Using Painkillers When Pregnant
Some medicines, including painkillers, can harm your baby’s health.
Paracetamol is generally considered safe during pregnancy. Always check the packaging for the correct amount of tablets to take, and how often you may take them.
If you find you need to take paracetamol for more than a couple of days, you may need to speak to your GP.
Ibuprofen is sometimes recommended for headaches during pregnancy. You can only take this at certain times during your pregnancy. Always check with your GP, pharmacist or obstetrician before taking ibuprofen.
Advanced Imaging In The Pregnant Patient
Advanced neuroimaging should be obtained for patients with sudden onset severe headache, rapidly increasing headache frequency or neurologic deficits, and should be considered for patients with new onset headache or headache that differs from baseline. Non-contrast head CT is the initial study of choice.
The estimated fetal radiation dose from a head CT is very low, < 1 rad.57 At eight to fifteen weeks GA, the fetus is at greatest risk for radiation-related injury. A fetal dose of 12 rad may increase the risk of leukemia to 1 in 2,000 children compared to 1 in 3,000 children for the general population. The risk of fetal anomalies, growth restriction, or abortion is not increased with radiation doses of < 5 rad.5,6 Most CT contrast agents contain iodine derivatives, which have not been formally studied in pregnancy. However, neonatal hypothyroidism has been associated with some iodinated agents taken in early pregnancy. Contrast should be avoided unless absolutely necessary.58
Coffee Helps Prevent My Migraine Can I Have Caffeine While Pregnant
Caffeine and migraine have an interesting relationship. According to the National Headache Foundation, caffeine can help with pain relief, since âit contains properties that cause the blood vessels to narrow and restrict blood flow.â It can even make some pain relievers work better. Yet for some people, caffeine is a migraine trigger. And becoming reliant on caffeine every day can lead to rebound headaches.
All that said, even if you know caffeine helps relieve your migraine attacks, what can you do? Isnât caffeine off limits during pregnancy?
If youâve been resisting the urge to reach for a cup of coffee, take comfort. Dr. Crystal points out that some caffeine is ok during pregnancy . âDrinking up to 12 oz. of coffee per day, or about 200 mg of caffeine, is considered safe,â she says. Still, itâs always smart to double check with your doctor before pouring yourself a cup.
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Types Of Pregnancy Headaches
There are many different types of headaches you can get when youre pregnant. These include tension headaches and dehydration headaches. Migraines and sinus headaches are also common. The first step is to understand what causes the headaches. Then, you can create an action plan to reduce aches and pains and avoid headaches in the first place.
Heres a quick rundown of the different types of headaches you may experience when pregnant:
Frequency Of Migraines During Pregnancy
Many women have migraines for the first time when theyre 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 theyre expecting, particularly during the second and third trimesters.
Thats because their migraines are likely caused by the “withdrawal” of estrogen that occurs just before menstruation during pregnancy, estrogen levels remain consistently high.
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Take A Nap Or Practice Yoga
Sometimes, a lack of sleep can trigger headaches and migraines so if you think you are experiencing a headache because of poor sleep, take a nap, and you will feel better. If you want to sleep longer, then do try anything that will make you feel better.
If you are feeling super-stressed, doing some yoga would be a good idea because of the multiple benefits it offers. Yoga will help lower your stress and help you sleep better. It will also make sure that your body gets the required exercise during pregnancy.
Causes Of Migraine Headaches
Exactly what causes migraine headaches isn’t known. But migraines appear to involve changes in nerve pathways, neurochemicals, and blood flow in the brain.
Researchers believe that overly excited brain cells stimulate a release of chemicals. These chemicals irritate blood vessels on the brain‘s surface. That, in turn, causes blood vessels to swell and stimulate the pain response.
Estrogen is thought to play a role in migraines. That’s why pregnancy, menstruation, and menopause often change a woman’s pattern of migraine headaches.
The neurotransmitter serotonin also appears to have a key role in migraines.
