The prevalence of head and face pain decreased from 1997 to 2017 in Switzerland.

BACKGROUND: Pain in the head and the face is highly prevalent but may have changed during the past years. This study aimed to analyze changes in the prevalence of pain in the head and the face in Switzerland from 1997 to 2017. METHODS: This is a secondary analysis of data collected in the Swiss Health Surveys of 1997-2017. Included persons were 15 years and older. Besides studying demographic data, we analyze the item assessing the presence of "headache, pressure in the head, or facial pain" during the past 4 weeks. Percentages with their Wilson confidence intervals are reported for each response option of categorical variables. Moreover, we calculate the age-standardized number of persons affected by the pain. RESULTS: While 41% reported head and face pain in 1997, the proportion dropped to 31% in 2017. There was a decrease of 19.5% in women and 29.4% in men; after age standardization, the decrease was 16.5% in women and 25.4% in men. The most considerable numerical changes in the percentages of women with pain occurred in those aged 55-69 and 85 and above. In men, the changes were not limited to specific age groups. CONCLUSIONS: The proportion of people reporting headaches, pressure in the head, or facial pain has dropped in Switzerland from 1997 to 2017. However, in women, the prevalence diminished more strongly and consistently in the middle-aged and the elderly than in the young.

Endometriosis Features in Women With and Without Migraine.

Background: This study examines endometriosis (EM) features in women with EM and migraines (MG) (EM-MG) and women with EM alone (EM-O). The comorbidity of MG and EM is well known. However, knowledge about differences in symptoms, clinical manifestations, and severity of EM between EM-MG and EM-O is scarce. Materials and Methods: We conducted a cross-sectional observational study of premenopausal patients with biopsy-confirmed EM treated in our department from 2015 to 2021. All patients underwent surgical treatment for EM. Information about infiltration depth and localization of EM was available. We interviewed patients using a structured questionnaire that includes questions about clinical characteristics, symptoms, and treatment history. We reported categorical variables as frequencies and continuous variables as means with standard deviations. We compared subgroups (EM-MG vs. EM-O) using an independent sample t-test, the Wilcoxon-Mann-Whitney test, chi-square test, and Fisher's exact test. The significance level was 0.05. Results: We included 344 participants: 250 with EM-O and 94 with EM-MG. EM-MG had less severe revised American Society of Reproductive Medicine scores (p = 0.023), more deliveries (p = 0.009), more and higher scores of dysmenorrhea at menarche (p = 0.044; p = 0.036), prolonged heavy menstrual bleeding (p = 0.009), more and prolonged pain during menstrual bleeding (p = 0.011, p = 0.039), and more dyschezia (p < 0.001) compared with EM-O. Conclusion: Migraineurs experienced more intense EM symptoms at lower EM stages. This discrepancy strongly indicates pain sensitizations and a lower pain threshold in patients with EM-MG. Knowledge about EM features allows early diagnosis and treatment of women with potential EM-MG, both highly disabling conditions. Clinical Trials.gov (NCT04816357).

Dealing with Headache: Sex Differences in the Burden of Migraine- and Tension-Type Headache.

OBJECTIVE: The aim of this study was to investigate sex differences in the burden of migraine and tension-type headache (TTH). BACKGROUND: Migraine and TTH are more common in women than in men, with differences in comorbidities, treatment responses, disease-modifying factors, and ictal and interictal burden of disease. Information about sex-related influences on ictal and interictal burden is limited, and an increased understanding is mandatory to provide tailored individual treatment for female and male patients. METHODS: Participants answered an online survey based on the EUROLIGHT questionnaire. Inclusion criteria were the consent to participate, complete responses to the diagnostic questions, and information about their sex. Sex differences were investigated using the Mann-Whitney U test or Chi-square test. For detecting factors that influence the burden of disease, we built binary regression models. RESULTS: We included 472 (74.6% female) migraineurs and 161 (59.6% female) participants with TTH. Women with migraine reported significantly more problems in their love lives, more self-concealment, less feelings of being understood by family and friends, more interictal anxiety, a higher pain severity, and more depression and anxiety symptoms than men. For TTH, we did not find significant sex-related differences. A higher headache frequency was the factor that increased the burden of disease in female but not in male migraneurs. CONCLUSION: The burden of disease was higher in women than men with migraine in many aspects, but not with TTH. Therefore, according to our results, there is a need for sex-specific precision medicine for migraine but not TTH. Controlling the headache frequency with a proper acute or prophylactic treatment and treating comorbid depression and anxiety symptoms is crucial to ease migraine's burden, especially in women.