Medical Oncologist
Medicines
Exemestane (Aromasin) for breast cancer: the complete patient guide
Exemestane is a daily hormone tablet for hormone-receptor-positive breast cancer, mainly in women after menopause. It lowers oestrogen to reduce the chance of cancer returning or to help control advanced disease. This page explains how it works, why it is taken after food, how it is used, common side effects, the checks involved and when to contact your team.
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Medically reviewed by Dr. Naresh GunduConsultant Medical Oncologist · MBBS, DNB (Internal Medicine), DM (Medical Oncology, AIIMS) · last reviewed September 2026, next review due September 2027
On this page
The short answer
What is exemestane, and what should you know before you start?
Exemestane, sold under the brand name Aromasin and as many generics, is a daily hormone tablet for hormone-receptor-positive breast cancer. It belongs to a group of medicines called aromatase inhibitors, alongside letrozole and anastrozole. After menopause, the ovaries stop making oestrogen, but the body still makes a small amount in fat, muscle and other tissues using an enzyme called aromatase. Exemestane blocks that enzyme, so oestrogen levels fall very low and hormone-sensitive cancer cells lose a signal they use to grow. Unlike letrozole and anastrozole, exemestane has a steroid-like chemical shape and binds to aromatase permanently, which is why it is called a steroidal aromatase inhibitor. That word describes its structure; it is not a cortisone-type or muscle-building steroid. Exemestane is mainly used for women past menopause, either for about five years after surgery, or after two to three years of tamoxifen to complete the course. Younger women with higher-risk cancer sometimes take it together with injections that switch off the ovaries. In advanced breast cancer, it may be used after another hormone tablet has stopped working, often combined with a targeted medicine called everolimus. It is usually taken once a day after a meal, because food helps the body absorb it. Common side effects include hot flushes, joint aches, tiredness and gradual bone thinning, so bone checks are part of treatment. It does not work for hormone-negative cancer.
Who it is for
Mainly women past menopause with hormone-receptor-positive breast cancer.
How it is taken
One tablet a day after food, at the dose your doctor prescribes.
What to watch for
Joint aches, hot flushes, tiredness and bone health.
This page gives general information only. Your oncologist will explain how exemestane fits your treatment.When it is used
Four ways exemestane is used
Your cancer stage, menopause status and earlier treatment decide how it fits in.
After surgery for early cancer
Taken for about five years to lower the chance of the cancer returning, often after chemotherapy or radiotherapy.
After tamoxifen
Women who started on tamoxifen may switch to exemestane after two to three years to complete their hormone therapy.
Menopause must be confirmed before switching.Before menopause, with ovarian suppression
For some younger women with higher-risk cancer, exemestane is combined with injections that stop the ovaries working.
Advanced breast cancer
Used when cancer has spread, often after letrozole or anastrozole has stopped controlling it.
It may be combined with
- Everolimus, a targeted tablet
- Other treatments in clinical trials
- Bone-strengthening treatment if cancer is in the bones
At a glance
Exemestane in brief
Question
In general terms
What type of medicine?
A steroidal aromatase inhibitor, a form of hormone therapy
How is it taken?
One tablet by mouth each day, preferably after a meal
How long for?
Usually about five years of hormone therapy in total for early cancer
Main side effects
Hot flushes, joint aches, tiredness, sweating, poor sleep, bone thinning
Main checks
Bone density scan, vitamin D, cholesterol and regular follow-up
Words you will hear
The vocabulary, in plain language
- Aromatase inhibitor
- A tablet that blocks the enzyme the body uses to make oestrogen after menopause.
- Steroidal
- Describes exemestane's chemical shape, which resembles natural hormones. It does not mean it acts like cortisone.
- Hormone-receptor-positive
- Cancer cells with receptors for oestrogen or progesterone, which use these hormones to grow.
- Adjuvant treatment
- Treatment after surgery to lower the chance of cancer returning.
- Ovarian suppression
- Injections or surgery that stop the ovaries making oestrogen.
- Everolimus
- A targeted tablet sometimes combined with exemestane for advanced cancer.
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Have a question about your situation?
Call the helpline or leave your details, and someone will help you arrange a consultation at the CION centre nearest you. One helpline serves every CION centre.
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Being straight with you
The honest picture about exemestane
Exemestane is an effective, well-studied medicine, but it helps to go in with realistic expectations.
