Migraine Management in Women Across the Cycles of Care

To update clinicians on the effectiveness of migraine management in women throughout the lifecycle, the American Medical Women’s Association aims to create a 90-minute webinar and companion podcast on treatment advances for effective migraine treatment in women. The proposed program will give consideration to the sex differences in migraines as affects women and the need to treat patients aggressively throughout their lives, particularly during post-menopause. And expert faculty will be convened to address this neglected area of clinical practice. The program includes an enduring webcast, a podcast to reach physicians on the go, and distribution to significantly extend the reach and broaden the audience to primary care, family physicians, and specialists.

Launch Date: 6/16/2021
Expiration Date: 6/16/2022

1. Identify 4 key influences of environmental triggers, genetic predisposition, and sex differences in the development of this neurological, chronic migraine condition
2. Describe bidirectional relationship between migraine and comorbid conditions that commonly occur in women
3. Identify risk of migraine during different stages of a woman’s life, particularly during the menopausal transition
4. Indicate preferred management strategies (ie, diet, neurostimulation), pharmacologic therapies, and combination approaches for individual patients.

References:

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·       Lipton RB, et al. Reduction in perceived stress as a migraine trigger: testing the "let-down headache" hypothesis. Neurology. 2014;82(16):1395-1401. doi:10.1212/WNL.0000000000000332

·       Vives-Mestres M, et al. Patterns of Perceived Stress Throughout the Migraine Cycle: A Longitudinal Cohort Study Using Daily Prospective Diary Data. Headache. 2021;61(1):90-102. doi:10.1111/head.13943

·       McEwen BS. Allostasis and the Epigenetics of Brain and Body Health Over the Life Course: The Brain on Stress. JAMA Psychiatry. 2017;74(6):551-552. doi:10.1001/jamapsychiatry.2017.0270

·       Tietjen GE, et al. Childhood Maltreatment in the Migraine Patient. Curr Treat Options Neurol. 2016;18(7):31.

·       Anda R, Tietjen G, Schulman E, Felitti V, Croft J. Adverse childhood experiences and frequent headaches in adults. Headache. 2010;50(9):1473-1481. doi:10.1111/j.1526-4610.2010.01756.x

·       Tietjen GE,. Recalled maltreatment, migraine, and tension-type et al headache: results of the AMPP study. Neurology. 2015;84(2):132-140. doi:10.1212/WNL.0000000000001120

·       Tietjen GE, Karmakar M, Amialchuk AA. Emotional Abuse History and Migraine Among Young Adults: A Retrospective Cross-Sectional Analysis of the Add Health Dataset. Headache. 2017;57(1):45-59. doi:10.1111/head.12994

·       Gordon-Smith K, et al. Migraine associated with early onset postpartum depression in women with major depressive disorder .Arch Womens Ment Health. 2021;10.1007/s00737-021-01131-6. doi:10.1007/s00737-021-01131-6

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·       Martin VT, et al. Perimenopause and Menopause Are Associated With High Frequency Headache in Women With Migraine: Results of the American Migraine Prevalence and Prevention Study. Headache. 2016;56(2):292-305.

·       Vetvik KG, MacGregor EA. Sex differences in the epidemiology, clinical features, and pathophysiology of migraine. Lancet Neurol. 2017;16(1):76-87. doi:10.1016/S1474-4422(16)30293-9

·       Minen MT, Weissman J, Tietjen GE. The Relationship Between Migraine or Severe Headache and Chronic Health Conditions. Pain Med. 2019;20(11):2263-2271. doi:10.1093/pm/pnz113

·       Burch RC, Buse DC, Lipton RB. Migraine: Epidemiology, Burden, and Comorbidity. Neurol Clin. 2019;37(4):631-649.

·       Buse DC, Reed ML, Fanning KM, et al. Comorbid and co-occurring conditions in migraine and associated risk of increasing headache pain intensity and headache frequency. J Headache Pain. 2020;21(1):23.

·       Minen MT, Begasse De Dhaem O, Kroon Van Diest A, et al. Migraine and its psychiatric comorbidities. J Neurol Neurosurg Psychiatry. 2016;87(7):741-749. doi:10.1136/jnnp-2015-312233

·       Tietjen GE, et al. Migraine comorbidity constellations. Headache. 2007;47(6):857-865.

