The Right Way To Change Migraine Medication For Pregnancy Safety
The key to migraine management leading up to and during pregnancy is consistency; any changes that are made need to be made slowly, says Starling.
When were starting new medication, we usually start at a very low dose, and we increase slowly over time. If were deciding to discontinue a medication because someone is planning on getting pregnant, then we will typically reduce it slowly over time, she says.
It might sound scary to taper off a medication that has been working for you, says Starling. There are certain medications that are safe to use in the setting of pregnancy, and those that are not. I will always talk to my patients about family planning and reassure them that I will be there to support them through that journey, and that well come up with an alternative plan that will be safe, she says.
Headaches are common during pregnancy. While theyre painful, theyre usually nothing to worry about. However, headaches in pregnancy can sometimes be a warning sign of a more serious problem like preeclampsia.
Heres what you need to know about the different types of headaches during pregnancy, how to recognize them, and what to do if you think your headache may be a sign of a dangerous complication.
Sickness Nausea And Vomiting
If youre sitting in meetings fighting the urge to vomit, youre definitely not alone. About 50% to 80% of pregnant women will throw up or feel nauseous . That can start happening any time from two to eight weeks after you conceive your baby.
The most likely cause is fluctuating levels of pregnancy hormones .
Oh, and the term morning sickness is a bit misleading too. Nausea or vomiting can happen at any time during the day .
A small number of women might find themselves with a severe form of nausea and vomiting called hyperemis gravadarum .;HG can lead to pregnancy complications like dehydration, weight loss and electrolyte imbalance so you might need to be admitted to hospital .
Getting The Most Out Of Your Doctors Appointment
Youve found a headache doctor and made an appointment.;Now how will you and your doctor determine that you have migraine? Theres no blood test, ultrasound, or MRI that will tell your doctor if your head pain is migraine.;The only real way for your doctor to know is for you and him or her to talk about the specifics of your head pain , how you have handled the pain until now, family history of migraine, current and previous treatments including over-the-counter medications, and how your head pain limits your quality of life.
You wont have a lot of time with the doctor, especially if youre seeing a primary care physician, so go prepared.;Think about these questions, write down the answers if you can, and take them with you to the appointment.
About the head pain:
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Does Migraine Affect The Outcome Of Pregnancy
Migraine has long been mentioned as a possible predictor of complications in pregnancy, although because migraine is so common in females systemically establishing a link to complications in pregnancy has been a challenge. Several associations have been proposed, including miscarriage, pre-eclampsia, congenital anomalies, and low birth weight, but these associations remain clouded by a lack of well controlled studies.
I Am Pregnant And Getting Blind Spots With My Migraine Should I See My Doctor
It is not uncommon for a woman to have her first attack of migraine aura during pregnancy. Symptoms are typically bright visual zig-zags growing in size from a small bright spot and moving across the field of vision over 20-30 minutes before disappearing. A sensation of pins and needles moving up an arm into the mouth may accompany this. If you experience these typical symptoms and your doctor confirms that this is migraine, there is no need to be concerned and no tests are necessary. However, if the symptoms are not typical of migraine aura, it is important to exclude other disorders, such as blood clotting disorders or high blood pressure, which may occasionally produce symptoms not dissimilar from migraine.
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What Do Early Pregnancy Headaches Feel Like
If youre at the beginning stages of your journey, you might be wondering what early pregnancy headaches feel like. Although you may get a typical tension headache, migraines are also common during the first weeks or months. In fact, a headache or migraine might be one of the first signs of pregnancy for some people. However, since theres many possible causes, you wont know without taking a pregnancy test.
A tension headache;creates mild to moderate pain behind the eyes and might feel like having a tight band around your head. These are the most common type of headaches.
A migraine feels like a throbbing sensation, usually on one side. They may cause nausea and vomiting in severe cases.
Managing a headache or migraine in the first trimester may be particularly difficult because theres many medications you should avoid.
Drugs To Treat The Symptoms Of Migraine
Most painkillers are safe to use in pregnancy. However, check with your doctor, particularly if you are getting headaches more often than a couple of days a week.
; Paracetamol is the drug of choice in pregnancy, having been used extensively without apparent harm to the developing baby.9
; Aspirin has been taken by many pregnant women in the first and second terms of pregnancy.9 However, it should be avoided near the expected time of delivery since, it may be associated with early closure of the fetal ductus arteriosis and can also increase bleeding.9
; Codeine: Codeine is not generally recommended for the management of migraine in the UK.10 However, occasional use in doses found in combined analgesics is unlikely to cause harm.
