Headache related to pregnancy: management of migraine and migraine headache in pregnancy.

Evidence-based treatment algorithms are needed for managing headache during conception, pregnancy, and the postpartum period. Whereas most studies seem to indicate that headaches improve for most women during pregnancy (as estrogen levels increase), this often is not the case in women with more severe, frequent migraine. Few pharmacologic studies include pregnant women, so evidence-based treatments are lacking. Pregnancy registries to record adverse outcomes for various medications and large, population-based studies are needed to analyze the behavior of chronic headache, particularly chronic migraine, during pregnancy. Collaboration between headache specialists and obstetricians is needed to promote research and education for the optimal management of headache during pregnancy.