It lowers risk rather than removing it
Exemestane reduces the chance of the cancer returning. Some cancers still come back despite treatment.
Side effects are common
Many women have hot flushes or joint aches. Most can be eased, but for some they are hard to live with.
No test shows it is working
There is no blood test that confirms the benefit in early breast cancer. Taking it steadily is what counts.
What this page cannot tell you
It cannot say whether exemestane is right for you. Your oncologist can, with your reports.
Getting ready
Before you start exemestane
A few checks and conversations at the start make treatment safer and easier.
Confirm menopause status
Exemestane alone only works if the ovaries are inactive. If your periods stopped recently or after chemotherapy, hormone blood tests may be needed.
Check your bones
A bone density scan and vitamin D test are often arranged near the start, so bone loss can be tracked and treated.
Share your medicine list
Tell your team about every medicine and supplement, especially hormone products, epilepsy medicines, rifampicin and St John's wort.
Plan a routine
Link your tablet to a regular meal, such as breakfast or dinner, so it becomes a habit.
Staying safe
When to contact your team
Most side effects are manageable at routine visits, but some need quicker attention.
Seek urgent help
Chest pain, sudden breathlessness, a painful swollen leg, a severe allergic reaction or signs of a stroke need emergency care.
Contact your team soon
New bone pain that does not settle, a fracture after a minor fall, yellowing skin, a new breast lump or periods returning.
Raise at your next visit
Troublesome hot flushes, joint aches, low mood, poor sleep or vaginal dryness.
Commonly believed
What people assume about exemestane
Exemestane is a steroid like prednisolone.
Steroidal describes its shape only. It does not have cortisone-type effects.
It is a type of chemotherapy.
It is hormone therapy and does not cause chemotherapy-style hair loss or low blood counts.
It works for any breast cancer.
It only helps cancers that are hormone-receptor-positive.
Once scans are clear, it can be stopped.
The full planned course gives the protection. Discuss any wish to stop first.
Questions we are asked
Common questions about exemestane
Is Aromasin the same as exemestane?
Yes. Aromasin is the original brand name. Generic versions contain the same medicine, exemestane, at the same strength. Your pharmacy may supply different makers over time, so check the medicine name on the pack and ask your pharmacist if anything looks unfamiliar.
Why should exemestane be taken after food?
Food, especially a meal containing some fat, helps the body absorb exemestane more fully. Taking it after the same meal each day also makes it easier to remember. If you occasionally take it without food, it still works, so do not skip a dose over this.
Can I take exemestane before menopause?
Not on its own. While the ovaries are working, exemestane cannot lower oestrogen enough. Some younger women with higher-risk cancer take it together with ovarian suppression injections, which switch the ovaries off. Your oncologist will advise whether this suits you.
How is exemestane different from letrozole and anastrozole?
All three lower oestrogen by blocking aromatase and work similarly well. Exemestane binds to the enzyme permanently and has a steroid-like shape, while the other two do not. Some women who cannot tolerate one tablet manage better on another.
How soon do side effects start?
Hot flushes and tiredness can begin within the first few weeks. Joint aches often appear over the first few months. Bone thinning happens gradually and causes no symptoms, which is why bone checks matter. Many side effects ease after the first year.
Will exemestane thin my bones?
It can, because it lowers oestrogen, which helps keep bones strong. Vitamin D, calcium, weight-bearing exercise and regular bone density scans help. If bones become thin, a bone-strengthening medicine may be added while you continue exemestane.
Can I drink alcohol on exemestane?
Alcohol does not directly interact with exemestane, but it is linked with a higher risk of breast cancer and can worsen hot flushes and bone health. Keeping alcohol low, or avoiding it, is the healthier choice during and after treatment.
What if I forget a tablet?
Take it when you remember that day, ideally after food. If it is nearly time for the next one, skip the missed dose. Never take two together. An occasional missed tablet is unlikely to matter, but frequent gaps reduce protection.
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Speak to a breast cancer specialist
Call the helpline or leave your details, and someone will help you arrange a consultation at the CION centre nearest you. One helpline serves every CION centre.
Call 1800 202 8726
Helpline open 24/7
Sources
- National Cancer Institute — Exemestane
- Cancer Research UK — Exemestane (Aromasin)
- MedlinePlus — Exemestane
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.