Migraines During Pregnancy When To Worry

Never Be Afraid To Consult Your Doctor

If you have a very severe headache or one that comes on very quickly, it is best to consult your doctor. Its better to be safe than sorry. One phone call can give you that peace of mind.

Remember, headaches are a normal part of pregnancy, so try not to become alarmed every time you develop one.

Take Note

Migraine During Pregnancy Remedies

If you experienced migraines before pregnancy, its a good idea to talk to your doctor or midwife about strategies to put in place beforehand. Know your triggers and avoid them.

If you have an unexpected migraine, you might wonder what you can do to alleviate the pain. You might like to try any of these remedies:

• Rest in a dark room
• Apply a cold compress or ice pack to your forehead or neck
• Drink plenty of water, using pregnancy-friendly electrolytes
• Use relaxation techniques
• Make sure you get enough sleep.

Treatment Options During Pregnancy

Certain medications used for migraine treatment and prevention are contraindicated for pregnancy, due to safety concerns for the developing fetus. For patients who use oral contraceptives to regulate their hormone levels and manage migraine, having a conversation about migraine treatment options may happen when they want to go off of birth control and start trying to conceive. The good news is there are safe options for migraine prior to and during pregnancy.

Im always telling my patients, either preconception or patients that are pregnant, that we recommend in general to use the number of different medications for anything that were treating, Dr. Grossman says. And also, of course, the lowest dose possible that we can use in pregnancy and preconception is what we recommend. Her first-line treatment is non-medication options, and she then layers in other treatments as needed.

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Should I Go To The Er For Migraine Headaches While Pregnant

If you have a mild headache, you can contact your midwife or doctor for medical advice. They can advise which course of treatment would be best for you for example, taking paracetamol and using any of the remedies suggested above.

If you have a severe persistent headache, however, accompanied by blurry vision, dizziness and swelling in your hands, feet, and face, seek immediate medical attention.

These might be the warning signs of preeclampsia. This condition is often associated with high blood pressure and is dangerous to you and your baby.

You can read more in Preeclampsia | Signs, Symptoms And Causes.

Pregnancy Can Have A Significant Impact On Migraine Symptoms And How Women Should Treat Them Heres What Experts Have To Say

First, the good news: Between 50 and 80% of pregnant migraine patients actually experience a reduction in migraine attacks during their pregnancy, according to David Dodick, a professor of medicine at the Mayo Clinic School of Medicine in Arizona. Many doctors believe rising estrogen levels help reduce migraine frequency and intensity. Hormone replacement therapy that mimics pregnancys effect on the body is increasingly being used in migraine treatment plans, especially for those who experience migraines around the time of menstruation. Caution does need to be used however in women who have migraines with aura, as the increased risk of stroke may further be increased by the addition of an estrogen-containing oral contraceptive pill.

However, some women experience migraine for the first time during pregnancy and some experience an increase in migraine symptoms especially during the first trimester. The appearance or worsening of migraine in pregnant women should be taken very seriously: Studies show that migraine symptoms, when accompanied by high blood pressure, can increase the risk of developing preeclampsia or other vascular complications. Women whose migraine symptoms dont decrease during pregnancy should be particularly vigilant. Its important to work with your obstetrician and your headache doctor when you have migraine to establish a safe treatment plan.

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Migraines When To Worry

Pregnant women who have high blood pressure might experience severe pain from migraine headaches.

You might have high blood pressure at any time in your pregnancy and it pays to check this at regular intervals throughout your pregnancy.

More common in the second and third trimesters, high blood pressure can be accompanied by flashing lights in the eyes or blurred vision and sternal pain.

Left untreated, it can lead to preeclampsia, as mentioned above. Severe preeclampsia, also called HELLP Syndrome, could be another reason for migraines in pregnancy.

Migraine Triggers During Pregnancy

Hormonal change is a common trigger for women with migraine. During pregnancy, oestrogen levels increase sharply, while progesterone levels decrease and rise again towards the end of the pregnancy.

Overall migraine improves during pregnancy especially during the second and third trimesters. This improvement may be due to the increased oestrogen levels and increased levels of natural pain-killing hormones .

These hormones are several times higher during pregnancy, and though the relief from migraine attacks they provide might last the whole pregnancy, the levels settle back down after delivery, normally allowing migraine attacks to return.

However, not everyone will see an improvement in their migraine, especially in the early weeks of pregnancy. For some women, their migraine is unaffected. Some women experience worsening migraine during pregnancy although this is rare.

During breastfeeding, stable oestrogen levels continue to be protective against having headache again after pregnancy.

However you are affected, it can help to identify any migraine attack triggers that you have, such as lack of sleep, stress, missed meals and dehydration. Keeping a headache diary may help pinpoint your triggers so you can avoid those things. Log when the headache happened, what triggered it, and how long it lasted. Common triggers include but are not limited to:

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Relax In A Dark Quiet Room

Its not enough to just lie down on the couch and watch TV in most cases, as screens will only make matters worse. Instead, close the blinds and turn off the lights and just rest.

