What Causes Migraine Headaches During Pregnancy

How Frequent Are Migraines During Pregnancy

Warning Signs – Headaches During Pregnancy

The incidence and reoccurrence of migraine attacks in women vary widely. Some of them experience for the first time in pregnancy, while some women experience increasing migraine symptoms during the first trimester.

According to the American Migraine Foundation, around 50 to 80% of pregnant women experience reduced attacks . This reduction in symptoms is attributed to the increasing levels of estrogen during pregnancy.

What Are The Symptoms Of Pregnancy Migraines

Based on the associated symptoms, migraines are classified into two types .

  • Migraine with aura: People can experience sensory disturbances for up to an hour before the onset of a migraine, commonly known as aura experience. Such disturbances include tingling sensation, seeing sparks, bright spots, and difficulty speaking.
  • Migraine without aura: People do not see an aura however, they experience other migraine symptoms. Some of the signs and symptoms of migraine headaches during pregnancy are :
    • Nausea and vomiting
    • Severe throbbing pain in one side of the head
    • Sensitivity to light, loud noise, or strong smell

    It becomes essential to monitor the signs and symptoms of migraines during pregnancy. This information will be vital for a medical practitioner to understand the cause and give an effective management plan. One can note down the following details or mention them in their headache diaries.

    • Time of onset of symptoms
    • Were you at the home, workplace, or traveling when you experienced a migraine
    • In which activity you were involved when the symptoms began
    • What all eatables and drinks you have consumed throughout the day
    • Time of reoccurrence of symptoms

    Effect Of Pregnancy On Migraine

    Migraine headaches often improve during pregnancy, but have also been to known to worsen or start during pregnancy.2,3 A link between migraine and the female sex hormones, estrogen and progesterone, is seen in menstrual migraine and migraine in pregnancy.3 Almost half of women with migraine have improvment during the first trimester , and this improvement increases substantially in the second and third trimesters.4 The number of women with complete remission in the first trimester is low however, the rate of complete remission increases significantly as pregnancy progresses .5 Migraine with aura is less likely to improve or remit compared with migraine without aura.5 In a study of pregnant women with menstrual migraine, participants reported increased headache intensity but not frequency early in pregnancy , compared with pregnant women whose migraines were not menstrual.6 Regardless of whether womens migraines were menstrual or nonmenstrual, headache intensity decreased during the second half of pregnancy as did frequency of analgesic use.6

    Migraine itself may be a potential teratogen. A retrospective study showed that women treated for acute migraine had higher rates of preterm delivery, preeclampsia, and low birthweight.7 A more recent prospective observational study, however, showed no teratogenic effect of migraine itself.8

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    Headache And Migraine Remedies That Are Safe During Pregnancy

    Most women deal with headaches at some point in their lives. Data from the Centers for Disease Control and Prevention suggest that one in five women had a severe acute headache or migraine in the previous three months. Additionally, migraines are more common in women than men approximately 18 percent of women have them compared to 6.5 percent of men.

    Because headaches and migraines are so common, its probably no surprise that many women deal with them during pregnancy. For the majority of pregnant women, occasional headaches or migraines are no cause for alarm, and most standard treatments are safe. However, suffering a severe headache at key times during or after pregnancy can indicate a serious medical emergency.

    Headache As Preeclampsia Symptom

    Migraine During and After Pregnancy

    When a headache during pregnancy is accompanied by dizziness, blurred vision, or blind spots, its 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 migrainea 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 dont normally get migraines or the pain is different, more intense, or longer lasting than the headaches you usually get.

    Headaches Doctor Discussion Guide

    • High blood pressure

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    Treating Headaches During Pregnancy

    In about 75% of cases, migraines decrease or disappear during pregnancy. The remaining quarter of women who continue to experience headaches during pregnancy must contend with the fact that many of the medicines that are effective against migraines will affect the uterus and penetrate the placenta to affect the unborn child.

    Some migraine medications run the risk of inducing early labor, although one study found no adverse effects from taking sumatriptan during the first three months of pregnancy. Preventative medicines should not be taken until the last trimester. Amitriptyline and imipramine have excellent safety records when administered late in pregnancies but should not be taken for the last two weeks before delivery. Topiramate has been known to increase occurrences of cleft palate in newborns and should not be used during pregnancy.

    The best approach for dealing with headaches or migraines during pregnancy is to stress non-drug based treatment including preventative methods. In particular, close attention should be paid to diet for foods that trigger headaches. Some patients find that foods that cause headaches during pregnancy are ones that had no effect before pregnancy.

    For more information regarding headaches & migraines that affect women, see:

    Migraine Treatment During Pregnancy

    For safe, effective relief of migraines during pregnancy, consider using acetaminophen. In the U.S., 70 percent of pregnant women take acetaminophen. Using it in moderation is considered safe during pregnancy.

