Headaches and migraines in pregnancy: remedies and treatments

Migraines are severe, often unilateral, often (but not always) throbbing headaches, often accompanied by nausea and visual disturbances, vomiting, photophobia, and phonophobia, and are commonly experienced by pregnant women Headache and headache are synonymous.

Headaches in pregnancy: the causes

Many women experience headaches during pregnancy, especially in the first and third trimesters . If you are pregnant, you may notice an increase in the frequency of headaches around the 9th week of pregnancy .

In addition to hormonal changes , headaches in early pregnancy can be due to:

  • an increase in the volume of blood your body is producing;
  • sleep disorders;
  • reduction in the amount of caffeine consumed throughout the day (the Ministry of Health recommends pregnant women limit their caffeine intake to 200 mg per day)
  • drop in blood sugar level;
  • dehydration;
  • stress;
  • incorrect posture induced by the weight of the belly;
  • depression or anxiety;

Migraine in pregnancy

In pregnancy, migraines can get worse in the first few months, but for many women, they can get better in the later stages of pregnancy as estrogen levels stabilize . Other women may experience no change or a decrease in the number of migraines during pregnancy. Some women may experience differences in migraine during subsequent pregnancies.

Pre-eclampsia and headache

Frequent, unexplained headaches later in pregnancy could be a sign of a condition called pre-eclampsia , so let your doctor know if these occur.

Headaches in pregnancy: remedies

If you are pregnant and suffering from headaches or migraines you could try:

  • sleep, rest and relax more
  • do pregnancy yoga exercises or other relaxing exercises (autogenic training, breathing, etc.)
  • take care of your posture
  • eat regular and balanced meals
  • hold a warm washcloth over the eye and nose area
  • taking a hot bath, but not too much and do not overdo it

Headache in pregnancy: pharmacological treatments

Is it safe to use drug treatments for migraine in pregnancy? There is no yes or no answer to this question. When deciding whether to use migraine treatments during pregnancy it’s important to weigh how necessary treatment for your condition is against any risks to you or your baby, some of which may depend on how many weeks pregnant you are. Your doctor is the best person to help you decide what’s right for you and your baby.

Acetaminophen is considered the treatment of choice for mild to moderate pain in pregnancy. It is also generally safe during pregnancy. For more information read this article on taking tachypirine in pregnancy .

If paracetamol is not enough, non-steroidal anti-inflammatory drugs (NSAIDs) can be used in the first and second trimester , but should not be used after 30 weeks of pregnancy as they can affect the well-being of the baby after this stage. For more information read:

Sumatriptan may be suggested if acetaminophen has not controlled pain and the use of an NSAID is not advisable (e.g. in the third trimester). There is currently no evidence that the use of sumatriptan in pregnancy is harmful to the development of the baby, but more information needs to be gathered to confirm this. For more information read Sumatriptan in pregnancy

Codeine has a number of side effects and use in pregnancy, especially in the weeks leading up to delivery, can cause acodeine-in-pregnancy symptoms in the baby after birth. It can therefore only be offered by your doctor if the previous treatment options have not worked, are not suitable for you or cannot be used. More information on the fetal effects of use in pregnancy can be found in our article on codeine use in pregnancy.

Frequently asked questions about headaches in pregnancy

What can I take if I have nausea and vomiting with my migraine?

Metoclopramide is an anti-nausea medicine that can be used for nausea and vomiting with migraine.

What migraine prevention drugs can be taken during pregnancy?

Low-dose aspirin , propranolol and verapamil are known to be effective in preventing migraines in the non-pregnant population and have also been used in pregnancy. If you and your doctor feel that you need a migraine prevention medicine during pregnancy, it would be advisable to consider one of the above medicines.

Some medicines (for example topiramate, riboflavin, gabapentin, pizotifen, venlafaxine, botulinum toxin, magnesium citrate and coenzyme Q10) are used to treat and prevent migraine in non-pregnant people, but are generally not recommended for use during pregnancy . This is because there is very little information on safety or because some studies have suggested that use at certain stages of pregnancy could affect the baby.

Acupuncture can also be effective in migraine prevention.

Migraine prevention drugs that shouldn’t be used during pregnancy

Sodium valproate and a family of medicines called ACE inhibitors (including captopril, cilazapril, enalapril, fosinopril, imidapril, lisinopril, moexipril, perindopril, quinapril, ramipril and trandolapril) should not be used to prevent migraines in pregnant women.

Sodium valproate can cause birth defects and learning problems in your baby, and ACE inhibitors used after about 14 weeks of pregnancy can cause low levels of amniotic fluid and damage your baby’s kidneys.

Katherine Johnson, M.D., is a board-certified obstetrician-gynecologist with clinical expertise in general obstetrics and gynecology, family planning, women’s health, and gynecology.

She is affiliated with the Obstetrics and Gynecology division at an undisclosed healthcare institution and the online platform, Maternicity.com.

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