Joint and muscle pain. Joint pain is commonly experienced by people taking aromatase inhibitors. Talk with your healthcare team about troublesome joint pain. Your doctor may recommend:

• Regular, gentle exercise
• Anti-inflammatory medications, such as aspirin or ibuprofen
• Heat
• Massage
• Acupuncture
• Vitamin D, if your levels are low

Tips to manage joint pain

• Talk with your doctor about which over-the-counter medicine would be best for you.
• Wrap ice in a towel or use an ice pack to place over your joint for 15-20 minutes a few times a day.
• Soak in a warm tub or take a warm shower to relax your muscles and increase circulation.

To prevent joint discomfort, it is recommended to keep moving and stay active.

The exercises do not have to be time-consuming or complicated:

• Walking
• Yoga
• Taking an extra flight of stairs

Physical activity offers key benefits for cancer patients. It can give you an extra boost during and after cancer treatment. It helps lower your stress, improve your sleep patterns and elevate your mood. Something as simple as walking briskly around the block a few times can help you feel better both physically and emotionally. And because exercise can help ensure you get a good night’s sleep, it helps to combat fatigue.

Just take small steps to make your day more active, and always ask your doctor before starting any exercise program.

Loss of bone density. Aromatase can cause loss of bone density, which leads to higher rates of osteoporosis and bone fractures compared to tamoxifen. Your healthcare team can take a baseline measure of your bone density to compare against in the future in order to monitor any changes to your bone density.

To help prevent bone loss, your doctor may recommend:

• Regular exercise to help strengthen and protect your bones. For example, weight-bearing exercise (exercise that involves standing rather than sitting, i.e., walking and dancing) and resistance training (such as lifting weights and lunges) help protect bones and lower the risk of hip fractures.
• Calcium supplements and vitamin D to help maintain bone health and reduce the risk of fractures.
• Drugs called bisphosphanates or denosumab to help maintain bone density while you’re taking aromatase inhibitors.
• Quitting smoking in order to help strengthen your bones.
• Adding light weightlifting and stretching exercises to your workout routine. Physical activity offers key benefits for cancer patients. It can give you an extra boost during and after cancer treatment. It helps lower your stress, improve your sleep patterns and elevate your mood.
• Walking briskly around the block a few times can help you feel better both physically and emotionally. And because exercise can help ensure you get a good night’s sleep, it helps to combat fatigue.

Just take small steps to make your day more active, and always ask your doctor before starting an exercise program.

Source:

Susan G. Komen, 2024. Side Effects of Aromatase Inhibitors

Hot flashes/Night Sweats. are sudden and strong feelings of warmth or heat, especially over the face, neck, and chest. Hot flashes can cause heavy sweating and may leave you chilled after the hot flash passes. Your doctor may prescribe you non-hormonal medications such as antidepressants or nerve pain medicines that may decrease hot flashes. Beyond medication, there are certain things you can do to help with hot flashes and night sweats.

Patients should also pay attention to what triggers the hot flashes (i.e., stress, alcohol, spicy foods, caffeine) and avoid those triggers as much as possible.

Source:

American Cancer Society, 2023. Managing Hot Flashes and Sweating.

Tips to Manage Hot Flashes:

• Avoid caffeine and hot drinks.
• Avoid hot or spicy foods.
• Slowly sip on cold drinks.
• Avoid alcohol.
• Keep an ice pack under your bed pillow.
• Keep your home or bedroom cool.
• Dress in layers. Wear absorbent cotton clothing in layers that can be easily removed.
• Use sprays or moist wipes to help lower skin temperature.
• Quit smoking.
• Use relaxation techniques.
• Get acupuncture or massages.
• Exercise (physical activity), including yoga. In addition to helping with joint discomfort and bone loss, exercise can help you with hot flashes.
• Maintain a healthy weight.

Sources:

American Cancer Society, 2023. What are Hot Flashes and Sweating?

American Cancer Society, 2023. Managing Hot Flashes and Sweating.

Mayo Clinic, 2023. Hot flashes: Diagnosis & treatment.

Vaginal dryness/Itching. Vaginal dryness can cause pain during intercourse, vaginal soreness, and itching. It is one of the most common menopausal symptoms reported by women, and it is important to talk to your physician about it. There are over-the-counter and prescription options to relieve vaginal dryness, so talk with your healthcare team about which option is best for you.

Tips to manage vaginal dryness:

• Use vaginal moisturizers (such as Replens or Hyalo Gyn) on a regular basis. They are different from lubricants because instead of sitting on the skin’s surface, they are absorbed by the skin. Vaginal moisturizers are estrogen-free, and therefore are safe for breast cancer survivors. They need to be used regularly, not just at the time of intercourse. Use vaginal moisturizers at bedtime for the best absorption. It’s not uncommon for women who’ve had cancer to need to use moisturizers several times per week. Vaginal moisturizers are different than lubricants – they last longer and are not usually used for sexual activity. Vaginal moisturizers are available without a prescription (over-the-counter).
• Use water- or silicon-based lubricants before sexual intercourse, which provide a temporary smooth feeling in the vagina; however, they do not provide longer-term moisturization as vaginal moisturizers do. it’s best to choose a water-based gel that has no perfumes, coloring, spermicide, herbal remedies, or flavors added, as these chemicals can irritate your delicate genital tissues.
• Use over-the-counter (available without a prescription) antifungal creams to provide relief for yeast infections.

Sources:

American Cancer Society, 2020. Managing Female Sexual Problems Related to Cancer.

Breastcancer.org, 2024. Vaginal Dryness: Vaginal Moisturizers and Lubricants.

Pain during sex or dyspareunia. Pain during sex is a legitimate health concern that can affect you and your partner. There are many things that can cause pain during sex, so it is important to talk to your doctor about the type of pain you are experiencing so that s/he can determine what sort of treatment is best for you. Do not let embarrassment keep you from getting medical care. It is important to let your partner know if any types of touching cause pain. Show your partner ways to caress you or positions that don’t hurt. Usually, light touching around the clitoris and the entrance to the vagina won’t hurt, especially if the area is well-lubricated.

Some treatment options include:

• Vaginal moisturizers are estrogen-free, over-the-counter moisturizers that are used regularly rather than just at the time of intercourse. It keeps the vaginal area moisturized, unlike a lubricant which only makes the vaginal area slippery and is generally only used at the time of intercourse.
• Vaginal lubricants that are either water or silicone-based are used for sexual activity to increase comfort and pleasure, i.e. gels and lubrication suppositories (soft gel pellets).
• Pelvic floor physical therapy is helpful for women with tight or tender muscles. Working on pelvic floor muscle health can keep muscles relaxed and reduce pain during sex.
• Vaginal dilators can be helpful for women with pain during penetration. The dilator increases comfort during intercourse by stretching the vagina and reducing tightness.
• Vaginal lidocaine is a topical treatment applied to the vaginal opening before sexual intercourse. It can help decrease pain.

Sources:

American Cancer Society, 2020. Managing Female Sexual Problems Related to Cancer.

Breastcancer.org, 2022. Lidocaine May Help Ease Painful Intercourse After Breast Cancer Treatment.