Long Term Zoladex Use

[KattS]

I have been getting zoladex shots for 11 months with arimidex.  Is there a limit on how long I can take these shots? Are there any side effects for long term usage?  My doctor said she would do it as long as I wanted to.  I am 52 and surely I must be nearing menopause.  I get my hormone levels monitored almost every month and it still states premenopausal. What does the hormone level have to be to be in menopause?

[CCF-RN,MSN-rf]

Dear Katts:  The duration of various hormonal therapies can vary and depends on menopausal status, stage of disease and goals of therapy. Since aromatase inhibitors (such as Arimidex) are not effective in women who have functioning ovaries, these drugs are approved for use in postmenopausal women. When premenopausal women are treated with aromatase inhibitors they are usually given in combination with treatments to shut down the ovaries (essentially making the woman postmenopausal). The ovaries can be shut down permanently with surgical removal or temporarily with drugs like Zoladex.  During treatment with Zoladex, it is impossible to determine whether or not "natural menopause" has occurred as the shots will usually prevent menstrual cycles and will affect the blood tests frequently used to measure menopausal status. There is no exact limit as to how long zoladex can be continued, however, there are side effects such as discomfort at the injection site and bone density loss. If the Zoladex is stopped and the Arimidex is continued, it would be appropriate to follow estradiol levels regularly -the levels should remain very low if you are truly postmenopausal. It would be best to discuss this further with your physician.