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What Causes Migraines During Pregnancy



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 pregnancy’s 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 don’t decrease during pregnancy should be particularly vigilant. It’s important to work with your obstetrician and your headache doctor when you have migraine to establish a safe treatment plan.

What Are The Different Types Of Headaches

The headaches you’re suffering from while pregnant are just like the ones you can get at any other time, so it’s worth learning about some of the most common types. Here’s a short primer to help you figure out what kind of headache you might have:

  • Tension headaches: If you’re under stress, hungry or feel pain in your neck or shoulders, you could have a tension headache, which feels like a mild to moderate dull ache. It’s one of the most common types.
  • Migraines: With a migraine headache, you can expect moderate to severe pain that throbs and lasts for hours or even days. Some women with migraines also experience blurred vision, light flashes, numbness and nausea.
  • Sinus headaches: Pressure around your eyes, cheeks and forehead plus a stuffy nose may signal a sinus headache. These typically occur with a sinus infection, but they’re also commonly confused with migraines. In both cases, the pain can get worse when you bend forward or lie down.
  • Cluster headaches: These head pains are what they sound like — headaches upon headaches that start quickly and get worse, lasting for days or longer. The searing pain usually centers on one eye or affects one side of the head. The good news: Cluster headaches are rare, especially in women compared to men. 
  • Chronic headaches: If you’re getting headaches on more than half of the days in any given month, they could be considered chronic. This includes migraines and other headache types —“chronic” just refers to how frequently they happen. 

The Causes Of Migraines

When thinking about migraines and pregnancy you should think about the pregnancy hormones . Still in this case they aren’t the only ones to blame. According to the specialists, it is possible that the changes in the nervous pathways, blood flow of the brain and the imbalance of the brain chemicals also have a word to say.

The common triggers of the migraines during pregnancy involve stress, glaring lights, fatigue, loud noises, tobacco smoke, too much heat or cold, and also different kinds of foods. You should be careful about chocolate, nitrates in processed meats or artificial sweeteners.

What Happens To Migraine During The Third Trimester Of Pregnancy

Things tend to improve. But the third trimester may be a time when healthcare providers are particularly concerned about the secondary causes of headache. Please report any change in headache characteristics to your healthcare provider. Also, a “black box” warning for the use of nonsteroidal anti-inflammatory drugs after 20 weeks gestation has been recently issued by the FDA because of potential complications that can be caused by these treatments.

When Headaches Are Secondary To Other Problems

Migraine Medications That Are Safe During Pregnancy

Headaches can result from other conditions, some of which are life-threatening:

Stroke: Sudden and severe headaches might be a sign of a stroke. Women who have strokes during pregnancy or after delivery typically describe the pain as the worst headache of their lives. They also might report other symptoms, such as speech problems, vision issues, or functional problems on one side of the face or body. At the emergency room, the doctor will evaluate you for stroke symptoms, such as visual changes, facial drooping, and arm or leg weakness. If you are having or had a stroke, we will get you emergency treatment at our Advanced Comprehensive Stroke Center.

Preeclampsia: A headache with can indicate a dangerous spike in blood pressure. The doctor will assess you and might admit you to the hospital for management of blood pressure and treatment to prevent seizures.

Spinal fluid leak: A headache after an epidural or spinal block can indicate a spinal fluid leak, especially if it worsens when you sit or stand up. The most effective treatment is an epidural blood patch, in which the doctor injects a sample of your blood into the leaking area, essentially plugging the hole. This therapy provides dramatic relief right away.

Migraines During Pregnancy: When Should You Worry

Migraines may actually decrease in terms of severity and frequency during pregnancy. Research revealed that 50% to 75% of women who previously experienced migraine attacks showed marked improvement in their migraine symptoms during pregnancy. It also showed that these women experienced fewer and less severe migraines during pregnancy.

Comparatively, migraine without aura can begin during pregnancy in up to 10% of women, research indicated. In about 8% of women, migraines become worse during pregnancy. Also, research revealed that roughly 25% of women who experience migraines without aura continue to experience migraine attacks throughout pregnancy.

