Migraines and Endometriosis
Migraine is a complex condition that can occur alongside various comorbidities, such as high blood pressure or irritable bowel syndrome. However, recent studies also suggest that migraine may be a comorbid condition of endometriosis. In this article, you will learn what endometriosis is, how diet may influence it, and what research has discovered so far about the link between the two conditions.
Reading time: 7 minutes
Last updated: February 6, 2024
What you will learn in this article
What Exactly Is Endometriosis?
Endometriosis is a chronic inflammatory disease that affects 5-10% of women of reproductive age. It is characterized by the presence of endometrial-like tissue outside the uterus (1). This tissue most commonly develops in the lower abdomen around the reproductive organs or within the uterine muscles. However, in some cases, endometriosis lesions can also appear outside the reproductive system, such as in the gastrointestinal tract, bladder, lungs, or even the nervous system (2).
Similar to migraine, the symptoms of endometriosis can vary significantly, ranging from no symptoms at all to severe cases that greatly impact daily life. The most common symptoms include pelvic pain, heavy menstrual bleeding, and bladder or bowel issues. These symptoms are often cyclical and, like migraine, can become chronic. Additionally, endometriosis is associated with infertility.
Currently, the only definitive way to diagnose endometriosis is through surgery—most commonly a minimally invasive laparoscopy. While medication and surgical treatments can help manage the condition, they cannot completely cure it. During surgery, endometriosis lesions are removed, but since they can recur, more than 50% of women who undergo surgery require additional procedures within five years (3).
How Does Diet Affect Endometriosis?
Many studies indicate that diet may play a significant role in endometriosis—both positively and negatively.
Research has suggested that consuming saturated fats, trans fats, and red meat may increase the risk of developing endometriosis. On the other hand, antioxidants, polyunsaturated fatty acids, and vegetables have been associated with pain reduction and other positive effects (4).
Further studies have explored different dietary approaches and concluded that specific diets—including the Mediterranean diet, gluten-free diet, low-nickel diet, and low-FODMAP diet—could help alleviate symptoms and pain (5,6). If you are unfamiliar with the low-FODMAP diet, you can read our detailed blog article on Migraine & Irritable Bowel Syndrome, where we explain this dietary approach in depth.
There has also been ongoing debate about whether vitamin D supplementation might help with endometriosis. However, no study has yet demonstrated a significant effect (7).
While certain dietary approaches may be beneficial, they also come with risks. For example, it is not recommended to take antioxidant supplements for longer than six months, as the long-term effects remain uncertain. Additionally, dietary supplements should always be taken with caution, as they are often overdosed and could have negative consequences. Similarly, the low-FODMAP diet should not be followed long-term, as it may negatively impact the gut microbiome over time (6).
Before making major changes to your diet, it is always best to consult with your healthcare provider or a nutrition specialist.
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Migraines and Endometriosis
Migraine can occur alongside various comorbid conditions, and recent research suggests a strong connection between migraine and endometriosis.
A French study found that women with migraine had a significantly higher risk of developing endometriosis compared to a healthy control group. Furthermore, endometriosis-related pain was reported to be more severe in women with migraine than in those without migraine. The study established a significant correlation between the two conditions, leading researchers to recommend screening women with migraine for endometriosis. This approach could improve the medical and therapeutic management of endometriosis(8).
Other studies have confirmed the strong association between migraine and endometriosis. However, instead of screening migraine patients for endometriosis, some researchers suggest screening women with endometriosis for headaches and migraine. One hypothesis is that the impact of female sex hormones on both conditions, combined with increased pain sensitivity, may contribute to the development of both diseases (9).
Additionally, researchers have found genetic links between endometriosis and migraine, particularly involving genes related to sex hormones. Future discoveries in this area could lead to better treatment strategies for both conditions (10).
Prevention Strategies
Currently, there is no known way to prevent endometriosis. This makes effective migraine prevention even more important.
Recent studies suggest that blood sugar metabolism and fluctuations in blood sugar levels play a significant role in triggering migraine attacks (11–14). Therefore, a low-glycemic diet, which helps keep blood sugar levels stable, is considered crucial for reducing migraine attacks. You can find more detailed information in our blog articles on Sugar & Migraine and Blood Sugar & Migraine.
With Ebby, you can now test which foods help keep your blood sugar levels stable and actively work to reduce your migraine attacks (15).
Conclusion
Both endometriosis and migraine are complex conditions that cause significant suffering for many individuals. If one of these conditions remains undiagnosed and untreated, the burden can become even greater.