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When Should I Be Concerned
When a headache is severe, or just doesnt go away, or when you have dizziness, blurred vision, or changes in your field of vision, you should contact your healthcare provider. Headaches can sometimes be related to blood pressure problems in pregnancy. If they are persistent or severe and happen after 20 weeks of pregnancy, let your healthcare provider know. Although strokes during pregnancy are rare, migraines can increase a pregnant womans risk for them. If you have migraines, report them to your healthcare provider.
Outlook For Headache During Pregnancy
Headache pain during pregnancy is common. You may have tension headaches during your first trimester of pregnancy. This may happen because of the many changes that youre going through in a short period.
Headache pain may happen in the second and third period of your pregnancy for other reasons. Some causes of headaches in your mid to late pregnancy may be serious.
High blood pressure is a serious cause of headache pain during pregnancy. You can have high blood pressure at any time in your pregnancy. You may not have any symptoms at all. Check your blood pressure at least once a day with a home monitor.
Tell your doctor if you have headaches at any time in your pregnancy. Let your doctor know right away if you have a personal or family history of migraine, high blood pressure, seizures or diabetes.
Take all medications and treatment exactly as prescribed by your doctor. Follow all diet and exercise advice carefully. See your doctor for all follow-up and regular check-ups. Most causes of headaches during pregnancy are treatable or preventable with the right care.
For more pregnancy guidance and weekly tips tailored to your due date, sign up for our Im Expecting newsletter.
Last medically reviewed on May 6, 2019
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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.
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.
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Nasal Congestion And Irritation
Everything swells when youre pregnantincluding your nasal passageswhich can cause painful congestion and trapped allergens. These trapped allergens can irritate and inflame the tissues in your sinus area, causing sinus pressure and pain in susceptible women, which can lead to a full-blown headache or even a migraine.
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.
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I Background And Objectives For The Systematic Review
Headache, one of the most common symptoms in the general population, is also common during pregnancy. Primary headache refers to conditions where the headache itself is the disorder. In contrast, secondary headaches are caused by an underlying disorder, such as stroke, venous thromboembolism,1,2 or pituitary tumors.3,4 Therapy for secondary headache in pregnancy generally targets the underlying disorder, and is thus not the focus of this review.
Primary headaches that occur in pregnant women are classified into four types: migraine, tension headache, cluster headache, and other trigeminal autonomic cephalgias .5 Migraine is by far the most frequent type, accounting for about 90 percent of primary headaches in pregnant women.2 The lifetime prevalence of migraine disorder among pregnant women is approximately 30 percent.6,7 Other types of primary headache during pregnancy are rarer.8 Primary headaches can be pre-existing or can occur for the first time during pregnancy, postpartum, or breastfeeding. The stress of pregnancy and imminent infant care may exacerbate the frequency and/or severity of primary headaches. Migraine remains the most common type of both pre-existing and pregnancy-onset primary headache.
Why Does My Head Hurt
Women 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 a lot of additional weight, consider whether poor posture might be a factor in your headaches. The 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.
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What Is The Best Treatment For Headaches While Pregnant
If youre hoping to stop a headache naturally, there are plenty of pregnancy-safe steps you can take to battle your symptoms based on the common headache types:
- For tension headaches and migraines: Lie in a dark, quiet room for a few minutes or if you’re at work, close your eyes and put your feet up. You can also put an ice pack or cold compress on the back of your neck for 20 minutes while you relax. Deep breathing and quiet meditation are two more smart ways to channel calming vibes.
- For sinus headaches: A stuffy nose is very common in pregnancy, so try steam inhalation to relieve congestion and a humidifier to add moisture to the air. Apply hot and cold compresses to the achy spot, alternating 30 seconds of each for a total of 10 minutes, four times a day. Drinking lots of fluids, especially herbal tea or broth, can help clear stuffiness. And ask the doctor whether you could have a sinus infection and if theres a safe nasal decongestant you can use.
- For all headaches: While you shouldnt take ibuprofen or Aleve when you’re pregnant, acetaminophen can bring relief and occasional use is considered safe for pregnancy. Always check with your practitioner for the right dosage and never take any medication without getting your doctors okay first.
Is It Normal To Have Daily Headaches In Pregnancy
Most moms have a few instances to a few weeks of dealing with headaches in pregnancy, but they do pass.
