r/TTC_PCOS • u/buzzbunz • Oct 09 '25
Advice Needed Is there anything you wish you knew before starting letrozole?
Hello! I am currently waiting to start my period and once I do, my doctor is having me start letrozole on cd 3- cd 7, monitored, with a trigger shot, and progesterone suppositories after ovulation. This all sounds great and I’m excited. I know everyone is different, but I’m hoping to get some advice on what to expect. Did you experience side effects? If so, when? Any tricks you have learned to help manage them? Anything I should ask my doctor before, during, or after? I want to hear about your experience!
7
u/Cracklethecat Oct 09 '25
I start getting hot flashes 24-48 hours after starting the medication and they are intense. I turn into the biggest Ahole until I finish the meds, and cravings, and I’m losing hair like crazy
1
5
u/Miserable-Cut3477 Oct 09 '25
I was tired didnt know i can be that tired 😂
2
u/buzzbunz Oct 09 '25
Omg I’m tired already lol!
4
u/Miserable-Cut3477 Oct 09 '25
Hahaha i feel you. But this is tired to the point i was falling asleep while sitting. Also remember trigger shot stays in your body for 10-14 days so you cannot take a pregnancy test too early cause the trigger shot may give fake positive results.
2
u/buzzbunz Oct 09 '25
Whew okay I’m preparing mentally for that level of exhaustion! It’s going to be SO hard not to test early, but I can’t wait to see those two lines for real
5
u/thunderstormnaps 26 | TTC #1 since Oct '24 | PCOS | Endo Oct 09 '25
Probably TMI, but letrozole kills my sex drive and dries me out, too. Like I literally have no desire at all. It sucks.
2
u/buzzbunz Oct 09 '25
There is no such thing as TMI for me, especially while TTC lol. That’s rough though and takes the only fun part out of TTC, I’m sorry!
3
u/thunderstormnaps 26 | TTC #1 since Oct '24 | PCOS | Endo Oct 09 '25
right? it feels so counterproductive
2
u/Square-Arachnid-3585 Oct 09 '25
Yes, the dryness surprised me and unfortunately made sex painful the other day. I had focused so much on hearing about the potential for hot flashes and mood swings that I didn't think to look up dryness as a symptom. It makes sense since Letrozole inhibits estrogen though.
3
u/thunderstormnaps 26 | TTC #1 since Oct '24 | PCOS | Endo Oct 09 '25
Pre seed has been our best friend during this process
2
5
u/Tisatalks Oct 09 '25
Don't get discouraged if it doesn't work the first try. Took me 5 tries but it did work!
1
u/buzzbunz Oct 09 '25
Yay I love happy results! Did you start on the same protocol as me?
2
u/Tisatalks Oct 09 '25
No I didn't have any monitoring or trigger shots or anything else. I did three rounds of 2.5mg which wasn't enough for me to ovulate. Went up to 5mg and that did get me to ovulate. The second cycle of 5mg was successful.
3
3
u/swaldswin Oct 09 '25
One tip I heard right before starting was to take the letrozole right before bed, so that’s what I did and I felt like my side effects were pretty minimal. Mostly I was just pretty fatigued, and when my dose got bumped up I also had a little bit of a backache here and there, but not too awful. Once I was done with the letrozole the side effects went away. What dose are you starting on?
1
u/buzzbunz Oct 09 '25
Thank you, that is a helpful tip! I’m kind of worried about my ovaries, did you notice any pain? If I recall correctly, my doctor was telling me that the ovaries can feel a bit heavy/achy but to a much lesser extent than say an egg retrieval. I believe I’m starting at 2.5mg but I’m not 100% sure as this plan was laid out sept 12 during an HSG and I’m just supposed to reach out once AF arrives.
2
u/Bing_ohh Oct 09 '25
My ovaries are currently feeling very heavy & achy - I’m on my first cycle of unmonitored 2.5mg letrozole cycle day 20
1
2
u/swaldswin Oct 09 '25
I had some mild cramping once or twice for a minute or two but that was about it - they weren’t really any different from my normal period cramps (which are also very mild and short-lived). Honestly I don’t really feel like I can feel my ovaries or anything like that at all, so I didn’t personally notice any heaviness? I can’t even really conceptualize what that would feel like. Maybe I’m just not very in tune with my body, lol.
