title: Sexual Dysfunction in Women With Migraine and Overweight/Obesity: Relative Frequency and Association With Migraine Severity.
abstract: OBJECTIVE
  Previous studies suggest that migraine might be associated with female sexual dysfunction (FSD), although this association may be complicated by overweight/obesity. To disentangle relationships of migraine and obesity with FSD, we examined: (1) FSD rates in women who had migraine and obesity with a matched sample of women with obesity who were free of migraine and (2) associations between indices of migraine severity and FSD in a larger sample of participants with migraine and overweight/obesity, controlling for important confounders.
  
  
  METHODS
  Women with migraine and obesity seeking behavioral weight loss treatment to decrease headaches (n = 37) and nonmigraine controls (n = 37) with obesity seeking weight loss via bariatric surgery were matched on age (±5 years), body mass index (BMI; ±3 kg/m2), and reported sexual activity during the past month. Both groups completed the Female Sexual Function Index (FSFI), with a validated FSFI-total cutoff score used to define FSD. In participants with migraine and overweight/obesity (n = 105), separate logistic regression models evaluated associations of migraine attack frequency, intensity, and duration with odds of having FSD, controlling for age, BMI, depression, and anxiety.
  
  
  RESULTS
  On average, participants and matched controls had severe obesity (BMI = 42.4 ± 3.8 kg/m2; range = 35-49.9) and were 37.3 ± 7.2 years of age (range = 22-50). FSD rate did not differ between migraine participants and controls (56.8% vs. 54.1%, P = .82). In the larger sample of participants with migraine and overweight/obesity (38.2 ± 7.8 years of age; BMI = 34.8 ± 6.4 [range = 25-50 kg/m2]; 8.0 ± 4.3 migraine days/month, maximum pain intensity = 5.9 ± 1.4 on 0-10 scale; average attack duration = 18.3 ± 9.7 hours), FSD was not associated with attack frequency (P = .31), pain intensity (P = .92), or attack duration (P = .35) but was associated with more severe anxiety symptoms (Ps < .017).
  
  
  CONCLUSIONS
  Rates of sexual dysfunction did not differ in severely obese women with and without migraine. Moreover, indices of migraine severity were not associated with increased risk of FSD in women with overweight/obesity. Replication of present findings in wider populations of women with migraine and of both normal-weight and overweight/obese status are warranted.
authors.affiliation: Alpert Medical School of Brown University/The Miriam Hospital Weight Control and Diabetes Research Center, Providence, RI, USA.
authors.forename: Dale S
authors.initials: DS
authors.lastname: Bond
authors.affiliation: Albert Einstein College of Medicine/Montefiore Medical Center, Montefiore Headache Center, Bronx, NY, USA.
authors.forename: Jelena M
authors.initials: JM
authors.lastname: Pavlović
authors.affiliation: Albert Einstein College of Medicine/Montefiore Medical Center, Montefiore Headache Center, Bronx, NY, USA.
authors.forename: Richard B
authors.initials: RB
authors.lastname: Lipton
authors.affiliation: Alpert Medical School of Brown University/The Miriam Hospital Weight Control and Diabetes Research Center, Providence, RI, USA.
authors.forename: J
authors.initials: J
authors.lastname: Graham Thomas
authors.affiliation: University of Utah Health Sciences Center, Salt Lake City, UT, USA.
authors.forename: Kathleen B
authors.initials: KB
authors.lastname: Digre
authors.affiliation: Department of Neurology, Alpert Medical School of Brown University/Rhode Island Hospital, Providence, RI, USA.
authors.forename: Julie
authors.initials: J
authors.lastname: Roth
authors.affiliation: Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University/The Miriam Hospital, Providence, RI, USA.
authors.forename: Lucille
authors.initials: L
authors.lastname: Rathier
authors.affiliation: Alpert Medical School of Brown University/The Miriam Hospital Weight Control and Diabetes Research Center, Providence, RI, USA.
authors.forename: Kevin C
authors.initials: KC
authors.lastname: O'Leary
authors.affiliation: Alpert Medical School of Brown University/The Miriam Hospital Weight Control and Diabetes Research Center, Providence, RI, USA.
authors.forename: E Whitney
authors.initials: EW
authors.lastname: Evans
authors.affiliation: Alpert Medical School of Brown University/The Miriam Hospital Weight Control and Diabetes Research Center, Providence, RI, USA.
authors.forename: Rena R
authors.initials: RR
authors.lastname: Wing
mesh_terms: D000328:Adult; D015992:Body Mass Index; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D005831:Genital Diseases, Female / Q000209:etiology*; D006801:Humans; D008875:Middle Aged; D008881:Migraine Disorders / Q000150:complications*; D019964:Mood Disorders / Q000175:diagnosis / Q000209:etiology*; D009765:Obesity / Q000150:complications*; D010147:Pain Measurement; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D055815:Young Adult
keywords: depression; female sexual dysfunction; migraine; obesity; pain; women