Several medications can be used to block the effects of oestrogen. For women who have not had their menopause, the decrease in oestrogen can lead to the sudden onset of menopausal symptoms including hot flushes, vaginal dryness and mood swings. Your specialist can advise you on managing these.
Tamoxifen is the most well know hormonal treatment for breast cancer, it has been used for decades to prevent cancer coming back in pre-menopausal women. Tamoxifen blocks the oestrogen receptors on the cancer cells, stopping the hormone stimulating growth. It is given regularly as a tablet and is usually taken for 5 to 10 years.
Aromatase inhibitors, such as anastrozole and exemestane, also decrease oestrogen levels by stopping the body making the hormone.
They can reduce the amount of oestrogen circulating in the blood to very low levels and are effective for use in women after the menopause. You will also be offered a bone density scan whilst having this treatment to monitor your bone health as it can for some patients make the bones thinner and increase the risk of osteoporosis. Oestrogen receptor down-regulators, such as fulvestrant, are used in post-menopausal women with advanced breast cancer.
It blocks oestrogen receptors on breast cancer cells and also knocks out many of the receptors so the cancer cell is less responsive to circulating hormones.
Luteinising hormone releasing hormone (LNRH) blockers: Drugs like goserilin stop the pituitary gland releasing luteinising hormone.
This hormone normally stimulates the ovaries to produce oestrogen. LHRH blockers stop the signal getting through to the ovaries, so that less oestrogen is produced. Once stopped the effects are reversed.