Female sexual dysfunction and distress in premenopausal women with migraine followed in a tertiary headache center: A pilot study.

BACKGROUND: Female sexual dysfunction (FSD) is an underdiagnosed and undertreated problem. Few studies have addressed sexual distress in migraine. We aimed to perform a pilot study to determine if there is an association between migraine and sexual dysfunction/distress in premenopausal women and to identify their respective risk factors. METHODS: Retrospective, cross-sectional pilot study, including 71 premenopausal female patients with migraine, from the headache outpatient clinic of a tertiary hospital, and 34 age-matched-controls. Female Sexual Function Index-6 (FSFI-6), Female Sexual Distress Scale-Revised (FSDS-R), Migraine Disability Assessment (MIDAS) Scale, Brief Pain Inventory (BPI), Hospital Anxiety and Depression Scale (HADS) and Sleep Health Scale (RU-SATED) were applied. RESULTS: Of the 71 patients [40.0 (IQR = 11.00) years], only 12.7 % (n = 9) were not under migraine prophylactic treatment, and most (n = 33, 62.3 %) reported severe disability (MIDAS-IV). FSD and sexual distress were present in 50.7 % (36) patients with migraine [vs 20.6 % (7) controls]. Migraine patients showed lower FSFI-6 scores [19.0 (9.0) vs 24.0 (6.0), p = 0.005], with significantly lower levels of desire (p = 0.011), lubrication (p = 0.002), and satisfaction (p = 0.013), higher sexual distress [11.2 (25.6) vs 3.2 (9.6), p = 0.001], anxiety (p < 0.001), and depression (p < 0.001) levels, and lower sleep health scores (p = 0.005). Old age of onset, being under preventive medication, anxiety/depression, and dysfunctional sleep, were significantly associated with sexual distress. Certain domains of sexual function were associated with sociodemographic and migraine characteristics, anxiety, depression, and sleep health. CONCLUSIONS: This pilot study highlights the possible association between migraine and elevated sexual dysfunction/distress levels among premenopausal women. It underscores the importance of sexual health assessments in these individuals, particularly those with higher levels of anxiety, depression, or poor sleep quality. It is important to exercise caution when interpreting results, as they may not be applicable to a wider context. This research paves the way for a larger study that will include a broader population of women from the community and encompass patients followed in different levels of health care.