Migraine Resource Network is a comprehensive educational initiative for clinicians seeking current and emerging information on migraine headache. Our mission is to provide ongoing medical education that embodies evidence-based scientific data, current treatment strategies, and the insightful knowledge of expert faculty. Our goal is to support your ongoing dedication to optimizing treatment outcomes for your patients.

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The Art and Science of Understanding Menstrual Migraine

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Release Date: August 06, 2009
Expiration Date: August 06, 2010


Menstrual migraine is a chronic disorder affecting approximately 12.6 million women in the United States. The incidence of migraine varies over the course of the menstrual cycle. In the general population, approximately 60% of women with migraine report an increased frequency of headache during menses. In spite of its widespread prevalence, menstrual migraine often goes undiagnosed. Characteristics of menstrual migraine, which include functional disability, increased headache severity, and lack of aura, are often overlooked, resulting in missed or underdiagnosis.

A critical step in diagnosis of menstrual migraine is identifying co-occurrence of migraine in association with menses. Communication between health care provider and patient is essential to establishing a comprehensive headache history and necessary for accurate diagnosis of menstrual migraine

By educating practitioners on important communication strategies and recognizing characteristic patterns and common triggers associated with menstrual migraine, prompt, acute, or preventive therapy may be used to effectively manage the disorder and reduce its related disability.

Target Audience

This activity is designed for physicians, pharmacists, advanced practice nurses, nurses, and other allied health professionals with an interest in the management of migraine.

Learning Objectives

After completion of this educational activity, participants will be able to:

  • Recognize menstrual migraine in the differential diagnosis of headaches
  • Understand basic pathophysiology of menstrual migraine and how fluctuating hormone levels affect female migraine patients
  • Explain communication strategies which clinicians can utilize to maximize their effectiveness in diagnosing and treating menstrual migraine patients
  • Describe pharmacologic and nonpharmacologic options for menstrual migraine treatment

General Information

This activity is eligible for credit through August 6, 2010. After this date, this activity will expire and no further credit will be awarded.

There are no fees for participating in this activity. All participants must complete the Online Activity Evaluation. Participants must receive a minimum score of 70% on the self-assessment portion of the form to qualify for CE credit. Certificates may be printed immediately after successfully completing the online self-assessment and evaluation.

This activity is supported by an educational grant from Endo Pharmaceuticals
Endo Pharmaceuticals

Faculty Biographies

Norman M. Gordon, MD – Chairman
Clinical Associate Professor
Department of Neurosciences
Brown University
Chief of the Division of Neurology, Miriam Hospital
Providence, Rhode Island

Dr. Norman Gordon obtained his medical degree at the University of the Witwatersand, Johannesburg, South Africa. He completed his residencies in internal medicine and in neurology at Brown University, Providence, Rhode Island. Dr. Gordon is chief of the Division of Neurology at the Miriam Hospital, and clinical associate professor of neuroscience at Brown University. He is the director of the Miriam Hospital Cognitive Disorders Clinic and is also in private practice in adult neurology in Providence.

Dr. Gordon is board certified in internal medicine and neurology and is a member of numerous medical associations, including the American Academy of Neurology, National Headache Foundation, American Headache Society, and serves on the Rhode Island Medical Society Council. He has participated as primary investigator and co-investigator in multiple clinical studies in many neurologic conditions, particularly headache, pain, dementia and stroke.

Kathleen (Cas) Cahill, DNP, ARNP
Assistant Professor, College of Nursing
University of South Florida
Consultant, Headache/Pain Management Center
Tampa General Hospital
Tampa, Florida

Dr. Cas Cahill earned her doctorate in nursing practice from the University of South Florida College of Nursing in Tampa. She is engaged in practice at Tampa General Hospital where she treats patients with headaches and pain. She is also an assistant professor at the University of South Florida College of Nursing where she designs the clinical education for undergraduate nursing students; teaches evidence-based practice, the neurology component of the NP primary care course, and pediatric neurology.

Dr. Cahill is a member of the American Headache Society where she was elected to the position of NP chair of the NP/PA special interest section. She is also a member of the American College of Nurse Practitioners, and has published and lectured both nationally and internationally on the topic of headache and its management. Her poster presentation of an outcomes paradigm on interdisciplinary headache management was selected for presentation at the International Headache Research Symposium in Denmark. Dr. Cahill was recently awarded a $3.5 million grant from the VA to establish the VA Nursing Academy at the USF CON where she is the director.


MediCom LogoCME Credit
Accreditation Statement: MediCom Worldwide, Inc. is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
Designation Statement: MediCom Worldwide, Inc. designates this educational activity for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

ACPE LogoCPE Credit
MediCom Worldwide, Inc. is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. This activity is acceptable for 1 contact hour(s) of Continuing Education Credit. Universal Activity Number: 827-000-09-227-H01-P Knowledge-based CPE activity.

MediCom LogoNursing Credit
Accreditation Statement: MediCom Worldwide, Inc., 101 Washington Street, Morrisville, PA 19067 is approved by the California Board of Registered Nursing, Provider Number CEP11380. MediCom designates this CNE activity for 1.0 contact hour.
Program Number: 09-227-224


In accordance with the Accreditation Council for Continuing Medical Education (ACCME), ACPE and California Board of Nursing, MediCom Worldwide, Inc. requires that all program planners, faculty, and providers who are in a position to control the content of a CE activity are required to disclose any relevant financial relationships they may have or have had within the last 12 months with the commercial supporter or the manufacturer(s) of any commercial device(s) discussed in this educational activity. Accordingly, the following disclosures were made.

Faculty Disclosures

The presenting faculty reported the following: Dr. Norman Gordon and Dr. Cas Cahill have disclosed that they have no significant relationships with the grantor Endo Pharmaceuticals or any other commercial company whose products and services may be related to their presentations.

Provider Disclosures

The individuals listed below from MediCom Worldwide, Inc. reported the following for this activity: Joan Meyer, executive director; Norma Jean Talley, manager, professional education; and Ruth Widmer, medical editor, have nothing to disclose.

Off-Label/Investigational Disclosures

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The opinions expressed in the educational activity are those of the faculty. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings. Further, attendees/participants should appraise the information presented critically and are encouraged to consult appropriate resources for any product or device mentioned in this program.

Dr. Gordon indicated that his presentation would not include the discussion of unlabeled uses of commercial products or investigational products not yet approved by the FDA for any use in the United States.

Dr. Cahill indicated that her presentation would include the discussion of unlabeled uses of commercial products or investigational products not yet approved by the FDA for the treatment of menstrual migraine in the United States.

Conflict of Interest Resolution

To resolve identified conflicts of interest, the educational content was fully peer reviewed by members of the MediCom Content Review Committee. The resulting certified activity was found to provide educational content that is current, evidence-based, and commercially balanced.

Hardware/Software Requirements

MediCom Worldwide, Inc. requires Internet Explorer® version 7.0 or higher, or Firefox 3.0 or higher, a computer running Windows® XP, Windows® Vista, or Mac OS X, 512MB of RAM or greater, 1.5 GHZ or faster processor, and a screen resolution of 1024x768 or higher. Certain educational activities may require additional software to view. These activities will be marked with the information and/or links to the required software. That software may be Adobe® Flash® Player, Adobe® Acrobat®, or Windows Media® Player.

©2009 MediCom Worldwide, Inc., 101 Washington St., Morrisville, PA 19067.

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