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Tamoxifen, Breast Cancer, and Your Health

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Updated May 31, 2012

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Tamoxifen is given to reduce the risk of recurrence for estrogen-receptor positive breast cancer. A well-established estrogen blocker, it's an important drug for many men and women who have been diagnosed with breast cancer. Be sure you know the basics of cost, side effects, how and when it works, and some precautions you may need to take, before you start treatment with tamoxifen.

Anti-estrogen Therapy for Breast Cancer

Tamoxifen citrate tablets
Photo © Karl D. Stephan
Tamoxifen is an important breast cancer drug that has been used for over 30 years. For cases of estrogen-receptor positive breast tumors, both male and female patients have taken tamoxifen to prevent a recurrence or to slow the growth of metastatic breast cancer. It is an anti-estrogen drug that is taken as a daily pill for five years after primary treatments. For women at high risk of developing breast cancer, tamoxifen is sometimes given to lower their risk of a tumor. Before you start taking tamoxifen, it’s a good idea to learn the basics about this drug and its potential side effects.

Covering The Cost of Tamoxifen

Even though tamoxifen is now available in generic form, it isn’t free, so you’ll need to budget for the monthly cost of the drug. Don’t skip taking this drug for estrogen-sensitive breast cancer -– there are various resources you can use to help pay for your prescription. Tamoxifen costs more per dose than an aromatase inhibitor, but it is still very effective in premenopausal women, as well as male breast cancer patients.

Understanding Genetic Resistance

Tamoxifen doesn't always for work for everybody. Some people have a variation of the CYP2D6 gene that makes them somewhat resistant to this anti-estrogen drug. If you aren’t benefiting from this drug, you may have other options. Be sure to talk to your doctor to understand how your body uses tamoxifen.

Antidepressants Can Interfere

Tamoxifen, Zoloft, Effexor
Photo © Pam Stephan
Your doctor may prescribe an antidepressant to help you cope with the common side effects of tamoxifen. Low estrogen levels result in menopausal symptoms can be moderated by an SSRI (selective serotonin reuptake inhibitor). However, while these drugs make you feel better, it may be because it interferes with the effectiveness of your tamoxifen dose. Here is a list of antidepressants and how they interact with your hormone therapy.

5 Years After Tamoxifen and Zoloft

If you have already taken your five-year course of tamoxifen –- and used an antidepressant that dampened the benefits of your hormone therapy -– you may be worried. Did all that tamoxifen really work for you? You want to make sure that you’ve done all you can to prevent a recurrence of your breast cancer. Taking five more years of tamoxifen is not appealing -– so make sure you know what you may need to do.

Don't Mix Tamoxifen and Pregnancy

Chemotherapy and hormone therapy can have an effect on your present and future fertility. But once you have survived the surgery, chemo, and radiation treatments and you’re ready to get on with your life, you may be thinking about having a child. Don’t rush into a pregnancy or have unprotected sex while taking an estrogen blocker like tamoxifen. Make plans before you start treatment to preserve your fertility and protect your health.

Tamoxifen and Your Sex Life

You’ve overcome so much to be a breast cancer survivor. Your body, mind, and spirit have been greatly challenged -– and changed -– by the experience. No matter what your treatments have been, your body image and your chemistry are different now. Tamoxifen can affect your emotional state, your vaginal health, sleep quality, and fatigue levels. Add in the unpredictability of hot flashes and mood swings, and you may wonder if your libido has gone into early retirement.

If this describes your situation, please know that help is out there for you. Talk to your family doctor, gynecologist, or a therapist about strategies for renewing your sex life. Getting back into an intimate relationship and coping with low estrogen levels can take some effort and ingenuity. Set aside time for communication, preparation -- and hopefully, participation –- in your new love life after breast cancer.
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