Taking Letrozole (Femara) for Treating Infertility in Women

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Dr. Rima Sonpal(Gynecologist/Obstetrician)
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Taking Letrozole (Femara) for Fertility in Women

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Letrozole is an oral medication used to treat infertility in women. If you have been trying to conceive for a long time now and failing repeatedly, your doctor might prescribe you letrozole. Earlier, letrozole was used for treating cancer in the breast tissue. However, nowadays, this medicine is given to treat fertility issues in women.

What Is Letrozole?

In strict medical terms, letrozole is a non-steroidal medication. It is consumed orally and functions as an aromatase inhibitor. This inhibition helps in reducing estradiol levels in the body, which allows the follicle-stimulating hormone to rise and follicles in the ovaries to grow readily.

Who Should Take Letrozole?

Not all women with fertility problems will be recommended a dose of letrozole. Usually, letrozole is prescribed to women with polycystic ovary syndrome (PCOS). Many other disorders that affect the ovulation cycle of a woman are met with an administration of letrozole. Sometimes, doctors may also prescribe the medication if the cause of infertility has not been determined conclusively.

How Does Letrozole Work?

Many women may feel bloated after taking letrozole medication. This makes it important to understand how letrozole works in a woman’s body.

Letrozole is typically an aromatase inhibitor, which means that it blocks any kind of aromatase activity within the body. Aromatase is an enzyme responsible for the production of oestrogen hormone in the body. Once this drug enters a woman’s body, the cycle of converting androgens to oestrogen is halted in its path. As the oestrogen levels drop in the body, this is sensed by the pituitary gland, which is responsible for maintaining optimal hormone levels at all times. In order to balance the reduced oestrogen, the gland secretes the follicle-stimulating hormones to increase oestrogen. The effect of generating FSH is multifold, as it also affects the ovaries causing them to be stimulated and generate an egg. At times, higher FSH could cause a woman to release more than one egg as well.

Ovulation begins and reaches a peak once the dose is completed. Engaging in sexual intercourse at this stage can help increase the chances of natural conception substantially and achieve pregnancy.

How to Take Letrozole for Treating Infertility

Doctors usually recommend women to take around 2.5mg letrozole for improving fertility. The dosage usually lasts for 5 days to a week, if a tablet is taken every day. The right time to start taking letrozole is on the third or fourth day of your menstrual cycle. When you take it for 5 days in a row, ovulation usually kicks in and continues for about four days to a week after the course is completed.

A doctor advising a woman

What Is the Success Rate of Fertility With Letrozole?

The effectiveness of this medicine is difficult to determine as a successful conception depends on a variety of factors. However, after administering letrozole, a substantial improvement in ovulation is observed in women. Most women get pregnant after beginning with letrozole course and deliver their babies successfully. Women with PCOS or other ovulatory disorders may benefit from this medicine successfully.

Risks and Side Effects of Taking Letrozole for Infertility

While letrozole does have its benefits in countering instances of infertility in various women as well as helping most of them achieve improved ovulation cycles, there are a bunch of risks and side effects that might occur as a result of its intake. In most cases, letrozole is not recommended for long term usage due to the possibility of birth defects.

  • The primary action of letrozole is to stop the conversion of androgens to oestrogen, which causes the levels of the hormone to fall within the body. While the pituitary gland does stimulate the ovaries to counter this fall, the effect of oestrogen reduction can be observed easily. Women may experience instances of dizziness or headaches as a result of it. At times, hot flashes may occur and a few women may have tender and sensitive breasts more than usual.
  • The alternative to letrozole is clomiphene. However, the side effects of the drug range from mood fluctuations to a substantial impact on the lining of the uterus and on the mucous covering the cervix. While letrozole does not cause such effects, it does tend to cause leg cramps in some women. Thankfully, the cramps and headaches subside once the course is completed.
  • Since letrozole is taken for conception, there is a rare chance that a woman would be on birth control pills at the same time. In the rarest of the rare cases, any medication with letrozole is bound to react with the pills and reduce their effect. Similarly, women attempting to get pregnant during their breastfeeding phase should not take letrozole since it can find its way into the baby’s body and disturb his hormones.
  • Earlier, letrozole was attributed to being responsible for birth defects in children. But this was later observed to be in cases where women would continue to take letrozole even while breastfeeding the child, causing toxic reactions in the baby as well as the formation of physical anomalies in the development. Similarly, women who have a premenopausal endocrinal condition are suggested to avoid the drug entirely for similar reasons.  

Knowing how effective letrozole is for fertility may not provide a clear and concise answer because the actual effect of letrozole is not on fertility but on ovulation. Better ovulation can increase the chances of conception, but only when you indulge in sex on a regular basis.

Also Read: Fertility Drugs for Women

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