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Half to three-quarters of women with endometriosis may also suffer from migraines, but short-term records miss up to 90% of that overlap, according to a first-of-its-kind analysis of more than 13 million women presented at the 151st Annual Meeting of the American Neurological Association (ANA).

The analysis also showed women with endometriosis had 2.3 times the odds of having migraine compared with women who didn't have the pelvic condition. The research adds to evidence that migraine and endometriosis may share a pain pathway involving calcitonin gene-related peptide (CGRP)—a chemical messenger that helps transmit pain signals—and inflammation around nerves and blood vessels, the researchers say. They note the findings support further research into whether CGRP-targeting migraine medications could also help relieve endometriosis-related pain.

"There's a visibility gap because migraine and endometriosis are treated by different specialists and recorded separately, making the overlap easy to miss," said Yohannes Woubishet Woldeamanuel, M.D., lead author of the study and assistant professor of neurology at Mayo Clinic Arizona, Phoenix. "As a result, women's headaches and pelvic pain may be viewed as unrelated, even when they may be part of a broader pain pattern."

The researchers reviewed 35 studies spanning 50 years that compared migraine rates among 207,675 women with endometriosis and 12,963,120 women without the condition.

How the studies identified migraine in women with endometriosis made a difference. Clinic-based studies using patient interviews identified migraine in 54% to 78% of cases; insurance claims over longer periods reported rates of 18% to 43%; and one year of billing records identified fewer than 5%.

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