A recent study from the National Institutes of Health (NIH) found that many women who suffer from migraines also suffer with chronic pelvic pain. Is there a connection between what's going on upstairs and what's going on below the belt?

The two most common chronic conditions women seek medical care for are migraines and chronic pelvic pain. Chronic pelvic pain (described as pain below the navel and between the hip bones) accounts for about ten percent of all visits to the gynecologist and affects somewhere between 15 and 24 percent of women of reproductive age. That statistic is similar to the percentage of women who have migraines, about 20 percent. Only about seven percent of men have chronic pelvic pain. This led researchers and doctors to wonder if this connection was something more than coincidence. They discovered that seven out of 10 women with chronic pelvic pain also have migraines. 

Sometimes pelvic pain is caused by infections, cysts (or other growths), or endometriosis. Most of the time, however, doctors don't find a direct cause for pelvic pain. In this particular study, endometriosis was ruled out as a contributing factor for migraines since the migraine connection affected women with and without endometriosis. 

Migraines are often associated with "triggers" like certain foods, hormonal cycles, stress, etc. Researchers aren't sure yet what the direct connection is between pelvic pain and migraines, but they're hoping this finding will lead to better treatment options for both. The strong association between these two painful conditions, however, suggests a common pathology.

Scientists determined more research is needed, but they're considering several theories that connect the dots. 

  • One theory involves prostaglandins, a hormone-like compound present in men and women responsible for many functions, including inflammation and contraction/relaxation of blood vessels.
  • Another theory is that women with one type of pain condition may be more vulnerable to other types of pain because their nerve cells become overly sensitive. Their pain threshold is lowered and they now feel symptoms other people might not.
  • Yet one more theory is that pain medications taken for pelvic pain may have side effects that cause headaches.

What's the Solution? 

Some doctors suggest the key to treating migraine and pelvic pain disorders is to eliminate all pain medication and caffeine, improve diet, exercise and sleep and then see if one or both pain conditions disappears. If one source of pain continues, treatment options should focus on just that area.

If you experience chronic pelvic pain and migraines, talk to your doctor about this new study and see if there's a connection for you. 


Migraine in women with chronic pelvic pain with and without endometriosis.

Karp, Bl, Sinali N, Nieman LK, Silberstein SD, Stratton P

National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland.

December 8, 2010


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