tried 3 HT regiments. My question is would you please share the side effects you had and what you have done to effectively manage it.
For my part I have had significant bone pain from AI's and numbness in my hands that eventually needed surgery and switching to Tamoxifen. The bone pain is mostly gone but I am still struggling with SIGNIFCANT weight gain, insomnia, Hot flashes , vaginal dryness.
I have found that cocount oil and estace perscription helps with the dryness. I tried gabapentin for the hotflashes and numbness but gained so much weight quickly that I immediately went off of it. These are not uncommon side effects. Could you please share what you have done to manage these post therapy & menopausal symptoms.
weight gain, residual nueropathy, insomnia( this is the worst) Hot flashes ( worse at night but are a pain during the day) vaginal dryness, weight gain, depression, fatigue, muscle aches. etc.
Comments
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This is a great idea, exercise_guru!
Zoladex + Aromasin originally made me moody and depressed. My MO prescribed me Celexa and I've been on a more even keel ever since.
Hormonal therapy also gives me hot flashes, especially at night. I sleep in a cotton, short-sleeved shirt with a ceiling fan on all night.
I have long suffered from insomnia; I'm a fan of generic Unisom (Doxylamine Succinate), which is also an antihistamine and helps when I have a stuffy/runny nose (like now -- thanks, allergies). I also use Melatonin and Ativan (emergencies only) for sleep aids.
I have gained weight since I finished chemo (about 10 pounds). I am trying to exercise more and eat less. It's the "eating less" part that I'm having problems with. I work at a university; I have deliberately scheduled my classes in buildings far from my office so I have no choice but walk across campus for forty minutes on the days I teach. I have also been taking more walks with my sons.
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I have just started Tamoxifen, so I am probably not qualified to answer your question. However, since diagnosis I have dropped 30 plus pounds by clean eating. I eat no empty calories, maximize my protein to the daily required amount, purchase food without much sodium. I shop the external section of the grocery store focusing on fresh veggies/fruits, some meats, yogurt, cashew milk and coconut milk from the vegan section. Sugar snap peas are eaten instead of chips, lots and lots of spinach to increase my iron stores. Initially taking tamox I had an uneasy stomach and used ginger cubes to chew on.
I walk 10,000 steps most days of the week. I started out with 3,000, then 4,000 then 5,000. I was able to make the jump to more just knowing how many steps I took per minute, which is 100. Basically, it is walking 5 miles per day.
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For night sweats and warm spells (not really hot flashes), I sleep in summer nightwear with the ceiling fan on. For insomnia, I need to take Zyrtec anyway so Unisom or Benadryl would make me feel too dopey. Under a lot of stress so I do take 1/2 mg. Xanax at bedtime along with 1-2 mg melatonin ( the higher doses don't really do anything). If I eat close to bedtime, it's usually something high-protein. Weight gain has been a major problem--stress gave me carb cravings and a week of prednisone for laryngitis ad then a back strain when it wore off led to undisciplined eating and a 20-lb gain since diagnosis. Trying to walk more and have joined a gym--will meet w/trainer Friday. Am trying to cut back gradually on starch & sugar rather than go cold turkey, until I am comfortable eating cold turkey instead of a donut. Joint pain is helped by Celebrex in the morning and two Tylenol at bedtime; sometimes a little Bio-Freez or Voltaren or Traumeel gel. No knee pain because my knees are fake. For memory loss....I forget....
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Chi- you made me chuckle at that last line.
Insomnia is worse for me when I don't exercise and feel stress. I started alternating nights, melatonin and a homeopathic remedy that has valerian and something else. I'll get a photo. It's a homeopathic muscle relaxer and it really does seem to help.
Exercise guru- w you on the coconut oil. My whole being feels like the drive from LA to Vegas- it's the driest stretch of road I've been on- except the jackpot at the end is to be cancer free...
Moisturizer everywhere, extra moisturizer shampoo and conditioner too. Anybody have suggestions for dry eyes?
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I, too, am anxious to read the posts here. I started my hormonal therapy of Aromasin in November. I already have moderate arthritis and now everything hurts that much more. Although, how do I really know it's from the Aromasin? The hot flashes and dryness I can deal with. But the insomnia and the bone/joint pain make me want to scream at times. I haven't gained more than a few pounds (which is good because I am already overweight) I dance and teach dance so I am glad that activity is in my life. I love dancing and it helps me forget the pain once I can get on the dance floor. However, I feel like I am 100 years old some days just getting up from the chair and to the floor. And if I am having a fairly good day, then the sciatica starts to kick in. Geeessshhh But...I am still here and smile every day that is offered to me.
