Migraine in women with chronic pelvic pain with and without endometriosis

ObjectiveTo examine the prevalence of migraine in women with chronic pelvic pain with and without endometriosis.DesignProspective study of headache, pelvic pain, and quality of life before laparoscopic surgery for pelvic pain. Endometriosis was diagnosed pathologically. Headaches were classified as migraine or non-migraine using International Headache Society criteria.SettingClinical research hospital.Patient(s)108 women in a clinical trial for chronic pelvic pain (NCT00001848).Intervention(s)Laparoscopy to diagnose endometriosis, assessment by neurologist to assess headaches.Main Outcome Measure(s)Prevalence of migraine and other headaches in women with chronic pelvic pain with or without endometriosis. Headache frequency, severity and relationship to pelvic pain and endometriosis.Result(s)Lifetime prevalence of definite or possible migraine was 67% of women with chronic pelvic pain. An additional 8% met criteria for possible migraine. Migraine was no more likely in women with endometriosis than those without. Women with the most severe headaches had a lower quality of life compared with those with pelvic pain alone.Conclusion(s)Migraine headache is common in women with chronic pelvic pain, regardless of endometriosis, and contributes to disability in those with both conditions. The strong association suggests a common pathophysiology.