Headache has been associated with disorders of the thyroid and pituitary glands and fluctuations in estrogen levels associated with menstruation, pregnancy, menopause, and the use of hormonal contraceptives. Severe headache can be a striking presenting feature of thyrotoxicosis. Pituitary disease is associated with a wide range of headache phenotypes. Many migrainous women experience menstrual migraine mainly at the time of menses. Migraine may worsen during the first trimester of pregnancy, although many women become headache free during the last 2 trimesters. Migraine prevalence decreases with advancing age but may regress or worsen at menopause.
Relationship Disclosure: Dr Silberstein serves on the advisory panel, speakers bureau, or as a consultant for AGA Medical Corporation, Allergan, Inc., CAPNIA, Inc., Endo Pharmaceuticals, GlaxoSmithKline, MAP, Medtronic, Inc., Merck & Co, Inc., Minster Pharmaceuticals plc, NuPathe Inc., Pfizer Inc, Valeant Pharmaceuticals, Inc., and Vyteris, Inc. Dr Silberstein has received honoraria from Current Pain and Headache. Dr Silberstein receives research support from AGA Medical Corporation, Advanced NeuroModulation Systems, Inc., Allergan, Inc., Boston Scientific Corporation, Coherex Medical, Endo Pharmaceuticals, GlaxoSmithKline, Eli Lilly & Company, MAP, Medtronic, Inc., Merck & Co, Inc., NuPathe, Inc., and Valeant Pharmaceuticals, Inc.
Unlabeled Use of Products/Investigational Use Disclosure: Dr Silberstein discusses the use of unlabeled products for the treatment of headache.