Interesting to note: My midwife finds the most common window of headaches in her pregnant patients is between 16 to 20 weeks of pregnancy.
Other moms will struggle with chronic headaches in pregnancy. Just like how some moms throw up for the entire pregnancy, while most only have morning sickness in the first trimester, some moms are just extra sensitive to all of the changes in pregnancy and it triggers frequent headaches.
If you have excessive or debilitating headaches in pregnancy , talk to your healthcare provider. In rare cases, it can be a sign of preeclampsia or a cerebral blood clot , so youll want to double check with your provider just to be safe. Theyll want to monitor your blood pressure, test your urine for protein, and/or run other tests to rule things out.
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What Causes Headaches During Pregnancy
The primary culprits are pregnancy hormones, though there are many other causes of headaches during every stage of pregnancy. This type of pain can have lots of triggers, which means it can come on at any time. Some common causes:
- Hormones: Headaches are often an early sign of pregnancy and tend to begin during the first trimester when your hormone levels surge and blood volume increases.
- Trigger foods: Certain foods like cheese, chocolate, dairy and processed meats like bacon can trigger a headache in any trimester. Women who drink less caffeine in pregnancy may get withdrawal headaches.
- Sinus congration: If youre suffering from sinus congestion, a runny nose or allergies , a headache may accompany these symptoms.
- Dehydration: The dehydration that often goes hand in hand with nausea and vomiting can also cause your head to throb.
- High blood pressure: After week 20 in pregnancy, severe headaches may be related to high blood pressure. This may raise your risk of a number of pregnancy complications such as preeclampsia and premature delivery, so it’s important to talk to your doctor if you notice this symptom.
Other causes can include:
On the bright side, at least for those already prone to migraines: Surging hormones during pregnancy might actually make those less-than-pleasant headaches less frequent.
How To Treat Patients For Migraine During Pregnancy
Its important for providers who treat women during their reproductive years to be aware of treatment options that are safe during pregnancy. Many women with migraine who are pregnant or considering pregnancy stop taking their migraine medications and assume they dont have safe treatment options availablebut this is simply not true.
Women typically start to experience migraine attacks during adolescence, which aligns with when menstruation begins. The highest incidence of migraine is between ages 18 and 44, which are also the year many women experience pregnancy. The rate of migraine among women is three times higher than it is for men. Because of these figures, it is believed that fluctuations in estrogen levels play a role in migraine development.
Dr. Tracy Grossman, an obstetrician-gynecologist who has completed a fellowship in maternal-fetal medicine and earned a masters in neuroscience, shares the range of treatment options available for pregnant patients with migraine.
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What Can You Take For A Headache While Pregnant
For many moms, natural remedies can be a big help for headaches in pregnancy. For other moms, the pain may be so severe that they need a little something more to get through the day.
If natural remedies dont work, talk to your healthcare provider before taking anything.
Your doctor may recommend acetaminophenbut do know that its been linked to ADHD later in life.
Unfortunately, ibuprofen and aspirin are a no-go for headaches in pregnancy. If ibuprofen normally helps you, try taking ginger capsules or turmeric/curcumin capsules to act as a non-steroidal anti-inflammatory.
Some moms need to medication like Tylenol, acetaminophen, or other migraine drugs to find relief from headaches in pregnancy. They literally cannot function if they dont . Forgive yourself, and do the best you can to manage the pain naturally when you are able to.
If I Tend To Have Migraine Attacks During My Period Will I Also Get Them During Pregnancy
According to the American Headache Society, menstrual, or âhormonal,â migraine is a type of migraine that affects 7â19% of women.
These attacks tend to hit just before or at the start of your period. The quick drop in estrogen and progesterone that occurs before your period starts could be what triggers menstrual migraine, according to the US Office on Womenâs Health.
If you suffer from menstrual migraine, you might worry that youâll also be prone to get headaches triggered by hormonal changes that happen in your body during pregnancy, but thereâs good news. Dr. Crystal points out that many people who have menstrual migraine actually see an improvement in their condition while pregnant.
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