Female Sexual Dysfunction and Distress in Migraine: Results from a Tertiary Referral Hospital

Abstract

Background: Female sexual dysfunction (FSD) is an underdiagnosed and undertreated problem. Few studies have addressed sexual distress in migraine. We aim to determine if there is an association between migraine and sexual dysfunction/distress and to identify their respective risk factors. Methods: Retrospective, cross-sectional study, including 71 premenopausal female patients with migraine, followed in 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; 62.3% (n=33) reported severe disability (MIDAS-IV). FSD and sexual distress were present in 36 (50.7%) patients with migraine [vs 7 controls (20.6%)]. 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 related to sexual distress. Certain domains of sexual function were associated with sociodemographic and migraine characteristics, anxiety, depression, and sleep health. Conclusions: This study highlights the association between migraine and elevated sexual dysfunction/distress levels among premenopausal women. It underscores the importance of sexual health assessments in these individuals, mainly the ones with higher levels of anxiety, depression, or experiencing poor sleep quality.