Hi I have been taking letrozole for almost 2 years now, since November 2023.  I had a double mastectomy with immediate diep reconstruction in February 2024. My cancer was highly hormone receptive and in fact the letrazole considerably drunk my tumour prior to surgery.

During this time I have tried anastrozole and exemestane and none of them helped with the constant aching, joint pain and fatigue.  I had a dexa scan in January 2024 which was fine and take calichew and magnesium supplements. Although I am so grateful for my treatment I feel like I am 88 and not 58 and it is really getting me down.

I was taking sertraline, and have recently tried to stop taking this (using the slow reduction/withdrawal method discussed with GP).  Since stopping I genuinely feel my pain is considerably worse, which is not helping my mood. Is there a connection between sertraline and pain relief ? I have read that duloxetine is good for letrozole associated pain ? Would duloxetine be worth a try for low mood and pain ?

The only other alternative i think is to switch to tamoxifen. I am 58 post menopausal. would this be suitable to try ?

Thank you