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Endometriosis and Migraines: What’s the Connection?

Posted on February 11, 2021
Medically reviewed by
Peter J. Chen, M.D.
Article written by
Max Mugambi

Many women living with endometriosis (sometimes called “endo”) also experience migraine, a neurological condition known for causing intense, disabling headaches. It is estimated that women with endo are almost twice as likely to develop migraines as those without.

Like endometriosis, migraine is a common occurrence in women of reproductive age. Migraine is generally much more common in women, affecting up to three times as many women as men. Approximately 1 in every 4 women will experience migraines in their lives.

What Are Migraines?

Migraines are recurrent, episodic headaches. These headaches are characterized by a pulsating feeling, can be moderate to severe, and are often felt on one side of the head. Migraines can also be aggravated by physical activity and can feature other symptoms such as nausea, photophobia (sensitivity to light), and phonophobia (sensitivity to sound). Usually, many people living with migraine experience these attacks about once a month. However, some may experience them more frequently.

Migraines in Women With Endometriosis

Migraine is a frequently discussed topic on MyEndometriosisTeam. More than 7,000 members on the site report headaches.

One MyEndometriosisTeam member reported, “I am hopefully ending a four-day migraine. What baffles me is that I never usually get migraines during my period.”

“[I’ve been] cramped all day long, along with a migraine. My back is also killing me,” shared another member, continuing, “I’m seriously over the constant pain and daily migraines.”

Understanding the relationship between endo and migraines is important — it may help lessen the burden of symptoms in women living with both conditions.

What Is the Connection Between Migraines and Endometriosis?

Researchers have observed that migraines share a number of symptoms and risk factors with endometriosis. In fact, endometriosis has been shown to be an independent risk factor for migraines. In some cases, however, treatment for endo has triggered the occurrence of migraines. Estrogen and other hormonal treatments have been shown to trigger migraines and migraine-related aura. However, there are many different types of hormonal therapy for endometriosis. Many, including a specific type of oral contraceptives, often do not contain estrogen. They contain only progesterone. Therefore, they would not trigger migraine.

Nervous System and Inflammation

Some researchers believe that some of the changes caused by endometriosis could explain its connection with migraines. It’s been suggested that endo can cause the central nervous system to become overactive, which could trigger a migraine. Another theory is that endometriosis leads to the production of inflammatory and pain-causing chemicals. This could ultimately lead to excessive pain sensitivity and potentially trigger migraine attacks.

Hormones and Menstruation

The relationship between endo and migraines may be related to the involvement of female hormones in both conditions. These hormones, including estrogen and progesterone, are high in women of child-bearing age and low in postmenopausal women.

The involvement of female hormones may explain why migraines are especially common in women of reproductive age, usually starting at the age of their first period (menarche) and improving after menopause. Approximately 50 percent of women with migraines report menstruation-related headaches, whereas roughly 8 percent report only experiencing migraine attacks during menstruation. These attacks are thought to result from the abrupt decrease in estrogen levels that occurs just before the period starts.

Early menarche has also been found to be a risk factor for endo and migraine, as have long-lasting menstrual bleeding and a short cycle length.

The Impact of Migraines

Migraines can add to the burden of chronic pelvic pain and other common symptoms of endometriosis. Migraine is an underdiagnosed and undertreated condition — especially when it occurs alongside other disorders.

The following sections describe specific ways that migraines can affect quality of life.

Decreased Productivity

Evidence has shown a direct relationship between migraines and decreased levels of productivity, whether diagnosed or undiagnosed. The symptoms of migraines, such as intense pain, nausea and vomiting, and sensitivity to light and sound, can make it difficult or impossible to perform one’s tasks at work, school, or home.

Mental Impact

Researchers have observed a relationship between migraine and mental and emotional well-being. In particular, migraine has been linked to anxiety and depression.

People with migraine are five times more likely to experience depression than those without. However, it is not yet clear whether migraines cause depression, or whether depression leads to migraines.

Social Impact

If not properly managed, migraines can start to have an impact on your social life. The uncertainty of when attacks will come, as well as the debilitating effects they cause when they do occur, can make you withdraw from and cancel plans with loved ones.

It is important to understand that migraine and endo are not your fault. You may need to cancel plans sometimes, but those who support you will understand that your health can be out of your control. If you’d like, you can take extra care of yourself and your loved ones by leaving early from events, taking breaks from socializing to rest and relax, or letting your friends and family know what you are facing.

How To Treat Migraines

Treatment options for migraines range from prescribed and over-the-counter medications to home remedies and self-care. The treatment your doctor recommends will depend on several factors, including the severity and frequency of your migraines and other medications you are taking for endometriosis. The neurologist treating your migraines may need to consult with the gynecologist treating your endometriosis.

Preventive Medications

Preventive medications are designed to reduce the frequency, severity, and duration of attacks. These include antidepressants, antiseizure drugs, blood pressure-lowering drugs, calcitonin gene-related peptide drugs, and Botox (Botulinum toxin) injections.

Acute Treatment Medications

Some drugs are prescribed to be taken when a migraine attack begins. Most acute treatments work best when taken as early as possible in the attack. Generally, acute migraine treatments are most successful when taken in one large, single dose rather than spaced out in smaller doses.

Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as Aspirin, Advil (Ibuprofen), and Aleve (Naproxen), are the first treatments most people try for relieving migraine pain. Others such as Naprosyn (Naproxen), Indocin (Indomethacin), Celebrex (Celecoxib), and Voltaren (Diclofenac) require a prescription.

Other types of acute treatments include triptans, anti-nausea medications, and opioids. Because they can be habit-forming, opioid medications are typically reserved only for people who can’t take other types of medications for their migraines or those who haven’t found relief with any other treatments.

Home Care

You may be able to find relief from your migraines in a number of ways that don’t involve medication.

  • Take a break when you feel an oncoming migraine. Go to a quiet place and apply a cool cloth or ice pack wrapped in a cloth to your forehead or back of the neck.
  • Practice relaxation techniques to prepare yourself to deal with stress.
  • Sleep and eat consistently. Develop a sleeping and eating routine and follow it.
  • Stay hydrated by drinking plenty of fluids, especially water.
  • Keep a journal to better understand your migraines and identify potential triggers.
  • Consult your doctor on the right exercise routine for you.

Find Your Community

MyEndometriosisTeam is the social network for women with endometriosis and their loved ones. The platform is home to more than 112,000 members who offer support and share their unique experiences.

Are you living with endometriosis and also experiencing migraines? Share your story with other members in the comments below or start a conversation on your Activities page.

References

  1. Women With Endometriosis Are More Likely to Suffer From Migraines: A Population-Based Study — PLOS One
  2. Migraine Facts — Migraine Research Foundation
  3. Association Between Endometriosis, Headache, and Migraine — Journal of Endometriosis and Pelvic Pain Disorders
  4. Endometriosis and Headache — Current Pain and Headache Reports
  5. The Link Between Migraine, Depression and Anxiety — American Migraine Foundation
  6. Migraine — Diagnosis and Treatment — Mayo Clinic
  7. CGRP Inhibitors for Migraine — Innovations in Clinical Neuroscience
  8. Migraine — MedlinePlus
  9. How Opioid Addiction Occurs — Mayo Clinic
Peter J. Chen, M.D. is a fellow of the American College of Obstetrics and Gynecology. Review provided by VeriMed Healthcare Network. Learn more about him here.
Max Mugambi is a copywriter at MyHealthTeams with more than five years of experience writing about a diverse range of subjects. Learn more about him here.

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