I imagine there are different formulas of the AI. Has anyone switched to another and felt better?
I had a bone density test done a couple of weeks ago because I want to keep track of what damage might be occur. I was surprised at the results. I went from "better than average" 10 years ago to the beginnings of osteopenia. Shame on you chemo and steroids! :-(
Falconer, I am jealous. You have enough hair to use conditioner. :-)
To those using Unisom or like products...do you feel they work? My melatonin has stopped working for me. I even tried a spray version which is supposed to work faster. My Nyqull ZZZ doesn't seem to help much either. :-( I thought about asking my doctor for Ativan as my mom uses it successfully. The Onc. had initially prescribed Ambien but once I realized what the script was I chose not to take it. I've heard too many horror stories about that med.
~Heidi
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Heidi,
I use Unisom, but I don't know whether it works or I'm just using it as a mental crutch. I DO know that it helps me breathe, and since a stuffy or runny nose can impede sleep, it is helpful in that way. I have some Ativan on hand for those nights when it's midnight and I don't feel sleepy and I have to get up at 6:10 am the next day to go to work.
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I think I will ask about the Ativan and buy the Unisom as well. I have Percoset for pain and sometimes use a 1/4 tab of that before sleep when the limbs feel especially bothersome and won't let me relax. But I try not to do that too often.
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Some women find that using L-Theanine helps with sleep - two or 3 capsules. I find that it works at least as well as melatonin, so sometimes alternate a few weeks on one or the other, as one can become somewhat habituated to melatonin (per one RO).
I have no solutions for the aches and pains, which I find to be distinctly different from arthritis and bone spurs, etc. I exercise a lot, do lots of stretching, yoga, Pilates. I can't imagine how I'd feel without all that movement.
For those who do have issues on endocrine therapy, I think it takes a LOT of trial and error to find solutions (if any) and even more determination to just make it through, somehow.
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Heidi - Your experience with AIs sounds like mine. I only made it a total of ten months on two of them, then back to Tamoxifen. For joint pain, and I do still have it, I do clairitin, magnesium, one alleve daily. For hot flashes I do Effexor and magnesium. Sleep is generally fine, if I do have an occasional bad night I do this visual imaging thing of places I love to go to (like our farm) and I drift off, or I sing a song verse by verse in my head. I'm weird like that. I started vitamin D, fish oil, biotin and a baby aspirin since the oophmenopause.
Guru - it's hard for me to know what is menopause and what is the med.
I have some leftover klonopin from the year I was diagnosed and I very occasionally take half of one for anxiety.
Hugs all around. Great to "see" everyone!
Off topic, but the picture above is tonight's sunset at my happy place - our farm.
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Thanks for the gorgeous sunset, Lucy!!
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My cat Heidi also likes to climb on my chest and nuzzle and purr me to sleep (in fact, when she sees me put on a nightgown, she starts circling the bed and chirping to nag me to get the blanket & pillows ready so she can hop on).
I was told by my MO to avoid valerian because it can have an estrogenic effect (as can St. John's Wort, which is also contraindicated for those on letrozole). As for the Unisom (doxylamine), be aware that it's an antihistamine—it is marketed for sleep instead of allergies because it's too mild to be one's primary antihistamine, but does make one drowsy. Before Unisom, Benadryl (diphenhydramine) was used not just for allergy but also as an OTC sleeping pill—in fact, most OTC sleeping pills (and the “PM" components of nighttime analgesics) are diphenydramine…even the capsule and liqui-gel versions of Unisom! It is also one heckuvan antihistamine—in fact, they will give it I.V. for severe allergic reactions after initial emergency treatment with epinephrine. But it is also the most soporific (sleep-inducing) antihistamine out there.
If you are taking any antihistamine for sleep, be prepared to have to get up and pee at least once a night…or wear a heavy duty pad.
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ChiSandy, thanks for the info about the Valerian. I'm not surprised to discover that it has an estrogenic effect bc it makes me feel a little better, probably bc it is giving back what I want. I also think it's making me have to pee more, unless that's the Exemestane? Does the AI also act as a diuretic?
It's funny that just tonight I was reading Beatrix Potter's Tales to my 3 year old. She wrote that lettuce has a soporific effect on bunnies. 15 years ago, when my oldest was three, she would say soporific in her babbling play or, whenever we asked her about lettuce and bunnies thanks to listening to Beatrix.
So it makes me wonder what it is chemically that makes the lack of estrogen in our bodies create wakefulness?