; Ibuprofen: can be taken during the first and second trimesters in doses not exceeding 600mg daily.9 However, frequent use or exposure to high doses after 30 weeks is associated with an increased risk of premature closure of the ductus arteriosus.9
; Antisickness drugs Buclizine, chlorpromazine, domperidone, metoclopramide and prochlorperazine have all been used widely in pregnancy without apparent harm.
Data regarding safety of sumatriptan during pregnancy are reassuring.11 However, continuing triptans during pregnancy is not recommended without medical supervision.
; Ergots Ergotamine should not be used during pregnancy as it can increase the risk of miscarriage and perinatal death.
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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 Foods Trigger Migraines
There are many common foods that can trigger headaches, and these will vary from woman to woman. Most headaches in pregnancy will settle in the second trimester when the morning sickness has gone.
Some foods that might trigger your migraines are:
- Bread and cakes
- Fruits, such as citrus, bananas, raspberries, passion fruit, and plums
- Nuts and avocados
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If My Headache Isnt Going Away Should I Get Tested For Coronavirus
Headache is one of the symptoms of COVID-19, the illness caused by the novel coronavirus SARS-CoV-2, according to the Centers for Disease Control and Prevention . A February 2020 report of the WHO-China Joint Mission on COVID-19, from early in the pandemic, found that of 55,924 people confirmed to have the disease, 13.6 percent had a headache.
Theres no treatment for COVID-19, but the same OTC pain relievers that help with other types of headaches may alleviate headaches caused by this disease. does not recommend against;the use of ibuprofen for people with COVID-19.)
If you have symptoms of COVID-19 and want to get tested, the;CDC recommends calling your state or local health department or a medical provider. Most people with COVID-19 have mild illness and are able to recover at home, the CDC notes.
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Is It Safe To Take Ibuprofen During Pregnancy
Unless your doctor specifically approves it, avoid products containing aspirin or ibuprofen as they could negatively impact you and your baby. In the early stages of pregnancy, ibuprofen may increase your chances of miscarriage. During the third trimester, it can hamper your babys heart and lung development. Ibuprofen and other non-steroidal anti-inflammatory drugs also tend to prolong labor and increase the risk of bleeding.
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The First Three Months Of Pregnancy
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.
Are Migraines Hereditary
Migraines tend to run in families. As many as four out of five people with migraines have a family history. If one parent has a history of migraines, their child has a 50% chance of having them. If both parents have a history of migraines, the risk jumps to 75%. Again, up to 80% of people with migraines have a first-degree relative with the disease.
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When To Call Your Doctor
Headaches are common during pregnancy. While they’re painful, they’re usually nothing to worry about. However, headaches in pregnancy can sometimes be a warning sign of a more serious problem like preeclampsia.
Here’s what you need to know about the different types of headaches during pregnancy, how to recognize them, and what to do if you think your headache may be a sign of a dangerous complication.
Are Migraines Dangerous During Pregnancy
The only danger is when your headache may be a sign of something;else. You should ALWAYS call your health care provider when:
- Your headache is accompanied by a fever
- Your headache persists for more than a few;hours or returns frequently
- You are experiencing blurred vision
It is ALWAYS important to let your health care provider know when;you are experiencing any headaches and the details about them.
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Apple To Treat Migraine
An;apple a day keeps the doctor away similarly, it also keeps a migraine away. Eat an apple at the onset of the migraine pain. The crunchy apple will improve the blood flow to the brain, which will eventually reduce the pain. Moreover, it is believed that green apples are more effective as compared to red apples. According to the recent research smelling, a green apple will have the equal benefits.
When To Consult A Doctor
A migraine during early pregnancy is normal and does not require a visit to the hospital. However, if a fever accompanies a migraine, it could be an indication of an underlying condition. There are chances that it could be a stroke, meningitis or encephalitis. Any sudden increase in weight or bloating in the hands and face may be a sign of preeclampsia.
Migraines can be a major inconvenience in an already challenging situation, but it is something that can be controlled. The chronicling of triggers unique to you in your diary and the prevention methods mentioned above can help you avoid and control severe headaches to a large extent. Even if you are unable to do much about the pain, you can take solace in the fact that, in all probability, you will only have to endure it for the initial part of your pregnancy.
