Headache impact and quality of life following endometriosis surgery in women: a single-center observational study

Filiz Değirmenci, Hamza Yildiz, YILDIZ H, Aytan H, Hakan Aytan, Tekindal MA, Teki̇ndal MA, Mustafa Agah Teki̇ndal
BMC women's health · 2026 · vol. 26(1) · doi:10.1186/s12905-026-04720-8 · PMID:42907837 · PMC13688964 · W7171430341
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Endometriosis surgery reduced headache burden and improved quality of life in women with and without migraine, with greater benefits observed in those with migraine.

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This single-center observational study evaluated changes in headache burden and quality of life among 88 women who underwent endometriosis surgery between three months and five years prior to enrollment. Participants retrospectively recalled their preoperative status and reported current postoperative metrics using the Headache Impact Test–6 and the 12-Item Short Form Health Survey, with analyses comparing scores across groups with and without migraine. The results indicated that both physical and mental quality of life scores improved and headache burden decreased post-surgery for all participants, with these improvements being more pronounced in women diagnosed with migraine. The authors note that the retrospective assessment of preoperative status is a major limitation, necessitating prospective studies to confirm these findings and optimize multidisciplinary management strategies. This paper is centrally about endometriosis — specifically examining the secondary benefits of surgical intervention on comorbid migraine symptoms and overall patient-reported outcomes.

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Abstract

BACKGROUND: Endometriosis and migraine are common chronic conditions in women of reproductive age that impair quality of life and frequently co-occur as comorbid conditions. Evidence regarding the effects of treatments targeting one of these conditions on the course of the other remains limited. In particular, the association between endometriosis surgery and headache burden and quality of life has not been sufficiently investigated. The aim of this study was to examine changes in headache burden and quality of life following endometriosis surgery in women with and without migraine. METHODS: This single-center observational study included 88 women who had undergone endometriosis surgery between 3 months and 5 years prior to enrollment. Participants completed the Headache Impact Test-6 and the 12-Item Short Form Health Survey by retrospectively recalling their preoperative status, as prospective preoperative questionnaire records were not available, and reporting their current postoperative status. Changes over time, group differences, and time-by-group interactions were analyzed using mixed-design analysis of variance. Additional sensitivity analyses stratified by follow-up duration were performed to explore the potential influence of postoperative interval on change scores. RESULTS: In both women with and without migraine, headache burden scores were lower and physical and mental quality of life component scores were higher at the postoperative assessment than in the retrospectively recalled preoperative period (p < 0.001). These differences were more pronounced among women with migraine. CONCLUSION: Women reported lower headache burden and better quality of life at the postoperative assessment than in the retrospectively recalled preoperative period in both groups, with greater changes observed among women with migraine. Given the retrospective assessment of preoperative status, prospective studies are needed to confirm these findings, optimize multidisciplinary management of endometriosis and migraine and to identify patient subgroups most likely to benefit from surgical intervention.
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Abstract

Background Endometriosis and migraine are common chronic conditions in women of reproductive age that impair quality of life and frequently co-occur as comorbid conditions. Evidence regarding the effects of treatments targeting one of these conditions on the course of the other remains limited. In particular, the association between endometriosis surgery and headache burden and quality of life has not been sufficiently investigated. The aim of this study was to examine changes in headache burden and quality of life following endometriosis surgery in women with and without migraine.

Methods

This single-center observational study included 88 women who had undergone endometriosis surgery between 3 months and 5 years prior to enrollment. Participants completed the Headache Impact Test–6 and the 12-Item Short Form Health Survey by retrospectively recalling their preoperative status, as prospective preoperative questionnaire records were not available, and reporting their current postoperative status. Changes over time, group differences, and time-by-group interactions were analyzed using mixed-design analysis of variance. Additional sensitivity analyses stratified by follow-up duration were performed to explore the potential influence of postoperative interval on change scores.

Results

In both women with and without migraine, headache burden scores were lower and physical and mental quality of life component scores were higher at the postoperative assessment than in the retrospectively recalled preoperative period (p < 0.001). These differences were more pronounced among women with migraine.

Conclusion

Women reported lower headache burden and better quality of life at the postoperative assessment than in the retrospectively recalled preoperative period in both groups, with greater changes observed among women with migraine. Given the retrospective assessment of preoperative status, prospective studies are needed to confirm these findings, optimize multidisciplinary management of endometriosis and migraine and to identify patient subgroups most likely to benefit from surgical intervention. Similar content being viewed by others Abbreviations - BMI: - Body mass index - CI: - Confidence interval - HIT-6: - Headache Impact Test-6 - ICHD-3: - International classification of headache disorders, 3rd edition - MCS: - Mental Component Summary (SF-12) - PCS: - Physical Component Summary (SF-12) - SD: - Standard deviation - SF-12: - 12-Item Short Form Health Survey

Acknowledgements

Not applicable. Funding This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. Author information Authors and Affiliations Corresponding author Ethics declarations Ethics approval and consent to participate This study was conducted in accordance with the principles of the Declaration of Helsinki. Ethical approval was obtained from the Mersin University Clinical Research Ethics Committee (approval date: January 8, 2025; approval number: 2025/034). Institutional permission was obtained from Mersin University Hospital prior to data collection. Written informed consent was obtained from all participants prior to participation. Participant confidentiality and data anonymity were strictly maintained. Consent for publication Not applicable. Competing interests The authors declare no competing interests. Additional information Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Supplementary Information Rights and permissions Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/. About this article Cite this article Değirmenci, F., Yildiz, H., Aytan, H. et al. Headache impact and quality of life following endometriosis surgery in women: a single-center observational study. BMC Women's Health (2026). https://doi.org/10.1186/s12905-026-04720-8 Received: Accepted: Published: DOI: https://doi.org/10.1186/s12905-026-04720-8

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MeSH descriptors

Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Headache Headache Headache Headache Headache Headache Headache Migraine Disorders Migraine Disorders Migraine Disorders Migraine Disorders Migraine Disorders

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