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My guess is that there may be something in that homeopathic remedy that acts as a bladder stimulant. And as to why estrogen deprivation can cause insomnia, well, as we age we need less and less sleep--and estrogen deprivation can accelerate the effects of aging.
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Dear hang in there,
I have been on HT for almost 2 years and I have been struggling a great deal, I have tried all meds and I am back on exemestane:
1. weight again...it will come off when we stop the med. In the meanwhile I exercice (not crazily I don't have the energy I used to). I do barre classes twice/week, the stair master for 40 minutes once or twice a week, yoga twice/week and I walk my dog 1 hour almost every other everyday. I also use the app myfitnesspal.com and enter every calorie I eat. I maintain my weight at 140-138 pounds. I was 128 before my cancer ordeal.
2. Vaginal dryness was the worst under tamox. I did 3 mona Lisa laser treatments and it really helped. Maintenance is 1 laser once/year after that. This is not painful and it is a 10 minute treatment. My onc also prescribed an estradiol cream that you apply vaginally 3 times a week. This helps too.
3. Hot flashes...haven't found the cure. I take soy milk, multi vit. black cohosh, sage tea. Effexor work really well for hot flashes at 37.5 mgr. I was on it for almost 2 years. I quit because it is an anti anxiety med and I did not have energy, however it helped with insomnia...I might go back on it if I can solve the insomnia
4. THE WORST IS THIS INSOMNIA. I have tried everything! Sleeping pills, benadryl,melatonin. I am still investigating... Right now I do temazepan + 2 mgr of melatonin to sleep 7 hours. The muscle relaxant Flexeril also helps with insomnia but if you take it every night, it won't work
5. For pain, I take Flerexil and I do yoga.
The road is long for me too. And if anyone has a secret for sleep, let us know. I feel I can cope fairly well with the rest but the insomnia is just too much. I have to drug myself every night to get a miserable night! Good luck to you and don't quit. I know it is hard but this is our best protection against a recurrence.
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Farmerlucy - what a beautiful sunset .... I can see why it is your happy place ... so peaceful
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Thanks Hopeful and Farmdreams.
I also use marijuana lotion for aching legs at night. A secondary benefit is excellent sleep.
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Farmerlucy - did your doctor give you a script for the marijuana lotion.... I don't know anything about it or how to get.
I have aching legs and having issues sleeping.
I go back to work on Monday and won't be able to rest during the day.
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You can get the CBD lotion from Amazon or other places. The stuff with THC would need to be from a state where it is legal.
http://apothecanna.com/collections/pain-relief/pro...
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Farmerlucy - Thank you for the information and link!
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Wow, thank you ladies! So much information has been shared and I am going to look into several of the ideas presented here. Some I had not heard of before. Somethings are going to make me back down from trying others, but I would rather know than harm myself more.
I agree, the insomnia is probably the worst for me to deal with. I have tried essential oils too and although they smell lovely the drowsy effect doesn't kick in. I would love a solid 4 or 5 hours of sleep at one time. But I wake on and off during the night and already have to pee 2 or 3 times. Of course the big glass of water I habitually place on the night stand and drink is part of that problem.
I have that percoset for pain but don't like to take it unless my limbs are screaming out at me. I have to be careful of taking NSAIDS because of the arthritis med I am on. Activity is always good. I know if I were to just sit things would get worse. I push myself "just that little more." But I will be exploring the use of magnesium. Claritin works for pain? Isn't that the allery stuff? I take chondrotin daily and just started taking a turmeric capsule too to help with inflamation.
FarmerLucy, my next stop is going to be Amazon to check out the lotion. Thank you for sharing that beautiful picture with us. By the way I am in OK too.
My prayers seem to include the wish that I don't have to be on a hormone blocker more than the 5 years. 4 years, 8 months, 2 weeks to go.
~Heidi
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I also like Arnica Rub for help with achiness. I have some wonderful Argan oil that makes the skin dryness go bye bye for awhile.
~Heidi
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As for the osteopenia, my MO called and told me my Medicare Part B supplement carrier has greenlighted Prolia for all breast cancer patients on AIs who have been diagnosed with osteopenia or osteoporosis. Getting the shot next week. So the worry about a broken hip down the line has been greatly lessened.
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hi Tamoxifen sisters.
I posted this before too, but I just started Tamoxifen- and I have numbness and tingling in hands and my face. My forehead feels like I got Botox, but I didn't. Anyone else deal with this? Cd it be SE of the Tamoxifen? It's really prevalent now, been on drug only2 weeks!
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