Dyspareunia and pelvic pain in women with chronic migraine: A retrospective, observational analysis.

Background: Dyspareunia and pelvic pain are commonly comorbid conditions with migraine, with chronic migraine potentially contributing to the exacerbation of sexual dysfunction and pain.

Methods: We conducted a retrospective cohort study of female patients seen at the Stanford Headache Clinic between January 1, 2022, and March 24, 2024, for the management of chronic migraine for dyspareunia and pelvic pain and stratified for comorbidities related to both conditions.

Results: Patients with chronic migraine were overall found to be at higher likelihood of having a comorbid pelvic pain condition after adjusting for age, race-ethnicity, and marital status (adjusted odds ratio [aOR] 2.46; 95% confidence interval [CI]: 2.17-2.79, p < 0.001), with interstitial cystitis (aOR 3.04; 95% CI: 1.98-4.66, p < 0.001), vaginismus (aOR 2.51; 95% CI: 1.29-4.88, p = 0.007), dyspareunia (aOR 1.97; 95% CI: 1.57-2.49, p < 0.001), and vulvodynia (aOR 1.88; 95% CI: 1.04-3.40, p = 0.036) all increased in the chronic migraine population. Furthermore, conditions that are commonly comorbid with migraine, such as irritable bowel syndrome, fibromyalgia, and mood disorders, independently contributed to increased risk of pelvic pain conditions and dyspareunia.

Conclusions: Conditions that cause pelvic pain and sexual dysfunction in women are disproportionally common in women with chronic migraine and may contribute to disability and difficulties in interpersonal relationships. Early screening for disorders of pelvic pain in patients with chronic migraine and appropriate referrals can improve the quality of life of these patients.