Exploring the level of efficacy of pelvic floor physiotherapy intervention for the treatment of Genitourinary Syndrome of Menopause (GSM) in women after the treatment of breast cancer
Genitourinary Syndrome of Menopause and symptoms of vaginal dryness and sexual dysfunction in women survivors after breast cancer
Initially, the intervention will include a thorough medical examination, all relevant laboratory and diagnostic tests will be recorded, as well as pathological psychosocial factors and disorders that require drug intervention to exclude any other cause of vaginal dryness and dyspareunia. For the purpose of the study, validated questionnaires will be administered in the Greek language. The intervention will include, conducting a digital evaluation and recording of muscle tone of the pelvic floor (PF) at rest, by manometry. Then, a randomized separation of patients into two groups will be performed: In Group A (intervention group), the therapeutic protocol will be implemented with manual relaxation techniques, pelvic floor muscle retraining (PTMT) and use of vaginal dilators. The therapeutic intervention programme for Group A will be completed in 12 weeks with one session per week. In Group B (control group), standard treatment practice with vaginal lubrication and moisturizing products and counseling assistance will be implemented. Participants in Group B, will attend a next scheduled session at week 12 for necessary new measurement recordings and data updating. After the completion of the therapeutic interventions, a final pelvic floor physical therapy re-evaluation will follow with measurement and recording of all parameters and variables (outcomes) under study, data will be collected and possible differences between the two groups will be investigated.
Women aged 35-65 years with : 1. Pain during and/or after vaginal intercourse, greater than 7/10, based on the Visual Analogue Pain Scale (VAS). 2. Also, women who have undergone immunosuppressive chemotherapy, received or are receiving adjuvant hormone therapy with tamoxifen (TAM), or aromatase inhibitors (AIs) and report symptoms of vaginal dryness and dyspareunia will also be included. 3. Willing to be assigned to the study
1. Metastatic breast cancer 2. Vaginal or intravaginal stenosis 3. Pelvic surgery 4. Allergy to lubricating oils and moisturizers 5. Women using hormone replacement therapy (HRT) 6. Women who are on long-term use of birth control pills 7. Women who are on some type of drug intervention for dyspareunia 8. Diabetes 9. Hypertension 10. Obesity 11. Hypothyroidism 12. Urogynaecological infections 13. Psychiatric conditions 14. Vascular conditions 15. In addition after enrollment, patients who present with difficulty understanding how to coordinate their pelvic floor muscles