Migraine in relation with endometriosis phenotypes: Results from a French case-control study

Abstract

Background Studies have shown a significant association between migraine and endometriosis, but no study has explored the relationship between migraine and endometriosis phenotypes: Superficial peritoneal endometriosis, ovarian endometrioma, and deep infiltrating endometriosis. Methods We 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 (n = 182) are women with histologically proven endometriosis and controls are women (n = 132) without endometriosis. Occurrence of migraine was studied according to endometriosis phenotypes. Results Migraine prevalence in cases was significantly higher compared with controls (35.2% vs. 17.4%, p = 0.003). The risk of endometriosis was significantly higher in migrainous women (OR = 2.62; 95% CI = 1.43–4.79). When we take into account endometriosis phenotypes, 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). Conclusion Our study shows a significant association between migraine and endometriosis. 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.

Shared Molecular Genetic Mechanisms Underlie Endometriosis and Migraine Comorbidity

“…More recently, adolescents with surgically confirmed endometriosis had over two-fold greater prevalence (69.3% vs 30.7%) and nearly five-fold increased odds of migraine (adjusted Odds Ratio [AOR] = 4.77; 95% CI: 2.53-9.02) compared to their counterparts with no endometriosis [30]. Also, a recent French case-control study similarly found a higher prevalence of endometriosis in migraine cases (35.2%) compared to controls (17.4%, P = 0.003) [5].…”

“…With an estimated global prevalence of 14.7%, migraine, on the other hand, is the most disabling neurologic disorder and the third most common illness worldwide [3,4]. Like endometriosis, women in their reproductive and most productive years are more commonly affected with migraine [5,6]. A typical migraine presents with a recurrent, unilateral and episodic headache of moderate to severe intensity [7].…”

“…Furthermore, Danazol (a synthetic androgen for managing endometriosis) has been reported to reduce the frequency of migraine attacks [25]. In addition to their shared similarities and risk factors, the comorbidity (co-occurrence of two or more conditions in the same individual) of endometriosis with migraine has been consistently reported by observational epidemiological studies [5,6,18,[26][27][28][29].…”

Giving Researchers a Headache – Sex and Gender Differences in Migraine

“…As endometriosis shares similar characteristics in terms of its clinical manifestations, epidemiology, and pathogenesis with migraine, it has been shown that migrainous headache was more frequent in the women with endometriosis than in women without endometriosis as well as in infertile women. Authors of both studies, therefore, suggest that females with migraine should be screened for endometriosis criteria and vice versa, allowing for more individualized treatment (87,88).…”

The Five Diaphragms in Osteopathic Manipulative Medicine: Myofascial Relationships, Part 2

“…The vagus nerve innervates the subtentorial portion and the crural area of the diaphragm (esophageal hiatus) and with the presence of parasympathetic nerve endings to the pelvic tissues [1][2]. Considering that nervous tissue is a highway of electrical and biochemical information, capable of moving this information both towards the periphery and towards the medulla or the central nervous system, a dysfunction of the myofascial system can be one of the causes of chronic pain that involves more diaphragms: headache, alteration of the relationship between esophagus and diaphragm, impaired swallowing, brachialgia, pelvic pain [44][45][46][47][48]. The phrenic nerve and the sympathetic trunk near the vertebral bodies are enveloped by the prevertebral fascia [49].…”