Migraine Is Associated With High Risk of Erectile Dysfunction: A Systematic Review and Cumulative Analysis

Is sexual function impaired in patients with primary headaches? A systematic review of observational studies

INTRODUCTION

Primary headaches, particularly migraine and tension-type headaches, as chronic and painful conditions, have a significant impact on individuals' health and overall quality of life, including aspects such as sexual health parameters.

OBJECTIVES

The aim of this study was to review observational studies and to summarize the presence of sexual dysfunction in patients with primary headache and to discern whether it is more common in patients with primary headache than in healthy control subjects.

METHODS

Observational studies published between January 1, 2000, and May 21, 2023 were searched in Medline (PubMed), Web of Science, Scopus, and EBSCO. This review included 23 observational studies that evaluated sexual dysfunction with or without comparison with healthy control subjects.

RESULTS

As a result, the mean Female Sexual Function Index score, a score of <26.55 indicating sexual dysfunction, ranged from 19.25 ± 8.18 to 27.5 ± 7.5 in patients with primary headache. The prevalence of sexual dysfunction and erectile dysfunction was found to be between 10.7% and 93.75% in female patients and between 54.83% and 80% in male patients. Both migraineurs and tension-type headache sufferers had statistically significantly lower sexual function scores in females and lower erectile function scores in males compared with healthy control subjects.

CONCLUSION

Sexual function is significantly affected in patients with primary headache, which is a chronic painful disorder. Therefore, it is very important to ask these patients about their sexual health and, if necessary, to seek support from a sexual health professional. Additionally, future studies may prioritize tension-type headaches and male patients due to the limited amount of research available on these subjects.

Association between severe headache or migraine and erectile dysfunction in American adults: a cross-sectional of data study from the NHANES

Currently, few studies have explored the relationship between severe headache or migraine and erectile dysfunction (ED). The aim of our study was to assess the association between severe headache or migraine and ED in adult men in the US from the National Health and Nutrition Examination Survey (NHANES). We used data from two separate NHANES datasets for the analysis: 2001-2002 and 2003-2004. We used multiple logistic regression, subgroup analysis, and sensitivity analyses to assess the relationship between severe headache or migraine and ED. From 2001 to 2004, 3117 adult male participants (582 ED patients, 2535 non-ED patients) were identified. Categorical and continuous variables are described using counts and frequencies and means and standard errors, respectively. For continuous variables, the two groups were compared using survey-weighted linear regression, while for categorical variables, survey-weighted chi-square tests were performed. Multiple logistic regression analysis showed that in the fully adjusted Model 3, severe headache or migraine was statistically significantly associated with ED (OR 1.51; 95% CI 1.14-1.99; P = 0.0036). In the fully adjusted Model 3, the results of the subgroup analysis showed that an age of 40-60 years (OR = 1.55, 95% CI: 1.05, 2.31, P = 0.029), a body mass index (BMI) < 25 kg/m2 (OR = 1.68, 95% CI: 1.02, 2.75, P = 0.0406) or ≥30 kg/m2 (OR = 1.65, 95% CI: 1.07, 2.54, P = 0.022), hypertension (OR = 1.78, 95% CI: 1.22, 2.60, P = 0.0029), diabetes mellitus (OR = 1.71, 95% CI: 1.26, 2.31, P < 0.001), CVD (OR = 1.54, 95% CI: 1.12, 2.10, P = 0.011) and hyperlipidemia (OR = 1.83, 95% CI: 1.07, 3.13, P = 0.028) were associated with ED with severe headache or migraine. This study demonstrated a statistically significant association between severe headache or migraine and ED among adult men in the US. However, the results of the study should be interpreted with caution due to the failure to assess the effects of depression and anxiety on the outcomes.

Sexual Functioning Among Adults with Chronic Pain: Prevalence and Association with Pain-Related Outcomes

BACKGROUND

Prior research indicates that sexual functioning and chronic pain commonly coexist and impact each other; however, there are limitations in current research as to the prevalence and severity of sexual dysfunction in patients with chronic pain.

METHOD

This study used detailed measures across multiple domains of sexual functioning to describe the prevalence and correlates of self-reported sexual functioning among individuals with chronic pain presenting for treatment at a multidisciplinary pain management center (N = 247). Domains included sexual interest, satisfaction with sexual functioning, vaginal lubrication, vaginal discomfort, and erectile function. Individuals with and without sexual dysfunction were compared on pain-related outcome variables.

RESULTS

Results from this study showed a high prevalence of sexual dysfunction in populations with chronic pain and a positive association between sexual problems and pain severity and psychological concerns. Sex differences were noted, with female participants exhibiting significantly lower sexual satisfaction associated with higher levels of pain, pain-related life interference, depression, and anxiety, whereas these relationships were not significant for male participants.

CONCLUSION

Findings demonstrated that patients with chronic pain experience significant sexual dysfunction, including lack of interest in sexual activity and low satisfaction with their sex lives. Compared with patients without sexual dysfunction, patients with sexual dysfunction reported higher average pain levels and higher depressive symptoms, along with greater anxiety in patients with at least one area of sexual dysfunction. Adding to these findings are the pain-relevant correlates of sexual functioning domains and sex differences in these relationships, with women experiencing additional pain-related problems. Limitations and future research directions are discussed.