You can try and sleep it off, and use a cold compress on your neck and/or forehead for even better relief. This will help with the hot flashes you may feel from a migraine.

Chronic Migraines And Pregnancy

Chronic migraines mean youre having headaches on a regular, persistent basis.

This can be very debilitating as often you are already fatigued during pregnancy, and the symptoms of migraines can make life much harder to deal with.

It can affect your ability to function, work and even cope with regular day-to-day tasks.

Please reach out to your doctor or midwife if youre experiencing regular migraines during pregnancy. They can discuss potential triggers, check everything is going well with you and your baby, and prescribe medication as preventatives, if needed.

The medication treatment regimens are outlined above, along with some simple tips to relieve your migraine symptoms.

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When To Call The Doctor About Headaches During Pregnancy

Many women, even those who haven’t previously experienced a lot of everyday headaches, will get them during pregnancy. The vast majority of pregnancy headaches are primary meaning your head hurts, but theres nothing serious or anything to worry about.

But if your headaches persist for more than two or three hours or you have other symptoms , let your practitioner know right away.

In rare cases, so-called secondary headaches signal something else going on in your body, such as hypertension or risk factors for preeclampsia, and youll want to make sure you get both the headaches and the underlying conditions taken care of ASAP.

From the What to Expect editorial team and Heidi Murkoff, author of What to Expect When You’re Expecting. What to Expect follows strict reporting guidelines and uses only credible sources, such as peer-reviewed studies, academic research institutions and highly respected health organizations. Learn how we keep our content accurate and up-to-date by reading our medical review and editorial policy.

Headaches During Pregnancy: When To Worry

Everyone experiences a headache from time to time, and pregnant women are no exception. For most people, most of the time, headaches are innocuous. The same is true for pregnant women–most of the time. But in some cases, headaches during pregnancy can be a symptom of a more serious medical problem that requires immediate medical attention. For this reason, it is important to understand the different types of headaches, what causes headaches, and when to seek urgent care for headaches.

Types of Headaches

Pregnant women experience the same types of headaches as other people, such as:

• Migraine headaches: debilitating headaches that may last for days. They may be accompanied by sensitivity to light and sound.
• Sinus headaches: pressure and pain in the forehead and sinus areas caused by mucus buildup, possibly due to allergies.
• Cluster headaches: a series of one to four headaches, one after another, that cause intense pain and may last for 15 minutes to three hours each. That pain may be felt behind the eyes or on one side of the face and may be accompanied by swelling, flushing, sweating, nasal congestion, and eye tearing on the affected side of the face.
• Tension headaches: diffused dull, aching pain throughout the head that may be accompanied by tenderness in the neck and shoulder muscles, forehead, and scalp.

What Causes Headaches in Pregnant Women?

• Hormonal fluctuations
• Muscle tension in the head, neck, and back
• Sinus congestion

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When To Worry: Headache During Pregnancy

For a study published in the journal Neurology, doctors at Montefiore Health System and Albert Einstein College of Medicine in the Bronx, N.Y., analyzed the medical records of pregnant women with headaches over a five-year period. “We studied a large number of pregnant women presenting with severe headache attacks to the emergency and hospital setting,” the study’s lead author, Matthew S. Robbins, M.D., says. “We found that over one-third of the patients we evaluated had headache as a symptom of a separate underlying condition such as preeclampsia, rather than a more benign cause of headache such as migraine.”

Headaches have already been known to be associated with preeclampsia. But the researchers also found other factors in the women who went on to be diagnosed with the condition. Those women who had high blood pressure in addition to a headache were 17 times more likely to have preeclampsia than those who didn’t have high blood pressure. And women who didn’t have a previous history of headaches were five times as likely to have an underlying condition. Knowing this can help doctors decide when to raise the red flag. “The presence of these factors in such patients may lead doctors to order diagnostic tests, such as a brain MRI, and monitor the patients closely for further signs of preeclampsia,” Robbins says.

Natural Remedies For Pregnancy Migraines:

During the first three months the symptoms of pregnancy can make your migraine worse. Morning sickness can mean that you feel like eating and drinking less which can cause low blood sugar and dehydration. If you are not careful this can make your migraines worse. You should try to eat small frequent meals and drink frequent small amounts of water to prevent this. You will also be helping reduce any pregnancy sickness. Other remedies may include:

• Dark Room Often, a migraine can make you sensitive to bright lights. Find a dark room, and turn off any electronics.
• Nap Lying down to take a short nap can help alleviate migraines. Many people report that an hour nap is often enough to stop the pain.
• Cold Pack While lying down, place a cold pack or damp towel on your head. The cold should constrict blood vessels in your head and help alleviate the pain.
• Relaxation Techniques Talk to your doctor about relaxation exercises that are safe during pregnancy. Relaxing the muscles around your back, neck, and head can release the pressure causing the migraine.
• Take care of yourself Sometimes, migraines can be set off by dehydration, tiredness, not eating well, or lack of sleep. Try to maintain a healthy, balanced lifestyle, which can help mitigate the symptoms of migraines.

