Endometriosis, Menstruation, and Migraines

If you have severe migraines before, during, or after your period or around your ovulation, it could be endometriosis.

Endometriosis is a chronic inflammatory and sex hormone-dependent benign disease. Clinical features include dysmenorrhea, dyspareunia, dyschezia, dysuria, non-cyclical pelvic pain, heavy menstrual bleeding, irregular menstrual cycles and and infertility. Three major phenotypes are recognized: superficial, ovarian endometrioma and deep infiltrating endometriosis. Migraine is a complex disorder in which disabling headaches, lasting 4 to 72 hours variably accompanied by sensory alterations, nausea, vomiting, recur with low to high frequency. The International Classification of Headache Disorders, (ICHD-3) distinguishes three forms of migraine based on the relationship with the menstrual cycle: pure menstrual migraine, which is defined as the occurrence of migraine attacks exclusively on day 1 ± 2 of menstruation in at least two out of three menstrual cycles, menstrually-related migraine, when attacks occur during this window but also at other times of the cycle, and non-menstrual migraine.

Endometriosis and migraine share similarities in terms of pathogenesis, with pain being the main common symptom in both conditions. Both conditions have a high prevalence in women of childbearing age, and the pathogenetic mechanisms involve a hormonal influence and chronic inflammation phenomena.

A diagnosis of migraine was made in 53.4% (70/131) of patients. Pure menstrual migraine was reported by 18.6% of patients (13/70), menstrual-related migraine by 46% (32/70) and non-menstrual migraine by 36% (25/70). Dysmenorrhea and dysuria were significantly more frequent in patients with endometriosis and migraine compared to those without migraine.No difference was found for other variables, including age at diagnosis and duration of endometriosis, endometriosis phenotype, presence of other systemic comorbidities, or heavy menstrual bleeding. In most patient with migraine (91%) headache symptoms started years before the diagnosis of endometriosis.

Forward we go!

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Have you considered getting a laparoscopy ?