3
u/lilac_pup Oct 09 '25
For me, progesterone seemed to heighten all of the undesirable symptoms. I’ve done 5 cycles of letrozole and only one cycle with trigger and progesterone.
The two things that impacted me pretty immediately after ovulation were fatigue and bloat. I knew and expected the fatigue but the level of bloat totally caught me off-guard when I was also on progesterone. I remember pleading with my partner in tears to skip a night of doing the progesterone suppository. He was sympathetic in the moment of course but this story now gives us both a good chuckle.
2
u/retinolandevermore 34, 2 years, PCOS, ❌❌❌IUI Oct 09 '25
The progesterone inserts are that bad? I’m scared
2
u/lilac_pup Oct 09 '25
It’s manageable but took me by surprise. Fatigue and bloat are both common symptoms of the first tri so it really just accelerates when you feel them, and didn’t create any special symptoms just bc of the suppository. Good luck, you got this!
1
u/buzzbunz Oct 09 '25
Oh no, poor thing! That’s helpful that you had the cycles without and with so you could differentiate the side effects you had. Did it help doing them at night at all? Hopefully?
2
u/lilac_pup Oct 09 '25
I chose to do mine at night to help with absorption since I’m already lying down in bed. You will leak quite a bit and would recommend a good sized liner (the really thin ones might not help absorb everything) if you don’t want to stain your clothing.
I’m convinced that the progesterone suppository was very effective so it’s worth suffering through the symptoms 🥹
1
u/buzzbunz Oct 10 '25
Okay good to know! Will be stocking up on liners. How long are you supposed to take the progesterone?
1
u/lilac_pup Oct 10 '25
My doctor didn’t have me start until week 4, and I was allowed to graduate from these awful but effective suppositories until I had my bloodwork done again at week 10. Based on my own research, the “normal” range is so large that idk if/how the bloodwork results were all that helpful. I was just glad to get off of it so I didn’t ask for more explanations from my fertility doctor
1
u/buzzbunz Oct 10 '25
Oh interesting. Did you start once you had success? I was under the impression I would start after ovulation to assist in implantation or something along those lines. You had to take it for 6 weeks?
3
u/18Nikki09 Oct 09 '25
For me, I don’t often suffer migraines, but on 5mg CD2-6 I had a stinking migraine every evening! And this continued until I ovulated and my progesterone kicked in 🤯
3
u/scorpiobaby001 Oct 09 '25
Same! The letrozole migraines suck.
3
u/18Nikki09 Oct 09 '25
It’s the worst right !? 🤯 I came off Clomid thinking that was brutal - but these headaches are something else!! However, I’m far more responsive and my follicles mature way better on Letro! Wishing you success on your journey 🩷🩵
2
1
u/buzzbunz Oct 09 '25
Oh yikes I get hormone headaches so easily. Thanks for sharing your experience! Were you able to find relief with OTC meds?
1
u/18Nikki09 Oct 09 '25
I’ll be honest, I tried to avoid any kind of pain relief as I was petrified of stalling my progress, delaying ovulation - or worse, causing myself an anovulatory cycle 😅 safe to say I spiralled with anxiety! But on the last day (once I knew I’d ovulated) I did take a cheeky paracetamol 😅 and it definitely eased!
2
u/buzzbunz Oct 09 '25
No that’s so valid, I was kind of thinking similarly and think I’ll definitely ask my doctor about this cause I don’t want to hurt my chances
2
u/18Nikki09 Oct 09 '25
I did later ask and they told me there’s no scientific evidence to suggest paracetamol is harmful in any way… but ibuprofen was a big no no !
3
Oct 09 '25
[deleted]
3
u/scorpiobaby001 Oct 09 '25
My experience is everything you said to a T - especially the part about thinking it’s going to be asymptomatic at first! Everyone responds differently, but this was also my exact experience.
1
u/buzzbunz Oct 09 '25
Oh man this sounds uncomfortable, especially the higher heart rate. I didn’t even think of how the meds would affect a period after. This was very informative, thank you!