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What Do I Do If I Have A Migraine In Pregnancy

If youve never had a migraine call your midwife, doctor or hospital maternity unit. Serious conditions like pre-eclampsia can be like a migraine, so although its unlikely anything is wrong, your healthcare team may want to see you.

If you have always had migraines, you may find that they get better during your pregnancy. But pregnancy can also change the nature of migraines, so if you have a migraine that feels different to what youve had before, call your midwife, doctor or hospital maternity unit.

What Causes Headaches In Pregnancy

The exact cause of a headache isnt always clear. In the first trimester, changing hormone levels and blood volume may play a role. A dull, overall headache can come with stress, fatigue, and eyestrain. Sinus headaches may be more likely because of the nasal congestion and runny nose that are common in early pregnancy. Hunger and low levels of blood sugar can trigger headaches, too. Women who suddenly stop their morning coffee and sodas may experience caffeine withdrawal headaches. Those who also suffer with nausea and vomiting in early pregnancy can become dehydrated. This can also bring on a headache.

Migraine headaches are a common type of headache in pregnancy. These painful, throbbing headaches are usually felt on one side of the head and result from expansion of the blood vessels in the brain. The misery is sometimes accompanied by nausea, vomiting, and sensitivity to light. A small percentage of women with migraines also have an aura with the migraine. They see flashes of light or feel tingling in their arms and legs.

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When Will Your Headaches End

Your headaches are caused by other factors, typically pregnancy-related symptoms.

You dont have control over your hormones, but you can try to decrease stress and fatigue. If you can maintain these, you can help rid yourself of headaches.

The good news is that the hormone estrogen is probably the culprit for headaches. Once you reach your second trimester, your headaches should improve as your body adjusts to the higher estrogen levels .

Once you deliver that bundle of joy, your hormone levels will begin to go back to normal, and you should see a significant decrease in your headaches.

How Is A Migraine Treated During Pregnancy

The first trimester generally provides a good idea about whether a woman experiences migraines, as well as the best way to treat them. If a pregnant woman experiences a migraine attack, she should see her physician. Then, this woman and her physician can determine how to address migraine pain.

Preventative migraine medications are typically not recommended for use during pregnancy. These medications sometimes cause nausea and vomiting to worsen during pregnancy. They can also increase a pregnant womans risk of experiencing dehydration.

In one study, researchers indicated pregnant women should first use nondrug therapies to help treat migraine pain. These therapies may include relaxation, sleep and massage, along with the use of ice packs and biofeedback therapy. Following the use of nondrug therapies, pregnant women may consider paracetamol as the initial drug treatment for migraine pain. The risks of using aspirin and ibuprofen to treat migraine pain are usually lower than those associated with other types of migraine medications thus, pregnant women may sometimes use aspirin and ibuprofen to address a migraine attack.

Furthermore, pregnant women may use the antipsychotic medication prochlorperazine to treat nausea associated with a migraine. Research shows that prochlorperazine is unlikely to put a woman in danger during pregnancy and helps alleviate nausea.

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Why Does My Head Hurt

Some pregnant people often experience tension headaches during the first trimester. “It’s most likely because of fluctuations in hormones,” says Sheena Aurora, M.D., director of the Swedish Headache Center, in Seattle. “By the second trimester,” she says, the pain subsides because “the hormones are steadily high.”

Of course, there are many other possible reasons for your throbbing head. Ask yourself, ‘Are my headaches being stimulated by something in my diet?’ says Lillian Schapiro, M.D., an OB-GYN in Atlanta. ‘What medications am I taking? What time of day are they happening? Is there anything I can change?’

In the third trimester, when you’re carrying the additional weight of your growing baby, consider whether positional changes might be a factor in your headaches. For instance, strain on your neck and shoulders could lead to muscle spasms, which can irritate nerves in the back of your head. Or you might develop muscle tightening and spasms from sleeping with your head in an unnatural position.

Symptoms Of Migraines During Pregnancy

A migraine usually starts out as a dull ache and then eventually becomes a throbbing, constant, and pulsating pain in the temples, in front of the head, or base of the head. Migraines are sometimes accompanied by nausea, sensitivity to light, vomiting, dizziness, and auras, which are spots or lines that can occur across ones vision. The pain can sometimes make it difficult to focus, and symptoms can be debilitating.

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How Can I Treat A Headache In Pregnancy

If you have a mild headache, its safe to take paracetamol. Make sure you follow the instructions on the packet for how much you can take.

There are some painkillers you should not take while youre pregnant. These include tablets or capsules that:

• contain added caffeine
• contain codeine
• are anti-inflammatory, like ibuprofen or aspirin.

Some women may be advised to take a low dose of aspirin as a treatment if they have had miscarriages before or they are at risk of pre-eclampsia. This will be prescribed by a doctor. Aspirin should not be taken as treatment for a headache.

Try to take the lowest dose of paracetamol that works and for the shortest amount of time. Your midwife, GP or pharmacist can give you more advice if the pain is ongoing and doesnt go away with paracetamol.

Find out more about drugs and medicines in pregnancy.