Exemestane: What It Is, How It Works, and What You Need to Know

When you hear exemestane, a type of aromatase inhibitor used to treat hormone-receptor-positive breast cancer in postmenopausal women. Also known as Aromasin, it works by blocking the enzyme that turns androgens into estrogen, cutting off the fuel that some breast cancers need to grow. Unlike tamoxifen, which blocks estrogen receptors, exemestane actually reduces the amount of estrogen your body makes—making it a powerful tool after menopause when ovaries stop producing estrogen but fat tissue and adrenal glands still can.

It’s often prescribed after 2–3 years of tamoxifen, or as a first-line treatment if tamoxifen isn’t right for you. People use it because it’s effective, well-tolerated, and helps lower the risk of cancer coming back. But it’s not for everyone. If you haven’t gone through menopause, it won’t work—your ovaries are still making too much estrogen for exemestane to overcome. It also doesn’t help with estrogen-negative cancers. That’s why doctors test for hormone receptors before prescribing it. You’ll need regular bone scans too, because lower estrogen can lead to bone thinning over time.

Exemestane relates closely to other aromatase inhibitors, drugs like anastrozole and letrozole that also block estrogen production. While all three do the same job, some women respond better to one than another. Side effects vary—some get joint pain with exemestane, others feel more fatigue with letrozole. There’s no one-size-fits-all, so switching between them is common if one stops working or causes too much discomfort. It also connects to hormone therapy, a broad category of treatments that adjust or block hormones to slow or stop cancer growth. This includes drugs like tamoxifen, fulvestrant, and even ovarian suppression for younger women. Exemestane fits into this group as a targeted, non-surgical way to control cancer without chemotherapy.

What you’ll find in the posts below isn’t just drug info—it’s real-world context. You’ll see how people manage side effects like joint stiffness or hot flashes, how it compares to other treatments, and what to expect long-term. No fluff. Just clear, practical insights from people who’ve been through it and the experts who guide them.