Some research indicates that migraines are possible predictors of pregnancy complications, such as miscarriage, pre-eclampsia and low birth weight. Yet it is important to note that well-controlled studies are necessary to determine if there is an exact correlation between migraines during pregnancy and any of the aforementioned pregnancy complications.

On the other hand, pregnancy may affect the frequency and severity of a migraine attack. This is often the case in women with migraines without aura. Meanwhile, some women are prone to their first migraine attack during pregnancy or in the postpartum period. Migraine attacks sometimes increase in frequency during the first trimester of pregnancy, with fewer migraine attacks as a pregnancy progresses as well.

How To Relieve A Headache During Pregnancy

Do you often wonder?… I’m pregnant and my head hurts, what can I take?

You can resort to certain medications such as paracetamol to relieve headache during pregnancy.

But if you are determined not to use any type of medication, and you don’t know what to take, you may want to try some home remedies for headache during pregnancy.

Drugs To Prevent Migraine

If daily medication is considered necessary to prevent migraine during pregnancy, the lowest effective dose of propranolol is the drug of choice.9 Low dose amitriptyline is a safe alternative.9 There are no reports of adverse outcomes from pizotifen used during pregnancy or lactation, although it is less often used than the drugs above.

In contrast, sodium valproate, should not be taken during pregnancy for migraine as there is a high risk of fetal abnormalities. Indeed, women prescribed sodium valproate for migraine must use effective contraception.

Topiramate should not be used for migraine during pregnancy and breastfeeding as there are insufficient data regarding safety.

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.  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.

What Happens To Migraine During The First Trimester Of Pregnancy

For some women, migraine worsens within the first trimester of pregnancy. In some cases, women may experience aura for the first time or have a change in aura features. For example, if they had visual aura in the past they may have sensory or language aura as well. It’s a time when migraine clinical features can change.

One important point is that if the headache becomes severe or unresponsive to even conservative treatments, healthcare providers will be concerned about secondary causes. There is a higher chance of secondary headache in the setting of pregnancy due to hypercoagulability .

What Is Migraine

Headaches fall into two categories: primary or secondary. Secondary headaches are caused by an underlying health problem, such as a sinus infection or high blood pressure. Primary headaches are self-contained — the pain you feel is a direct result of the headache itself. Migraines are a classic example.

Migraine sufferers often experience:

  • Moderate to severe, throbbing head pain.
  • Symptoms — including increased sensitivity to light, noise orsmells, nausea, vomiting and loss of appetite — that last between four hours andthree days.

If you experience a migraine while pregnant, it often can go hand-in-hand with aura, too. is a temporary sensory disturbance that may include visual changes, numbness and tingling, or speech changes.

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Migraine With Aura In Pregnancy

If you experience migraine with aura you are more likely to continue to have attacks during your pregnancy. If you experience migraine for the first time while you are pregnant it is likely to be with aura.1

If you do think you are having migraine for the first time while you are pregnant it is important to visit your GP so the causes for your headache can be checked and treated if necessary.

Frequency Of Migraines During Pregnancy

How To Manage Migraine During Pregnancy?

Many women have migraines for the first time when they’re expecting; others, including women with a history of migraines, get them more often.

Blame your out-of-whack pregnancy hormones, plus all those other pregnancy-related triggers you’re experiencing: fatigue, tension, blood sugar drops, physical or emotional stress, nasal congestion and overheating — or a combination of all of these.

That said, some women who have a history of migraines related to their menstrual cycle actually end up getting these headaches less often when they’re expecting, particularly during the second and third trimesters.

That’s because their migraines are likely caused by the “withdrawal” of estrogen that occurs just before menstruation; during pregnancy, estrogen levels remain consistently high.

When Should I Call My Doctor

Whether you experience headaches or not, it’s 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. “It’s 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.”

Second And Third Trimesters

In the second and third trimesters, a woman may be less likely to experience headaches due to hormonal changes, as the body has usually adjusted to these changes by this stage of pregnancy.

However, some women continue to experience tension headaches from hormonal changes throughout their pregnancy.

In the later stages of pregnancy, symptoms such as headaches are more likely to be due to:

  • excess weight
  • poor diet

What Are Migraine Headaches

Migraines are a type of headache that affects nerves and blood vessels . The 2 most common types of migraines are migraine with aura and migraine without aura.

