Aromasin (Exemestane)

Exemestane, sold as Aromasin, is a steroidal aromatase inhibitor, and that distinction matters more than it sounds. Because it binds to the aromatase enzyme irreversibly, the body has to synthesise new enzyme to recover - which gives it a longer, more even effect than the reversible inhibitors like anastrozole.

When it is preferred

The steroid structure means it is less likely to worsen the lipid profile, which is one of the main reasons people switch to it. The trade-off is that it is dosed less frequently - a few times a week rather than daily - and it is more expensive. The same warning applies as with any AI: it will happily over-suppress estradiol, and the symptoms of that - joint pain, mood flatness, low libido - are the reason to titrate rather than hammer it.

Checks

• Label names exemestane and mg per tablet - genuine Aromasin is 25mg.
• Sealed bottle, printed batch and expiry, tablets intact.
• Store cool and dry, away from pets and children.
• Not to be confused with anastrozole; the two are not interchangeable at the same dose.