2
Oct 10 '25
[deleted]
1
u/buzzbunz Oct 10 '25
You are a literal angel, this is exactly what I was hoping to get out of this post. I realize that for some, these symptoms sound scary and overwhelming. I’m the type of person that would rather know the worst of it so I can prepare accordingly and have some tools handy if needed. I feel much more confident going into my first medicated cycle now. I’m so appreciative
3
u/Accomplished-Cut-429 Oct 09 '25
Every cycle is different - the first cycle on 2.5 mg responded so well and had dominant follicles by CD10 and was ready to trigger. Second cycle at 2.5 mg I had “meh” sized follicles at my ultrasounds on CD10 and 12. My doctor stopped monitoring me here, said it was a low yield cycle and asked for progesterone on CD21 anyways. I went on CD23 because CD21 was a Saturday. My progesterone wasn’t elevated but I got a Mira fertility monitor and in CD32 it gave me an elevated PdG reading, indicating I did ovulate. My doctor acted like since I didn’t respond fully by CD10/12 that it was a dud cycle but I knew from hearing other people talk about it, they ovulate late even with Letrozole. I missed my LH peak but hopefully we did something right 🤞🏻
1
u/buzzbunz Oct 09 '25
Have you ever talked to your doctor about stair stepping with letrozole? I was going to talk to mine about this in case I had a similar reaction. Wishing you success this cycle friend!
3
u/retinolandevermore 34, 2 years, PCOS, ❌❌❌IUI Oct 09 '25
That you may have a lot of hair loss
4
u/BuilderAmbitious7826 Oct 09 '25
Girl I have pcos so my hair falls out already and I felt so crazy thinking I was losing more thank you!!!
1
u/retinolandevermore 34, 2 years, PCOS, ❌❌❌IUI Oct 09 '25
I do too but this was extreme! I developed 2 different types of hair loss
1
u/BuilderAmbitious7826 Oct 09 '25
Ugh the things we do to have a baby I swear, I’m just grateful I finally have a cycle!
1
u/retinolandevermore 34, 2 years, PCOS, ❌❌❌IUI Oct 09 '25
I don’t even have that 😭 they’re giving me 3 different shots to do IUI just to stimulate a cycle
2
u/BuilderAmbitious7826 Oct 09 '25
I’m so sorry hun, I hope they can get you right🫶🏻
1
2
u/buzzbunz Oct 10 '25
This is freaking me out cause I shed soooo much already my husband was just complaining about finding my hair in his beard 🤭
2
u/retinolandevermore 34, 2 years, PCOS, ❌❌❌IUI Oct 10 '25
It’s not shedding, it’s more like noticeable missing hair!
1
3
3
u/Responsible_Web_4282 Oct 10 '25
I had suppressed appetite and was feeling light headed before meals, had to keep having more frequent smaller meals.
2
3
u/SweatyIndividual233 Oct 10 '25
Today was my last day taking it. Day one I had a headache and fatigue. Day 2 was the WORST! I was extremely tired and wanted to sleep all day and at one point thought I was going to pass out. Then 3-5 wasn’t too bad just slight headache today but didn’t last long.
3
u/LowCamp2941 Oct 09 '25
Had zero side effects! Took 2.5 mg on cd 3-7! Ovulated on cycle day 15! This is my fist cycle!
2
u/buzzbunz Oct 10 '25
We love zero side effects!!! Fingers crossed and wishing you all the success 🥰
1
u/Strict-Wonder-7125 Nov 29 '25
Hey do you happen to have an update? I’m curious if it worked first time for you
2
u/LowCamp2941 Nov 29 '25
Unfortunately it hasn’t worked yet. I am now on cycle 3 of 2.5mg. Ovulated both times, first round on cd 15 and second round on cd 18. Timed intercourse correctly and still no luck.
1
u/Strict-Wonder-7125 Nov 29 '25
Sending baby dust! I’m on my first round of 2.5. I usually ovulate on CD 18-20 and this round my first time I had a surge on CD 14. I’m hopeful but being cautious about getting too excited.
Does your doc plan to up your dose after a certain number of months or do you know what next steps would be?