Recent studies strongly suggest that having one of these conditions increases the risk of developing the other. However, current medical guidelines do not yet recommend routine screening for either condition in patients diagnosed with the other. More research is needed in this area, and medical societies acknowledge the need for further studies.
Sources
- Rahmioglu N, Mortlock S, Ghiasi M, et al. The genetic basis of endometriosis and comorbidity with other pain and inflammatory conditions. Nat Genet. 2023;55(3):423-436. doi:10.1038/s41588-023-01323-z
- Lukac S, Schmid M, Pfister K, Janni W, Schäffler H, Dayan D. Extragenital Endometriosis in the Differential Diagnosis of Non-Gynecological Diseases. Dtsch Ärztebl Int. 2022;119(20):361-367. doi:10.3238/arztebl.m2022.0176
- Saunders PTK, Horne AW. Endometriosis: Etiology, pathobiology, and therapeutic prospects. Cell. 2021;184(11):2807-2824. doi:10.1016/j.cell.2021.04.041
- Arab A, Karimi E, Vingrys K, Kelishadi MR, Mehrabani S, Askari G. Food groups and nutrients consumption and risk of endometriosis: a systematic review and meta-analysis of observational studies. Nutr J. 2022;21:58. doi:10.1186/s12937-022-00812-x
- Sverrisdóttir UÁ, Hansen S, Rudnicki M. Impact of diet on pain perception in women with endometriosis: A systematic review. Eur J Obstet Gynecol Reprod Biol. 2022;271:245-249. doi:10.1016/j.ejogrb.2022.02.028
- Nirgianakis K, Egger K, Kalaitzopoulos DR, Lanz S, Bally L, Mueller MD. Effectiveness of Dietary Interventions in the Treatment of Endometriosis: a Systematic Review. Reprod Sci. 2021;29(1):26-42. doi:10.1007/s43032-020-00418-w
- Kalaitzopoulos DR, Samartzis N, Daniilidis A, et al. Effects of vitamin D supplementation in endometriosis: a systematic review. Reprod Biol Endocrinol RBE. 2022;20. doi:10.1186/s12958-022-01051-9
- Maitrot-Mantelet L, Hugon-Rodin J, Vatel M, et al. Migraine in relation with endometriosis phenotypes: Results from a French case-control study. Cephalalgia Int J Headache. 2020;40(6):606-613. doi:10.1177/0333102419893965
- Karamustafaoglu Balci B, Kabakci Z, Guzey DY, Avci B, Guler M, Attar E. Association between endometriosis, headache, and migraine. J Endometr Pelvic Pain Disord. 2019;11(1):19-24. doi:10.1177/2284026518818975
- van der Vaart JF, Merki-Feld GS. Sex hormone-related polymorphisms in endometriosis and migraine: A narrative review. Womens Health. 2022;18:17455057221111316. doi:10.1177/17455057221111315
- Siva ZO, Uluduz D, Keskin FE, et al. Determinants of glucose metabolism and the role of NPY in the progression of insulin resistance in chronic migraine. Cephalalgia. 2018;38(11):1773-1781. doi:10.1177/0333102417748928
- Yilmaz N, Aydin O, Yegin A, Tiltak A, Eren E, Aykal G. Impaired oxidative balance and association of blood glucose, insulin and HOMA-IR index in migraine. Biochem Medica. 2011;21(2):145-151. doi:10.11613/bm.2011.023
- Bernecker C, Ragginer C, Fauler G, et al. Oxidative stress is associated with migraine and migraine-related metabolic risk in females. Eur J Neurol. 2011;18(10):1233-1239. doi:10.1111/j.1468-1331.2011.03414.x
- Gruber HJ, Bernecker C, Pailer S, et al. Hyperinsulinaemia in migraineurs is associated with nitric oxide stress. Cephalalgia Int J Headache. 2010;30(5):593-598. doi:10.1111/j.1468-2982.2009.02012.x
- Lelleck VV, Schulz F, Witt O, et al. A Digital Therapeutic Allowing a Personalized Low-Glycemic Nutrition for the Prophylaxis of Migraine: Real World Data from Two Prospective Studies. Nutrients. 2022;14(14):2927. doi:10.3390/nu14142927
About the Author
Kaya Harms
Kaya is studying for a Bachelor's degree in Medical Nutritional Sciences. Through her studies, she sees particular relevance in the interface between nutrition and medicine. As a working student at Perfood in the marketing department, she wants to impart knowledge creatively and in a way that everyone can understand.