  • Migraine with aura. This type of migraine includes an aura. You may see flashing lights or zigzag lines or lose your eyesight for a short time. This usually happens 10 to 30 minutes before the migraine starts. The aura may also happen during the migraine. 

  • Migraine without aura. This type of migraine generally does not have an aura. You may have other symptoms before it starts. 

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 , sensitivity to light, , , and “auras,” which are spots or lines that can occur across one’s vision. The pain can sometimes make it difficult to focus, and symptoms can be debilitating.

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 , tiredness, not eating well, or lack of sleep. Try to maintain a healthy, balanced lifestyle, which can help mitigate the symptoms of migraines.

I Am Pregnant What Can I Take To Treat My Migraine

Drugs tend to exert their greatest effects on the developing baby during the first month of pregnancy, often before the woman knows she is pregnant. Hence take as few drugs as possible, in the lowest effective dose. Although many of the drugs taken by unsuspecting women rarely cause harm, there is a difference between reassuring the pregnant woman that what she has taken is unlikely to have affected the pregnancy and advising her what she should take for future attacks. Most evidence of safety is circumstantial; few drugs have been tested during pregnancy and breastfeeding because of the obvious ethical limitations of such trials. Hence drugs are only recommended if the potential benefits to the woman and baby outweigh the potential risks.

Headache Evaluation During Pregnancy

When evaluating your headache, your doctor will perform a detailed history. She may ask you questions pertaining to any medical conditions you have, like high blood pressure or depression, or whether you are taking any medications or over-the-counter supplements, like vitamins, caffeine, or laxatives.

Your doctor will also inquire as to the characteristics of your headache such as how intense it is, how long it has lasted, or whether there are associated symptoms like nausea or vomiting. This is done in order to make an accurate diagnosis, as well as to assess and rule out medical emergencies.

Some specific headache warning signs that warrant immediate medical attention include:

  • “Worst headache of my life”
  • Blurry vision
  • Change in headache pain, pattern, or severity

When To Worry

Migraine During and After Pregnancy

As an expecting mom, anything and everything worries you. This is a journey of changes and you aren’t sure which ones to accept with open arms and which ones to question. This is exceptionally difficult considering pregnancy alone comes with its own set of symptoms and side effects.

While most headaches during pregnancy aren’t cause for concern, there are other cases where they could be. Be on the lookout for these combinations of symptoms because they may indicate a problem.

Remedies For Migraines During Pregnancy

Migraines are intense headaches that can occur as a symptom of pregnancy. These are different from stress or tension headaches. It is also normal to experience your first migraine during pregnancy. Some studies have found a slight correlation between migraines and hormones. This makes questions about how to treat migraines naturally while expecting common.

About Migraine Headaches During Pregnancy

Headaches are quite common in pregnancy. The most common are tension headaches and migraine headaches. Most headaches come and go, but others may be more bothersome or may be caused by other complications. It is important for women to consult their doctor about any headaches they may have before, during, or after pregnancy.

What Can I Do About Headaches

Steps to manage headaches include the following:

  • Avoid any known headache triggers, including allergens and certain foods, like monosodium glutamate, cured meats, and strong cheeses.

  • Smoking is never a good idea in pregnancy. You should also avoid secondhand smoke.

  • Try to eat well and drink plenty of fluids, especially if you are prone to morning sickness.

  • Reduce your stress level. Try a massage or cold pack to help with tension headaches. 

  • If your headache is a migraine, rest in a cool, dark room with no noise, and try using warm or cold compresses or an ice pack.

There is good news, however. Most women have fewer headaches during pregnancy, especially after the first trimester. And those with a history of migraines often find there is improvement during pregnancy.

Headache As Preeclampsia Symptom

When a headache during pregnancy is accompanied by dizziness, blurred vision, or blind spots, it’s time to call your obstetrician or healthcare provider.

These could be symptoms of serious complications, such as preeclampsia, a kind of high blood pressure that can occur after the 20th week of pregnancy. The condition can damage other organs like the liver or kidneys and lead to a low number of platelets, cells in the blood that are important in the clotting process.

