Migraine in women with chronic pelvic pain with and without endometriosis

Objective: To examine the prevalence of migraine in women with chronic pelvic pain with and without endometriosis. Design: Prospective 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. Setting: Clinical 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. (Fertil Steril (R) 2011; 95: 895-9. (C) 2011 by American Society for Reproductive Medicine.)