Prevalence of migraine subtypes in women with endometriosis and/or dysmenorrhea: results from a cross-sectional multicenter trial

Anna Cirkel; Hartmut Göbel; Carl Göbel; Ibrahim Alkatout; Antonia Kaiser; Norbert Brüggemann; Jens Minnerup; Achim Rody; Christoph Cirkel

doi:10.1186/s12905-026-04335-z

Prevalence of migraine subtypes in women with endometriosis and/or dysmenorrhea: results from a cross-sectional multicenter trial

Anna Cirkel^*, Hartmut Göbel, Carl Göbel, Ibrahim Alkatout, Antonia Kaiser, Norbert Brüggemann, Jens Minnerup, Achim Rody, Christoph Cirkel^*

^*Corresponding author for this work

Abstract

Background: Migraine and endometriosis are both debilitating chronic pain conditions that frequently co-occur in women. We aimed to assess the prevalence of migraine in women with surgically confirmed endometriosis (SCE) compared to women without surgically confirmed endometriosis (non-SCE), and to explore the distribution of migraine subtypes in this population. Methods: In a cross-sectional multicenter study, 838 women were recruited from two endometriosis centers and a patient association. Participants completed a standardized online questionnaire assessing migraine phenotype (ICHD-3 criteria), endometriosis status (surgically confirmed or not), and current hormone therapy. Group comparisons were performed using statistical tests, and odds ratios (OR) with 95% confidence intervals (CI) were calculated. Results: Surgically confirmed endometriosis (SCE) was present in 561 participants (67%), whereas 277 (33%) had no surgical confirmation (non-SCE). A total of 320 (38.2%) participants reported migraine. Migraine was more prevalent in women with SCE than in those without (41.0% vs. 32.5%; OR 1.44, 95% CI 1.07–1.95), and remained associated after adjustment for age, BMI, education, and hormonal therapy (adjusted OR 1.38, p = 0.048). Among those with migraine, 204 (63.8%) had non-menstrual migraine (NM), 93 (29.1%) had menstrually-related migraine (RM) and 23 (7.2%) had pure menstrual migraine (PM). Migraine with aura showed higher odds in the SCE group (OR 1.61, 95% CI 1.11–2.35), as did PM (OR 11.27, 95% CI 1.51–84.01). RM was associated with higher migraine frequency (p < 0.001), pain intensity (p = 0.019), and greater functional impairment (p < 0.001) than NM or PM. Participants with PM had lower rates of endocrine endometriosis/dysmenorrhea treatments (17.4% vs. 54.4% (NM) vs. 34.4% (RM); p < 0.001). Conclusion: Women with SCE show a higher prevalence of migraine – particularly migraine with aura and PM – than those without SCE. The observed co-occurrence of endometriosis and migraine highlights the need for increased clinical awareness and further prospective studies to explore implications for interdisciplinary management. However, no causality can be inferred from this cross-sectional study.

Original language	English
Article number	132
Journal	BMC Women's Health
Volume	26
Issue number	1
DOIs	https://doi.org/10.1186/s12905-026-04335-z
Publication status	Published - 01.2026

Funding

Interne Forschungsförderung der Universität zu Lübeck: LACS01-2024

Funders	Funder number
Deutsche Forschungsgemeinschaft	CRC/TR 296

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

DFG Research Classification Scheme

2.22-21 Gynaecology and Obstetrics

Access to Document

10.1186/s12905-026-04335-z

Cite this

@article{ed378045eb2a4bbabcc88e024a52dac8,

title = "Prevalence of migraine subtypes in women with endometriosis and/or dysmenorrhea: results from a cross-sectional multicenter trial",

