Tietjen, Gretchen E, Bushnell, Cheryl D, Herial, Nabeel A et al. · Headache · 2007 · DOI
This study found that women with migraines who also have endometriosis (a painful condition affecting the uterus) experience more frequent and severe headaches than women with migraines alone. Women with both conditions were also more likely to have other related conditions like chronic fatigue syndrome, anxiety, and bladder pain. The findings suggest these conditions may share common underlying factors, possibly related to hormones.
This study is relevant to ME/CFS patients because it documents that CFS is significantly more prevalent in women with both migraine and endometriosis (3.6-fold higher odds), suggesting shared pathophysiological mechanisms—possibly hormonal dysregulation, central sensitization, or neuroinflammation. Understanding these comorbidity patterns may help researchers identify common etiologic factors and clinicians recognize underdiagnosed conditions in complex patient presentations.
This study does not establish causation or explain why endometriosis, migraine, and CFS co-occur; it only documents higher prevalence in women with multiple conditions. The cross-sectional design cannot determine temporal relationships or whether one condition predisposes to others. Additionally, the study relies on self-reported endometriosis diagnosis without surgical confirmation, which may underestimate or misclassify true prevalence.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Tietjen, Gretchen E, Bushnell, Cheryl D, Herial, Nabeel A, Utley, Christine, White, Leah, & Hafeez, Faizan (2007). Endometriosis is associated with prevalence of comorbid conditions in migraine.. Headache. https://doi.org/10.1111/j.1526-4610.2007.00784.x
BibTeX
@article{mecfsatlas-tietjen-2007-endometriosis-associated,
author = {Tietjen, Gretchen E and Bushnell, Cheryl D and Herial, Nabeel A and Utley, Christine and White, Leah and Hafeez, Faizan},
title = {Endometriosis is associated with prevalence of comorbid conditions in migraine.},
journal = {Headache},
year = {2007},
doi = {10.1111/j.1526-4610.2007.00784.x},
note = {PubMed: 17635599},
url = {https://www.mecfsatlas.com/evidence/tietjen-2007-endometriosis-associated},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/tietjen-2007-endometriosis-associated
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