Menstrual migraine prevalence and features in women with endometriosis: A common disabling comorbidity

Introduction: Endometriosis is a highly prevalent disabling comorbidity of women with migraine. The aim of the current study was to identify menstrual migraine prevalence and features in women with endometriosis. Methods: This observational study included data from patients visiting our outpatient clinic from 2015 to 2021. Information was collected from charts and through structured phone interviews. Patients with surgically confirmed endometriosis and migraine were included. Results: A total of 92 from 344 endometriosis patients suffered from migraine and a subset of 35 from menstrual migraine (MM). From the subset of women with MM 42.9% reported to have auras. Groups did not differ with regard to rASRM stage. Women with MM reported significantly more pain days/month at present and 5 years ago and more often a MIDAS Grade 4 ( p < 0.01). Both groups had less migraine attacks/month now, compared with monthly attacks 5 years ago. All women experienced endometriosis surgery in this interval. There was a trend towards more severe dysmenorrhoea with onset at menarche and towards higher use of analgesics for menstrual pain during the bleeding in the MM group. Less deliveries were noted in the group with MM. Conclusion: In women with similar endometriosis stages MM is associated with a higher migraine frequency, more dysmenorrhoea days and a higher burden of disease. Future studies are needed to better understand a potential influence of menstrual migraine on the number of deliveries. Our findings suggest, that close collaboration of neurologists with gynaecologists and shared treatment decisions might be of advantage for patients with the comorbidity.