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Real members of MyBCTeam have posted questions and answers that support our community guidelines, and should not be taken as medical advice. Looking for the latest medically reviewed content by doctors and experts? Visit our resource section.

Has anyone had to stay on Zoladex alone due to intolerance of AI?

A MyBCTeam Member asked a question 💭
Ruskin, FL

Almost everything I see in here about tamoxifen and AI are terrible, so my expectation is that I’ll feel like garbage on AI when I start next week. Assuming that I can’t tolerate any of the 3, I’m wondering if anyone has had success and good prognosis on Zoladex alone. I feel totally normal on it right now, and I just generally don’t want to feel bad on a maintenance drug.

July 8
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Reactions
A MyBCTeam Member

Remember, the discussions about the AI side effects, are because some women are finding the side effects to be challenging. Often the members here, once they get to the AI stage, if the side effects are minimal, they get back to their life, and just are not as active on the site. Sometimes they pop in to give a positive vibes update, so we only hear from them infrequently. Hang in there, you may be one of the lucky ones!! Hugs!

July 8
A MyBCTeam Member

Keeping you in prayers that this drug works well for you with minimal and easily managed side effects! Hugs!

July 8
A MyBCTeam Member

I’m just so tired from everything that’s gone on this year. I need a break from pain and side effects. I did some googling today (not a doctor, I know) and found that it may be possible to only do Zoladex if none of the AIs work since switching back to tamoxifen isn’t an option. I also read that the side effects I was experiencing on tamoxifen were serious and that I was right to have stopped it. The other side effects listed seemed like more of annoyances to me—nothing I wouldn’t be willing to work through. But I know I won’t try to be the hero and keep taking a drug that causes serious side effects again. I won’t be listening to anyone who tells me the symptoms don’t matter and I have to take it.

July 8
A MyBCTeam Member

I started Anastrozole (one of the AIs) Feb 2023. My side effects have been moderate but tolerable. I have seen women on this site say they have had no side effects. Maybe you will be one of the lucky ones. I agree with @A MyBCTeam Member, women doing fine with little side effects might not be as likely to post as those that are struggling and need some support/advice. I hope your experience is positive. If one AI does not work, try another. I have seen women on this site say that switching from one AI to another made .a huge difference. It can be a long process of trial and error. Stay optimistic. Hugs

July 8 (edited)
MyBCTeam

It's completely understandable to feel anxious about starting an aromatase inhibitor (AI), especially when you're feeling well on Zoladex right now. It's worth remembering that everyone's experience is different — many MyBCTeam members do report side effects, but others tolerate AIs much better than expected. Try not to let Show Full Answer

It's completely understandable to feel anxious about starting an aromatase inhibitor (AI), especially when you're feeling well on Zoladex right now. It's worth remembering that everyone's experience is different — many MyBCTeam members do report side effects, but others tolerate AIs much better than expected. Try not to let the harder stories set your expectations in stone before you've even started.

That said, your concern about tolerability is valid and worth discussing openly with your oncologist. Here's why combination therapy is typically recommended:

- Zoladex suppresses ovarian function, reducing estrogen production
- AIs work by blocking the remaining estrogen in the body
- Together, they provide stronger protection against recurrence than either alone

If you find you can't tolerate one AI, there are three options available — letrozole, anastrozole, and exemestane — and some people tolerate one better than others. It's really important to have an honest conversation with your oncologist before assuming the worst. They can help you:

- Start at a lower dose to ease into treatment
- Manage side effects proactively
- Explore switching between AIs if one isn't tolerable
- Weigh the risks and benefits of any changes to your plan

Please don't adjust or stop any part of your treatment without guidance from your care team — staying on the recommended therapy can significantly reduce recurrence risk. You deserve to feel heard about this, and a good oncologist will work with you to find the best path forward.

July 8

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