Physiological congestions of the thyroid gland are not uncommon during
puberty, painful menstruations, pregnancy, and the menopause. The
=premenstrual= congestion may persist after the menstrual function has
been established, but this is comparatively rare. When the enlargement
remains there is more or less hypertrophy, and it should receive
appropriate treatment. Upper dorsal and cervical lesions are common.
The congestion during =pregnancy= occurs in the majority of cases and
seems to be a physiological process, wherein there is more or less
hypertrophy and hyperplasia, which probably counteracts the waste
products especially caused by this state, or due to the inactivity of
the ovary. During =delivery= the gland may rapidly enlarge and remain
so for an indefinite time. It seems probable that the straining due
to labor may cause lesions of the upper dorsal and neck that will
derange the function of the organ. When the enlargement occurs during
the =menopause= special care should be taken that the goiter is not
malignant.
Other possible causes of congestion are overfatigue, particularly when
associated with heavy lifting; tight clothing about the neck; overuse
of the voice; and in a few cases it may be discovered in boys at
puberty.
The =symptoms= are congestion, the gland being very vascular, either
soft or tense, somewhat painful owing to the tension of the capsule,
and in persistent cases there may be hypertrophy and hyperplasia. The
treatment is the same as given under simple goiter.