·       Lipton RB, Fanning KM, Buse DC, et al. Migraine progression in subgroups of migraine based on comorbidities: Results of the CaMEO Study. Neurology. 2019;93(24):e2224-e2236. doi:10.1212/WNL.0000000000008589

·       Tietjen GE, Brandes JL, Peterlin BL, et al. Childhood maltreatment and migraine (part III). Association with comorbid pain conditions. Headache. 2010;50(1):42-51. doi:10.1111/j.1526-4610.2009.01558.

·       Tietjen GE, Maly EF. Migraine and Ischemic Stroke in Women. A Narrative Review. Headache. 2020;60(5):843-863.

·       Evans RW, Burch RC, Frishberg BM, et al. Neuroimaging for Migraine: The American Headache Society Systematic Review and Evidence-Based Guideline. Headache. 2020;60(2):318-336. doi:10.1111/head.13720

·       Marmura MJ, Silberstein SD, Schwedt TJ. The acute treatment of migraine in adults: the american headache society evidence assessment of migraine pharmacotherapies. Headache. 2015;55(1):3-20. doi:10.1111/head.12499

·       Loder E, Burch R, Rizzoli P. The 2012 AHS/AAN guidelines for prevention of episodic migraine: a summary and comparison with other recent clinical practice guidelines. Headache. 2012;52(6):930-945.

·       Tepper SJ. Acute Treatment of Migraine. Neurol Clin. 2019;37(4):727-742. doi:10.1016/j.ncl.2019.07.006    

·       Burch R. Migraine and Tension-Type Headache: Diagnosis and Treatment. Med Clin North Am. 2019;103(2):215-233.

·       Digre KB. What's New in the Treatment of Migraine?. J Neuroophthalmol. 2019;39(3):352-359. doi:10.1097/WNO.000000000000083   

·       Wells RE, Beuthin J, Granetzke L. Complementary and Integrative Medicine for Episodic Migraine: an Update of Evidence from the Last 3 Years. Curr Pain Headache Rep. 2019;23(2):10. doi:10.1007/s11916-019-0750-8

·       Broner SW, Bobker S, Klebanoff L. Migraine in Women. Semin Neurol. 2017;37(6):601-610. doi:10.1055/s-0037-1607393

·       Todd C, Lagman-Bartolome AM, Lay C. Women and Migraine: the Role of Hormones. Curr Neurol Neurosci Rep. 2018;18(7):42. doi:10.1007/s11910-018-0845-3

·       Allais G, Chiarle G, Sinigaglia S, Benedetto C. Menstrual migraine: a review of current and developing pharmacotherapies for women. Expert Opin Pharmacother. 2018;19(2):123-136.

·       doi:10.1080/14656566.2017.1414182

·       Ansari T, Lagman-Bartolome AM, Monsour D, Lay C. Management of Menstrual Migraine. Curr Neurol Neurosci Rep. 2020;20(10):45. doi:10.1007/s11910-020-01067-x

·       Burch R. Epidemiology and Treatment of Menstrual Migraine and Migraine During Pregnancy and Lactation: A Narrative Review. Headache. 2020;60(1):200-216. doi:10.1111/head.13665

·       Saldanha IJ, Roth JL, Chen KK, et al. Management of Primary Headaches in Pregnancy. Rockville (MD): Agency for Healthcare Research and Quality (US); November 2020.

·       Wells RE, Turner DP, Lee M, Bishop L, Strauss L. Managing Migraine During Pregnancy and Lactation. Curr Neurol Neurosci Rep. 2016;16(4):40. doi:10.1007/s11910-016-0634-9

·       Martin VT. Migraine and the menopausal transition. Neurol Sci. 2014;35 Suppl 1:65-69. doi:10.1007/s10072-014-1745-1

·       MacGregor EA. Menstrual and perimenopausal migraine: A narrative review. Maturitas. 2020;142:24-30. doi:10.1016/j.maturitas.2020.07.005

·       MacGregor EA. Migraine, menopause and hormone replacement therapy. Post Reprod Health. 2018;24(1):11-18. doi:10.1177/2053369117731172

For questions about accessibility or to request accommodations please contact the IUSM CME office at 317-274-0104 or [email protected]. One week advance notice will allow us to provide seamless access. Please ensure to specify the accommodations you need in order to participate.