The Connection Between Reproductive, Neurological & Ocular Health

Endometriosis is diagnosed by a gynecologist. Migraine is managed by a neurologist. Dry eye is treated by an eye doctor. For most of the last century that division made sense, because the three conditions appeared to have very little to do with one another. 

That assumption is now being reconsidered. Endometriosis is increasingly described as a systemic disease rather than a purely pelvic one, with inflammatory activity and altered immune signaling documented well outside the reproductive tract. Studies have linked it to migraine, to autoimmune conditions including Sjögren’s syndrome, and to disease of the ocular surface. Neurology research continues to clarify how estrogen fluctuation and inflammatory mediators act on pain pathways that also carry sensation from the eye. 

None of this is settled. Much of the work is observational, the sample sizes are often small, and association is not causation. But the pattern has become consistent enough that treating these conditions in three separate rooms is starting to look like a limitation rather than a standard.

Dr. Karli Provost Goldstein, Dr. Inna Lazar, and Dr. Olivia Begasse de Dhaem will walk through what the evidence currently supports, where it does not yet reach, and which symptoms should prompt a conversation between specialties.

Our multidisciplinary panel will discuss: 

• The case for treating endometriosis as a whole-body disease 

• What is established about the migraine overlap, and what is still speculative 

• Why the tear film responds to hormones at all 

• Central sensitization, and why years of pain lower the threshold for pain elsewhere 

• Migraine with visual aura versus retinal migraine, and why the distinction changes the workup 

• The referral triggers each specialty wishes the others knew 

• What patients can reasonably ask of a care team today