Many women are taking hormonal agents for five to ten years after diagnosis for breast cancer. There are many nuanced considerations for these women regarding quality of life and reducing risk of recurrence. Defining the risk and benefit clearly is essential in the decision making process for the patient. In this lecture we will review the role of hormonal agents, their side effects and the state of the evidence in lessening these side effects. We will review the do?s and don?ts using the latest evidence on what may interfere and what may complement each drug class. What can be done to lessen side effects, based on the literature and experience will be covered.