Return of Menses While on Endocrine Suppression Therapy

Tamoxifen: development of endometrial carcinoma must be ruled out.

Recommendations:

  • Trans-vaginal ultrasound is highly recommended. Please refer the patient to the gynecologist if endometrial thickness is more than 10 mm or if there is persistent bleeding
  • Ensure adequate method of birth control

Aromatase inhibitor: (anastrazole, exemestane, letrozole)

  • Return of menses may signal return of ovarian function

Recommendations:

  • Stop the drug use immediately
  • Ensure adequate method of birth control
  • Refer back to the oncologist