REPLY to Comment on Correlation between endometriosis and migraine features: Results from a prospective case-control study'': Correlation between endometriosis and migraine features is not based on a broad strokes results

Background: Endometriosis and migraine frequently coexist, but only a limited number of studies have focused on their mutual association. The aim of our study was to investigate, in untreated women with comorbid endometriosis/ adenomyosis and migraine, the correlation between headache features and endometriotic subtypes and their possible relationship with pain severity and disease disability. Methods: Fifty women affected by endometriosis/adenomyosis and migraine matched (1:2) with 100 patients with endometriosis alone and 100 patients with only migraine were recruited and underwent pelvic ultrasound imaging and neurological examination. Results: Severe adenomyosis, posterior and anterior deep infiltrating endometriosis (p 1⁄4 0.027, p 1⁄4 0.0031 and p 1⁄4 0.029, respectively) occurred more frequently in women with migraine. Dysmenorrhea was the most commonly reported symptom in women with endometriosis and migraine and the mean VAS scores of all typical endometriotic symptoms were significantly higher in the presence of comorbidity. Women with both migraine and endometriosis reported significant higher pain intensity (p 1⁄4 0.004), higher monthly migraine days (p 1⁄4 0.042) and increased HIT 6-scores (p 1⁄4 0.01), compared with those without endometriosis. Conclusions: Our results demonstrated that the co-occurrence of migraine in untreated women with endometriosis is associated with more severe gynecological infiltrations and correlated with increased pain intensity and disease disability.