I have been taking 12.5 mgs of exemestane ED to get rid of a little gyno. I have been super tired, but I also started taking 75 mgs of effexor er ED about 5 days ago. I know effexor can do that, but I think my estrogen is too low also. I am switching to nolvadex. My question, I guess, is if my estrogen levels are high enough that its causing gyno nolvadex wont lower my E levels, just block certain receptors. I want to start a combination of nolvadex and exemestane. I am thinking about 10 mg of nolvadex ED and 6.25 mgs of exemestane every 3 days. Then get bloodwork. Thoughts?