Endometriosis and migraine strongly linked

Endometriosis and migraine strongly linked

There is a significant association between migraine and endometriosis, according to a French case-control study.

They suggest that in clinical practice, women of reproductive age who suffer from migraine should be screened for endometriosis criteria in order to optimise the medical and therapeutic care of this condition.

Studies have shown a significant association between migraine and endometriosis, but no study had explored the relationship between migraine and endometriosis phenotypes: superficial peritoneal endometriosis, ovarian endometrioma, and deep infiltrating endometriosis.

The researchers conducted a case-control study using data collected from 314 women aged 18 to 42 years who had undergone surgery for benign gynecological conditions between January 2013 and December 2015.

All women completed a self-administered headache questionnaire according to the IHS classification. Cases: 182 were women with histologically proven endometriosis and 132 controls were women without endometriosis.

According to the study results:

  • Migraine prevalence in cases was significantly higher compared with controls (35.2% vs. 17.4%).

  • The risk of endometriosis was significantly higher in migrainous women (OR = 2.62; 95% CI = 1.43–4.79).

  • When endometriosis phenotypes were taken into account, the risk of ovarian endometrioma and deep infiltrating endometriosis were significant (OR = 2.78; 95% CI = 1.11–6.98 and OR = 2.51; 95% CI = 1.25–5.07, respectively).

  • In women with endometriosis, the intensity of chronic non-cyclical pelvic pain was significantly greater for those with migraine (visual analogic scale (VAS) = 3.6 ± 2.9) compared with the women without headache (VAS = 2.3 ± 2.8, p = 0.0065).

With an estimated global prevalence of 14.7%, migraine is the most disabling neurologic disorder and the third most common illness worldwide

Like endometriosis, women in their reproductive and most productive years are more commonly affected with migraine.

Increased exposure to menstruation is a known risk factor for endometriosis just as menstrual migraine and menstrually-related migraine (with prevalence varying from 4%-70%) are common subtypes of migraine in women.

Danazol (a synthetic androgen for managing endometriosis) has been reported to reduce the frequency of migraine attacks.

Read more: https://journals.sagepub.com/doi/10.1177/0333102419893965

Endometriosis and migraines

Endometriosis and migraines

By I.Soussis. MD,MSc, FRCOG

A new study of 391 adolescent girls in the Boston area revealed that those with a surgically diagnosed

endometriosis were more likely to suffer from migraines. The study was published in Fertility and Sterility.

Endometriosis is a chronic condition in which the endometrium grows outside the uterus, typically in the abdominal cavity or on internal organs. Patients often experience significant pain and discomfort during their period or intercourse. Endometriosis may also lead to infertility or hysterectomy.

Current diagnostic methods that rely on laparoscopy, which often patients try to avoid, are delaying the diagnosis typically five to 10 years from the onset of symptoms.

Τhe presence of migraine may be a useful clue to better early detection.

Researchers compared the self-reported frequency and pain of migraine among two populations: adolescent girls with surgically-diagnosed endometriosis and girls of a similar demographic with no such diagnosis.

After adjusting for differences in population, researchers found that those with endometriosis were 5 times more likely to suffer from migraine than the comparable group.

Researchers have also seen a close linear relationship between the severity of migraine pain and the odds of endometriosis. The more painful the migraine was, the more likely it was that a subject had endometriosis. In a scale of zero to ten, for each one point increase in pain the odds of endometriosis increased by 22%.

A serious limitation of this study is that girls who have confirmed endometriosis were more likely to have taken hormonal medications, which could increase the risk of migraines.

The results of this study seem to corroborate a rapidly growing body of evidence from other researchers who have drawn the same conclusion in adult women and it presents a useful signal to help us diagnose women more accurately and at a younger age.


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