abstract = "Background: Migraine and endometriosis are both debilitating chronic pain conditions that frequently co-occur in women. We aimed to assess the prevalence of migraine in women with surgically confirmed endometriosis (SCE) compared to women without surgically confirmed endometriosis (non-SCE), and to explore the distribution of migraine subtypes in this population. Methods: In a cross-sectional multicenter study, 838 women were recruited from two endometriosis centers and a patient association. Participants completed a standardized online questionnaire assessing migraine phenotype (ICHD-3 criteria), endometriosis status (surgically confirmed or not), and current hormone therapy. Group comparisons were performed using statistical tests, and odds ratios (OR) with 95\% confidence intervals (CI) were calculated. Results: Surgically confirmed endometriosis (SCE) was present in 561 participants (67\%), whereas 277 (33\%) had no surgical confirmation (non-SCE). A total of 320 (38.2\%) participants reported migraine. Migraine was more prevalent in women with SCE than in those without (41.0\% vs. 32.5\%; OR 1.44, 95\% CI 1.07–1.95), and remained associated after adjustment for age, BMI, education, and hormonal therapy (adjusted OR 1.38, p = 0.048). Among those with migraine, 204 (63.8\%) had non-menstrual migraine (NM), 93 (29.1\%) had menstrually-related migraine (RM) and 23 (7.2\%) had pure menstrual migraine (PM). Migraine with aura showed higher odds in the SCE group (OR 1.61, 95\% CI 1.11–2.35), as did PM (OR 11.27, 95\% CI 1.51–84.01). RM was associated with higher migraine frequency (p < 0.001), pain intensity (p = 0.019), and greater functional impairment (p < 0.001) than NM or PM. Participants with PM had lower rates of endocrine endometriosis/dysmenorrhea treatments (17.4\% vs. 54.4\% (NM) vs. 34.4\% (RM); p < 0.001). Conclusion: Women with SCE show a higher prevalence of migraine – particularly migraine with aura and PM – than those without SCE. The observed co-occurrence of endometriosis and migraine highlights the need for increased clinical awareness and further prospective studies to explore implications for interdisciplinary management. However, no causality can be inferred from this cross-sectional study.",

author = "Anna Cirkel and Hartmut G{\"o}bel and Carl G{\"o}bel and Ibrahim Alkatout and Antonia Kaiser and Norbert Br{\"u}ggemann and Jens Minnerup and Achim Rody and Christoph Cirkel",

note = "Publisher Copyright: {\textcopyright} The Author(s) 2026.",

year = "2026",

month = jan,

doi = "10.1186/s12905-026-04335-z",

language = "English",

volume = "26",

journal = "BMC Women's Health",

issn = "1472-6874",

publisher = "BioMed Central Ltd",

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TY - JOUR

T1 - Prevalence of migraine subtypes in women with endometriosis and/or dysmenorrhea

T2 - results from a cross-sectional multicenter trial

AU - Cirkel, Anna

AU - Göbel, Hartmut

AU - Göbel, Carl

AU - Alkatout, Ibrahim

AU - Kaiser, Antonia

AU - Brüggemann, Norbert

AU - Minnerup, Jens

AU - Rody, Achim

AU - Cirkel, Christoph

PY - 2026/1

Y1 - 2026/1

N2 - Background: Migraine and endometriosis are both debilitating chronic pain conditions that frequently co-occur in women. We aimed to assess the prevalence of migraine in women with surgically confirmed endometriosis (SCE) compared to women without surgically confirmed endometriosis (non-SCE), and to explore the distribution of migraine subtypes in this population. Methods: In a cross-sectional multicenter study, 838 women were recruited from two endometriosis centers and a patient association. Participants completed a standardized online questionnaire assessing migraine phenotype (ICHD-3 criteria), endometriosis status (surgically confirmed or not), and current hormone therapy. Group comparisons were performed using statistical tests, and odds ratios (OR) with 95% confidence intervals (CI) were calculated. Results: Surgically confirmed endometriosis (SCE) was present in 561 participants (67%), whereas 277 (33%) had no surgical confirmation (non-SCE). A total of 320 (38.2%) participants reported migraine. Migraine was more prevalent in women with SCE than in those without (41.0% vs. 32.5%; OR 1.44, 95% CI 1.07–1.95), and remained associated after adjustment for age, BMI, education, and hormonal therapy (adjusted OR 1.38, p = 0.048). Among those with migraine, 204 (63.8%) had non-menstrual migraine (NM), 93 (29.1%) had menstrually-related migraine (RM) and 23 (7.2%) had pure menstrual migraine (PM). Migraine with aura showed higher odds in the SCE group (OR 1.61, 95% CI 1.11–2.35), as did PM (OR 11.27, 95% CI 1.51–84.01). RM was associated with higher migraine frequency (p < 0.001), pain intensity (p = 0.019), and greater functional impairment (p < 0.001) than NM or PM. Participants with PM had lower rates of endocrine endometriosis/dysmenorrhea treatments (17.4% vs. 54.4% (NM) vs. 34.4% (RM); p < 0.001). Conclusion: Women with SCE show a higher prevalence of migraine – particularly migraine with aura and PM – than those without SCE. The observed co-occurrence of endometriosis and migraine highlights the need for increased clinical awareness and further prospective studies to explore implications for interdisciplinary management. However, no causality can be inferred from this cross-sectional study.

