Why can premenopausal women participate in ExCel?
Exemestane is one member of a class of drugs called aromatase inhibitors. Exemestane, given alone, is not recommended in premenopausal women for 2 reasons: Aromatase inhibitors work against breast cancer by suppressing the body’s ability to produce estrogen. In premenopausal women estrogen production comes mainly from the ovaries and the aromatase inhibitors are not powerful enough to suppress this amount of estrogen produced by the ovaries. In postmenopausal women, estrogen is still produced in the body’s fat, skin and muscle and it can be fully suppressed by the inhibitors. By partially, but inadequately, suppressing estrogen from the ovaries, the aromatase inhibitors cause a reflex stimulation by hormones from the pituitary gland in the brain. This over stimulates the ovaries and can cause ovarian cysts, pain and discomfort. It can also result in an increase in fertility and an unwanted pregnancy.
