(Newswise)–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.
The analysis also showed women with endometriosis had 2.3 times the odds of having migraine than 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 striking 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%. The findings suggest that short-term health records miss up to 90% of women who have both conditions.
“Women who have – or think they may have—both migraine and endometriosis should understand it’s likely not a coincidence and tell their doctors about all of their symptoms,” said Megan Wasson, D.O., FACOG, co-author of the study and chair of the Department of Medical and Surgical Gynecology, Mayo Clinic Arizona. “Health care providers need to connect the dots, too. Neurologists should ask about severe menstrual cramps and pelvic pain, while gynecologists should screen for migraine. Earlier recognition could lead to better, more coordinated care.”
Previous research has found an association between migraine and endometriosis, but this study provides a clearer picture of how often women may experience both. CGRP is a natural chemical in the body that plays a key role in migraine attacks. It sends and amplifies pain signals in the brain and can also trigger inflammation in nerve tissue, which may worsen pain. Endometriosis tissue contains nerve fibers and immune cells associated with inflammation, and research suggests that CGRP may also contribute to pain.
In endometriosis, tissue similar to the lining of the uterus grows elsewhere in the body, causing inflammation, scar tissue and, in some women, severe pelvic pain, menstrual cramps and infertility. Traditional treatments may include hormone therapy, opioids or repeated surgery, all of which have potential side effects. For example, hormone therapy can stop ovulation. Several types of migraine treatments can relieve attacks or help prevent future ones, including CGRP-targeting therapies, which block the activity of a chemical messenger involved in migraine pain and are considered first-line options for prevention.
The findings presented at ANA 2026 support studying whether existing CGRP-blocking migraine medications could also relieve endometriosis pain, potentially offering one treatment for both conditions, the researchers say.