AB - Background: Migraine and endometriosis are both debilitating chronic pain conditions that frequently co-occur in women. We aimed to assess the prevalence of migraine in women with surgically confirmed endometriosis (SCE) compared to women without surgically confirmed endometriosis (non-SCE), and to explore the distribution of migraine subtypes in this population. Methods: In a cross-sectional multicenter study, 838 women were recruited from two endometriosis centers and a patient association. Participants completed a standardized online questionnaire assessing migraine phenotype (ICHD-3 criteria), endometriosis status (surgically confirmed or not), and current hormone therapy. Group comparisons were performed using statistical tests, and odds ratios (OR) with 95% confidence intervals (CI) were calculated. Results: Surgically confirmed endometriosis (SCE) was present in 561 participants (67%), whereas 277 (33%) had no surgical confirmation (non-SCE). A total of 320 (38.2%) participants reported migraine. Migraine was more prevalent in women with SCE than in those without (41.0% vs. 32.5%; OR 1.44, 95% CI 1.07–1.95), and remained associated after adjustment for age, BMI, education, and hormonal therapy (adjusted OR 1.38, p = 0.048). Among those with migraine, 204 (63.8%) had non-menstrual migraine (NM), 93 (29.1%) had menstrually-related migraine (RM) and 23 (7.2%) had pure menstrual migraine (PM). Migraine with aura showed higher odds in the SCE group (OR 1.61, 95% CI 1.11–2.35), as did PM (OR 11.27, 95% CI 1.51–84.01). RM was associated with higher migraine frequency (p < 0.001), pain intensity (p = 0.019), and greater functional impairment (p < 0.001) than NM or PM. Participants with PM had lower rates of endocrine endometriosis/dysmenorrhea treatments (17.4% vs. 54.4% (NM) vs. 34.4% (RM); p < 0.001). Conclusion: Women with SCE show a higher prevalence of migraine – particularly migraine with aura and PM – than those without SCE. The observed co-occurrence of endometriosis and migraine highlights the need for increased clinical awareness and further prospective studies to explore implications for interdisciplinary management. However, no causality can be inferred from this cross-sectional study.

UR - https://www.scopus.com/pages/publications/105031003005

UR - https://www.mendeley.com/catalogue/f9459c39-db72-3b19-96f9-0ba0eb84b7ab/

U2 - 10.1186/s12905-026-04335-z

DO - 10.1186/s12905-026-04335-z

M3 - Journal articles

C2 - 41680759

AN - SCOPUS:105031003005

SN - 1472-6874

VL - 26

JO - BMC Women's Health

JF - BMC Women's Health

IS - 1

M1 - 132

ER -

Prevalence of migraine subtypes in women with endometriosis and/or dysmenorrhea: results from a cross-sectional multicenter trial

Abstract

Funding

UN SDGs

DFG Research Classification Scheme

Access to Document

Other files and links

Fingerprint

CRC/TRR 296 LocoTact: Local control of TH action

Cite this

Prevalence of migraine subtypes in women with endometriosis and/or dysmenorrhea: results from a cross-sectional multicenter trial

Abstract

Funding

UN SDGs

DFG Research Classification Scheme

Access to Document

Other files and links

Fingerprint

Projects

CRC/TRR 296 LocoTact: Local control of TH action

Cite this