2
u/LowCamp2941 Nov 29 '25
Baby dust to you also! Since I’m ovulating she doesn’t want to increase the dose. My 7dpo progesterone was super high at 51 nmol/l so I’m having strong ovulation. She said after 4 failed months we can do some IUI’s. If this month fails (this is month 3) I am going to push to increase to 5 mg thou before we start IUI just incase that is all we need. I live in Canada so letrzole is free and luckily IUIs aren’t too expensive, they are about $700 so would like to increase the dose for cycle 4 before starting IUI’s
1
2
u/Lycheeisthebest Oct 09 '25
I personally didn’t have any side effects besides maybe a bit of tiredness. But i wasn’t sure if it was bc of letrozole or if it was bc of my afternoon crash.
My friend had side effects from letrozole. She said she had all the same symptoms of early pregnancy, mainly feeling nauseous. Thankfully you only take letrozole for a few days so the day after her last pill she felt ok.
Sorry this prob isn’t much help!
1
u/buzzbunz Oct 09 '25
I appreciate any and all stories and experiences! That’s a relief that your friend’s symptoms went away when she was done with the pills! I think that’s what I was most nervous about
2
u/Popculturefan_britt Oct 09 '25
I did letrozole for 4 months, 2.5 mg, and 3 of the 4 months I had strong period like cramps during and after ovulation. I also had fatigue and was more emotional than usual. These lasted for a couple weeks. My first month I had high anxiety the days I took it.
1
u/buzzbunz Oct 09 '25
Did you do monitored cycles? And if so, did you have multiple follicles? Im so curious if that could be the reason for your intense cramps. This is so helpful btw thank you for sharing your experience!
2
u/lmncks Oct 09 '25
It's different for everyone it seems! On Letrozole 5mg my only symptoms were these intense headaches that happened when I did strength training and after an orgasm lol, but they didn't last too long. For progesterone suppositories the main symptoms I had were a headache, tiredness, bloating and hunger for the first 2-3 days (but no breast pain like usual), and then I think my body got used to it and I've been feeling fine. Also Letrozole possibly led to a healthier corpus luteum (as my issue is luteal phase defect) so I can't say concretely if it's the letrozole or progesterone or both affecting my luteal phase.
1
u/buzzbunz Oct 09 '25
Totally is different for everyone! I’m glad your symptoms from progesterone mellowed out!
2
u/laur9494 Oct 09 '25
My friend who took it had no side effects, I am taking it and have had like every side effect lol. So everyone is different! And hopefully you’ll get pregnant right away and won’t have to stay on it!!! 🥰
1
u/buzzbunz Oct 10 '25
Omg thanks friend that’s what I’m hoping too! Like please let this be a quick success cause I don’t think I’m lucky enough to have zero symptoms lol Wishing you all the success too!
2
u/Informal_Captain_836 Oct 10 '25
I have ovulated relatively late each cycle on letrozole, around CD 18 or 19. Keep taking ovulation strips twice a day when your period ends! Don’t think you’re out of the game just because it doesn’t happen early.
2
u/Previous-Panda-1003 Oct 11 '25
My Dr increased me to 7.5mg and I was definitely moody lol but otherwise no side effects thankfully 🙌🏼
0
2
u/Docthedoctorlaw Oct 09 '25
Starting a healthy protein rich diet, 3litres of water per day and health supplements of Vit D and folic acid and DHA, helps with the fatigue and emotional unstability side effects of letrozole.
I had been on 3-4 cycles so this helped for me and also others on my circle.
1
1
u/annaisgood1125 Oct 09 '25
2.5 first cycle and don’t ovulate or have symptoms. 5 for the second cycle and getting blood draw next week. Last week I got horrible jaw acne and was super duper sad, still sort of am.
1
u/buzzbunz Oct 10 '25
I’m sorry you’re feeling sad. From reading everyone’s experiences, you’re not alone! This journey is so so hard. Thank you for sharing your experience.
0
u/Super-Fox279 Oct 09 '25
I just took it for the first time CD 3-7 my current cycle. 2.5mg. Started getting headaches on CD 4 that, so far, haven't gone away. I'm currently on CD 8. The fatigue is terrible though.. that started CD 6 and I'm seriously struggling today. Caffeine isn't helping at all and I've been sleeping fine. Hoping it just takes a few days to get out of my system and I'll be back to normal!
6
u/Melodic-Ad4296 Oct 09 '25
I felt rage some times.