    Natural remedies for migraines include placing a cold compress on your forehead, lying down in a dark room, and getting as much rest as possible.

    However, some studies have reported a link between long-term acetaminophen use and ADHD in babies. So if you suffer from chronic migraines and prefer to steer clear of medications altogether, non-drug treatment options are available.

    Natural remedies for migraines include placing a cold compress on your forehead, lying down in a dark room, and getting as much rest as possible. Maintain stable meal and sleep patterns, and try to avoid common triggers. Consider keeping a migraine diary to identify triggers such as emotional stress or eating chocolate or aged cheeses.

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    Preventive Treatment In Pregnancy

    Behavioral Approaches

    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

    Monoclonal Antibodies


    When To Seek Help

    Is it normal to get migraine headaches during pregnancy, and what should I do about them?

    Migraines during pregnancy arent a major cause for concern in women with a history of these types of headaches. However, a first-time migraine attack during pregnancy could indicate an underlying health issue and should be discussed with your doctor so they can evaluate your symptoms and rule out other potential causes. Migraines during pregnancy can also signal preeclampsia, a serious complication related to high blood pressure.

    The most important thing to remember is that, in general, migraines do not pose a direct threat to the health and safety of your baby. If you have further questions or concerns about recurring headaches, make an appointment to see your doctor.

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    How To Deal With Migraines During Pregnancy

    On top of the morning sickness, insomnia, and body pain, the last thing you need to deal with is migraines during pregnancy. But, unfortunately, they are a common ailment those expecting will have to experience.

    These painful headaches arent like any other, leaving you debilitated for the rest of the day, or longer. Even after they pass, the fatigue you feel can affect you for days to come.

    Like many of the discomforts youll experience while pregnant, there are some ways to prevent migraines, along with some tricks to help them pass quicker.

    Well also cover the topic of whether migraines during pregnancy are cause for concern, and justify a doctor’s visit. Before we get into all that, lets distinguish between a typical headache and a migraine.

    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

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    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.

    The Causes Of Migraines

    Migraine Medications That Are Safe During Pregnancy

    When thinking about migraines and pregnancy you should think about the pregnancy hormones . Still in this case they arent 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.

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    Drugs To Treat The Symptoms Of Migraine

    Pain killers

    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.

    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.

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    How To Treat Migraines When Naturally Doesnt Work

    Sometimes, a migraine might continue to plague you, even after you have tried the above remedies. If the pain persists, you can take Tylenol however, it is important to avoid Aspirin and Ibuprofen. These are not safe to take during pregnancy. If the migraines become a constant nuisance, you may want to talk to your doctor about alternative medications that are safe to take during pregnancy. You can learn more about which medications are safe during pregnancy here.

    If you currently take pain medication for migraines, it is best to discuss with your doctor whether it is safe to continue using. It is best to avoid using any herbal remedies to alleviate migraines during pregnancy, as many have not been tested, and some have been shown to lead to complications.

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

    3 things you should know about headaches 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

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    When Do Pregnancy Headaches Start

    Pregnancy headaches can become more frequent around nine weeks, when hormones and blood volume increase.

    But, in general, headaches during pregnancy can start any time and feel like a typical headache you might have had when you werent pregnant.

    The pain from a pregnancy headache might be concentrated on one side of the head, the sinuses, or both sides of the head, Columbo says.

    What Causes Migraines During Pregnancy

    If you experienced migraines prior to your pregnancy, you are more likely to experience them while pregnant. Even if youve never had a migraine, your chances are higher due to the changing of your hormones during pregnancy.

    But your changing hormones arent the only thing responsible for this. There are plenty of other triggers that can contribute to migraines, including but not limited to:

    • Fatigue
    • Stress
    • Blood sugar drops
    • Higher body temperatures
    • Nasal congestion

    Any combination of these triggers can result in a migraine. But for women who experienced migraines in tandem with their menstrual cycle prior to pregnancy, we actually have good news!

    Your migraines may decrease in intensity and frequency as your pregnancy progresses. Since estrogen will be at a high level throughout your 9 months, this trigger wont affect you as much.

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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.

    Primary Headaches During Pregnancy

    Headache And Vomiting Symptoms Of Pregnancy

    The three most common primary headache disorders are migraines, tension-type headaches, and cluster headaches. While women can develop a new headache disorder during pregnancy, typically these disorders have already existed. Aside from migraines, tension-type headaches and cluster headaches tend to remain stable during pregnancy.

    Migraines are the most common headache in pregnancy but are generally less severe and occur less often than those outside of pregnancy. That said, migraines may be worsened initially during the first trimester, especially with the change in hormone levels in the body and the added stress occurring.

    There is some scientific evidence that women with migraines may be at a higher risk of developing preeclampsia and/or preterm birth, although more research needs to be done to tease apart this relationship.

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