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When Should I Call My Doctor
Whether you experience headaches or not, its always important to discuss your pre-pregnancy history, obstetrical history and concerns with your doctor for an individualized assessment and management plan. However, if none of the above treatments resolve your mild headache or your headaches become more frequent and severe, talk to your doctor to determine the cause.
This includes new headaches that present after 20 weeks, a sudden onset of severe headaches, headaches associated with a fever, mental health changes, elevated blood pressure and vision changes, Dr. Saunders said. Its important to keep an open line of communication with your physician and let them know about any changes in your health so they can rule out anything serious.
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What Can You Take For A Migraine While Pregnant
Most migraine treatments are not recommended during pregnancy, although most pregnant people can safely take acetaminophen to treat occasional migraines.;Compazine ;and most anti-nausea medications are generally considered safe.
Make sure to speak to your healthcare provider before taking any medication, including over-the-counter medications and herbal treatments.
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Unusual Feelings And Emotions
If your emotions feel a little out of balance in early pregnancy, the reason is once again hormones. Its most common in the first trimester, so the feeling of being on an emotional roller coaster will likely settle down after a little while.
As with other early pregnancy symptoms, you may find that staying active, eating a healthy diet, and maintaining a social life can help you deal with these symptoms.
What Are Possible Complications Of Migraines
If you have a history of migraine headaches, and have no other health problems, migraines during pregnancy are not usually a concern.;
But if a first-time migraine-like headache occurs in pregnancy, it’s important to;check for;any other type of condition that may be dangerous. This includes bleeding in the brain, meningitis, high blood pressure, or tumors. You may need further testing;to find the cause of the headache. This testing may include urine and blood tests.
Online Medical Reviewer: Donna Freeborn PhD CNM FNPHeather M Trevino BSN RNCIrina Burd MD PhD
Date Last Reviewed: 7/1/2021
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Whos At Risk For Migraines During Pregnancy
As many as 20 percent of pregnant women report having migraine headaches. Even with no prior history of migraines, you might experience your first attack during pregnancy.;
Interestingly, how often these headaches present during pregnancy varies among people who got migraines before becoming pregnant. While 6070 percent show noticeable improvement during pregnancy, roughly 5 percent claim their migraines increased in severity.
As many as 20 percent of pregnant women report having migraine headaches. Even with no prior history of migraines, you might experience your first attack during pregnancy.
For people who get fewer migraines, the improvement is possibly related to the absence of monthly menstruation. Migraines which occur right before your period are triggered by a drop in estrogen levels. This may be why for some pregnant women, no menstruation means no migraines.
Early Pregnancy Signs And Symptoms
A number of symptoms begin in the early stages of pregnancy:
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Remember These Five Steps For Emergency Migraine Treatment: Cold + Heat + Inhale + Liquids + Lights Off Chill Just Chill
Picture this: youre away for the day in a hot air balloon with your family. Bright sun, a loud engine, the smell of exhaust, a jerking ride in the wind just the day your kids dreamed of.
Suddenly, you feel a Migraine attack coming on. You dig through your backpack and no meds. Short of bumming two aspirin from a fellow tourist, what can you do? How to get rid of a Migraine fast before its in full swing?
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Preventive Treatment In Pregnancy
It is best to start nonpharmacologic behavioral changes known to decrease frequency and severity of migraines before pregnancy to make them learned behaviors. These approaches include relaxation therapy, biofeedback, and behavioral sleep modification, the latter of which may revert chronic migraines to episodic.11,12 Although these approaches are viable first-line treatment options for some pregnant women or individuals considering pregnancy, they may not be sufficient for others. For women with high frequency of migraine or significant disability due to migraine, the risk of pharmacologic agents needs to be weighed against the health consequences of untreated migraine, which can negatively affect both the mother and fetus. Untreated migraine can lead to poor oral intake, resulting in inadequate nutrition and dehydration in addition to sleep deprivation, increased stress, and depression.13
Vitamins and Minerals
Oral Pharmacologic Agents
A recent cohort study evaluating outcomes of children born to mothers who used beta blockers during pregnancy showed no increased congenital malformation risk.18 A prior cohort study, however, did show an association between beta blockers and fetal growth restriction, preterm birth, and perinatal mortality. The use of beta blockers for migraine prevention in pregnancy may warrant close monitoring of fetal growth.19
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