Hormonal effect on the relationship between migraine and female sexual dysfunction

DOI: https://doi.org/10.1007/s10072- 017- 3023- 5

Abstract-Summary It is not a well-established finding in migraine that female sexual dysfunction (FSD) emerging as a natural course of disease, as a result of accompanying depression/ anxiety, or an underlying endocrinological abnormality.

Our aim is evaluating the relationship among frequency and severity of migraine,

FSD, depression, anxiety, and related hormones in migrainous women.

Beck Depression and Anxiety Inventories, Female Sexual Dysfunction Inventory,

Migraine Disability Assessment Test, and hormonal analysis were done.

FSD was not related to frequency or severity of migraine. FSH-LH combination and PRL were found as independent factors which had

effect on FSD in migraine.

Our study is a precursor study about the effect of several hormones on FSD and

migraine relationship.

Hormonal effect on FSD in migraine will be clearer with future studies. Extended: FSH-LH combination and PRL were found as independent factors which can affect FSD in females with migraine by multivariate linear and stepwise regression analysis.

Our study is important because it is a precursor study as there is no such a study about the relationship between hormones which are related to sexual function and FSD in migrainous females.

We think that the relationship between FSD in migrainous females and related

hormones will become clearer with future studies.

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2 Mechanisms

Introduction Migraine is a chronic disorder affecting lots of women all over the world which is associated with sexual dysfunction and different psychological disorders such as depression and anxiety [698].

Several studies identify that women with migraine have higher sexual pain, sat-

isfaction disorders, difficulties in lubrication, and orgasm [699, 700].

It has not yet been clearly identified that FSD in patients with migraine occurs as a natural course of disease, as a result of accompanying depression and/or anxiety, or due to an underlying endocrinological abnormality.

A few studies have been done to understand the relationship in between FSD, migraine and comorbid psychiatric disorders such as depression and anxiety recently.

Relationship with hypothalamic and sex hormones in females with migraine who

were suffering from FSD have not been studied yet.

Our aim in this study is evaluating the relationship among frequency and severity of migraine, FSD, depression, anxiety, and related hypothalamic and sex hormones in females with migraine for identifying a new perspective.

Method We excluded patients who had secondary headaches, other primary headaches, other forms of migraine, diagnosis of depression, anxiety and other psychiatric dis- orders, PCOS, DM, hypertension, obesity, metabolic syndrome, hepatic or renal failure, endocrinological diseases and any other medical condition which may affect sexual function, patients who were pregnant, breastfeeding, or postmenopausal.

Migraine patients and healthy individuals in the control group were asked to complete the questionnaires consisting of Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and Female Sexual Dysfunction Inventory (FSFI) after sociodemographic features were noted.

E, P, FSH, LH, and PRL levels of migraine patients and controls were analyzed if there was a difference between groups and if there was a significant relationship between any hormone level and depression; anxiety; results of MIDAS, BDI, BAI, and FSFI; and FSD and its domains such as desire, arousal, lubrication, orgasm, satisfaction, and pain.

Results Depression (p 0.77) and anxiety (p 0.31) were not different whereas FSFI score, FSD, arousal, lubrication, orgasm, and satisfaction were very significantly different (p < 0.001); P (p  0.004) and PRL (p  0.02) were significantly different between patients and controls.

Premenstrual or menstrual relationship of migraine was negatively correlated to

depression (p 0.045, r −0.255).

Depression had no correlation with FSD although it was negatively correlated to

arousal (p 0.014), lubrication (p 0.000), orgasm (p 0.018), and FSFI (p 0.012).

When hormonal levels and FSD correlation was examined in patient group, we

found that E and P were not related to depression, anxiety, and FSD domains.

2.5 Hormones

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PRL was negatively correlated to depression (p  0.003), anxiety (p  0.046),

whereas it was positively correlated to desire (p 0.023) and lubrication (p 0.057).

Discussion Relationship with comorbid disorders such as depression and anxiety was related to some sub-scales such as arousal and lubrication; they had limited effect in total FSD.

It indicated that not just only natural course of disease itself and comorbidities such as depression and anxiety but also hormonal factors should be important in occurrence of FSD in migraine patients.

We found that PRL was positively correlated to desire and lubrication, although it had negative correlation with depression and anxiety; FSH was positively corre- lated to orgasm and LH was negatively correlated to pain in patient group.

Although there were some relationships reported for FSD sub-scales, FSD in total was not directly related to frequency and severity of migraine and comorbid disorders such as depression and anxiety.

Our study is important because it is a precursor study as there is no such a study about the relationship between hormones which are related to sexual function and FSD in migrainous females.

Acknowledgement A machine generated summary based on the work of Dogan, Vasfiye Burcu; Dagdeviren, Hediye; Dirican, Ahmet; Dirican, Ayten Ceyhan; Tutar, Nurhan Kaya; Yayla, Vidan Ayse; Cengiz, Hüseyin. 2017 in Neurological Sciences.

Sexual dysfunction and distress in premenopausal women with migraine: association with depression, anxiety and migraine-related disability