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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Diagnosing and Managing Hormonally Associated Migraine

Release Date: August 26, 2009
Expiration Date: August 26, 2010



Migraine prevalence is reported as increased in women during their reproductive years, although reported percentages range from 25% to 60%. Sex steroid hormone level fluctuations, especially those associated with estradiol (E2), have been implicated as a primary cause of migraine at time of menses (pure menstrual migraine) or during the menstrual cycle (menstrually related migraine) as well as migraine that occurs at other specific times, as in response to diminished E2 levels following oophorectomy.

In this program, Dr. Aurora discusses the four hypotheses of sex hormone-migraine association and introduces information about the cascade of neurochemical events that occur in response to falling E2 levels. The presentation provides the learner with a basic foundation to better understand treatment strategies for women who may experience migraine associated with menses or for a migraine that occurs as a direct result of falling E2 levels due to an alternate circumstance. This knowledge will, in turn, assist the practitioner in the goal to improve patient outcomes.

Target Audience

This activity is designed for physicians, pharmacists 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 why prevalence of headache in women during their reproductive years is reported within a wide percentage range in the literature
  • Understand the connection between estradiol levels and migraine in women
  • Discuss the four hypotheses of sex-steroids and migraine
  • Differentiate biophysiologic effects that result from sex hormones other than estrogen

General Information

This activity is eligible for credit through August 26, 2010. After this date, this activity will expire and no further credit will be awarded.

Expected time to complete this activity as designed: 15 minutes

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 completing the online self-assessment and evaluation.

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

Faculty Biography

Sheena Aurora, MD
Swedish Headache Center
Seattle, Washington

Dr. Sheena Aurora is past medical director of the Headache Clinic at Henry Ford Hospital in Detroit. She is board certified in neurology and electrodiagnostic medicine and has extensive experience in hyperkinetic-movement disorders including dystonia and dysphonia. In addition to routine electromyograms (EMGs), she also conducts special studies including transcranial magnetic stimulation, autonomic studies, and laryngeal and pudendal EMGs. Dr. Aurora has been widely published and lectures frequently. An experienced researcher, Dr. Aurora was one of the principal investigators of the first migraine program project funded by the National Institutes of Health. Her areas of research include headache, migraine, movement disorders, and various topics in neurophysiology.


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 0.25 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

MediCom Worldwide, Inc. is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. This activity is acceptable for .25 contact hour(s) of Continuing Education Credit. Universal Activity Number:­­­­­­­­ 827-000-09-233-H01-P Knowledge-based CPE activity.


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 Disclosure

The presenting faculty reported the following: Dr. Sheena Aurora has received honoraria from AstraZeneca PLC; Merck & Co. Inc.; GlaxoSmithKline; Ortho-McNeil (Division of Ortho-McNeil-Janssen Pharmaceuticals, Inc.); and Valeant Pharmaceuticals International, as well as consultant fees from Ortho-McNeil; AstraZeneca; Merck; GlaxoSmithKline; Pfizer Inc.; Allergan Inc.; and NMT Medical. She has received grant support related to research activities from Alexza Pharmaceuticals; GlaxoSmithKline; AstraZeneca; Allergan; Winston Laboratories; and Merck.

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. Aurora indicated that her 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.

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.

Americans with Disabilities Act/Special Needs

MediCom Worldwide, Inc. is committed to equality of educational opportunity and does not discriminate against applicants, students, or employees on the basis of race, color, religion, sex, national origin, age, disability, veterans status, or sexual orientation.

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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