One study found that pregnant women with high blood pressure and a headache were 17 times more likely to suffer severe complications, like preeclampsia.

Besides high blood pressure , other signs and symptoms of preeclampsia include:

  • Abdominal pain
  • Swelling, usually in the feet, legs, face, and hands
  • Sudden weight gain
  • Nausea and vomiting

Pregnant people with type 1 or type 2 diabetes have a two- to four-fold risk of preeclampsia.

Some people with preeclampsia develop a headache that resembles a migraine—a throbbing headache with nausea and/or a sensitivity to light or sound. This is another cue to contact your doctor right away, especially if you don’t normally get migraines or the pain is different, more intense, or longer lasting than the headaches you usually get.

Headaches Doctor Discussion Guide

  • A high fever
  • High blood pressure

If Approved By Your Doctor Take A Tylenol

Assuming you’ve already discussed a migraine with your doctor and they’ve given you the green light to use OTC pain medication in the future, you can take a small dose of Tylenol for the infrequent migraine.

This isn’t a long term solution, as it only puts a bandaid on the issue. We recommend really figuring out what your triggers are, and coming up with a more holistic solution.

What To Know

Women who have been suffering from migraines before their pregnancy could get pregnancy migraines more often than other women but in some cases they have fewer migraines than they had before. On the other hand it is possible for women to experience these headaches for the first time during their pregnancy.

According to the studies that have been conducted regarding migraines and pregnancy, those women who suffer from migraines are more prone to preeclampsia, hypertension and other vascular disorders. This is why you may want to tell your doctor if you have migraines from time to time.

When Should You Go To The Er For A Migraine During Pregnancy

Some specific headache warning signs that warrant immediate medical attention include:

  • Experiencing the worst headache of your life, which comes on suddenly and reaches its peak within a minute
  • Blurry vision
  • Muscle strain from changes in your posture as the baby grows and you gain weight
  • High blood pressure in pregnancy

What Are Possible Complications Of Migraines

Home Remedies For Severe Headache During Pregnancy ...

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 is 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.

Hormonal Changes In Pregnancy

How a pregnancy might affect your migraine and how you will manage is a common question for women who have migraine and are trying to get or are pregnant. Key issues include what medicines are safe to use and whether your attacks will change, including whether you will have aura for the first time.

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.

When To Worry About Migraines During Pregnancy

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Experiencing a during pregnancy is sometimes problematic. If a pregnant woman understands the warning signs and symptoms of a migraine attack, she can treat her migraine pain properly. Now, let’s examine some of the key questions surrounding migraines during pregnancy, and how pregnant women can treat their migraine symptoms.

Migraine Relief And Remedies During Pregnancy

A migraine bearing down on you? Stay away from ibuprofen and talk to your doctor before taking an aspirin. Try the following instead:

  • Relax. If you suspect a migraine coming on, lie down in a quiet, dark room with a cold compress on your neck or forehead for two or three hours. With any luck, you’ll fall asleep and wake up migraine-free.
  • Pop an acetaminophen. While you should never take any pain medication — over the counter, prescription or herbal — without the OK from your doctor, the occasional use of Tylenol is considered safe during pregnancy. Check with your practitioner for recommendations on dosing.
  • Talk to your doc. If you relied on strong migraine medications before you conceived, you may have to avoid them until the baby arrives . Your doctor may be able to recommend safer drug options, or refer you to a migraine specialist, who can suggest other strategies for managing your pain.

Is A Headache During Pregnancy Something To Worry About

Pregnancy is a beautiful thing to be celebrated, but few people fill you in on the not-so-great symptoms that may occur during the journey. Namely, heartburn, gas, constipation and, for some pregnant mamas, headaches.

While headaches can be just another normal symptom of pregnancy, should they ever be a cause for concern?

“Headaches are common in women both in and outside of pregnancy,” said Kelley Saunders, MD, an OBGYN with Banner – University Medicine Women’s Institute. “But whether they are normal or not should always be discussed with your doctor.”

Here is some insight into what causes headaches during pregnancy, some remedies to treat them and why your doctor should be kept in the loop.


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