Pelvic floor muscle function and symptoms associated in patients with breast cancer using tamoxifen, aromatase inhibitors, and healthy controls.

BACKGROUND

The estrogen reduction caused by endocrine therapy can lead to symptoms associated with pelvic floor dysfunction in patients with breast cancer. Identifying medication-related symptoms can help prevent or mitigate adverse effects.

PURPOSE: The objective of this study was to compare pelvic floor muscle function among women treated with tamoxifen, aromatase inhibitors, and cancer-free controls.

METHODS

Cross-sectional observational study comparing three groups of women: tamoxifen users, aromatase inhibitor users, and healthy controls. Pelvic floor muscle function was assessed through vaginal inspection and palpation. Symptoms of dysfunction and vaginal complaints were evaluated through the Pelvic Floor Bother Questionnaire and Incontinence Questionnaire Vaginal Symptoms Module. Descriptive statistics included frequencies and medians. Group comparisons used Kruskal-Wallis and Mann-Whitney U tests. Associations were assessed via odds ratios, Chi-square, Phi coefficient, and Spearman's correlation. Multiple correspondence analysis, multiple linear regression, and binary logistic regression were also performed.

RESULTS

Ninety-three women were included - 31 in each group. A significantly higher prevalence of descended perineum was observed in the aromatase inhibitors group compared to the tamoxifen and control groups (12.9% vs 0% vs 0% respectively, p = .034). The prevalence of pelvic organ prolapse was higher in the groups on endocrine therapy (IA 19.4%, TAM 16.1%, control 0%, p = .037). The remaining pelvic floor muscle functions and dysfunctions were similar between the groups, as was the associated bother.

CONCLUSION

Women treated with endocrine therapy showed a higher prevalence of pelvic organ prolapse, with a descended perineum observed in the aromatase inhibitor group.