Headache and migraines commonly affect pregnant women, often during the first trimester. An expert shares treatments to try and when to call your doctor. Show
Pregnancy is a crucial time of life — a time when the expectant mother wants to make sure that she is taking care of herself and that everything is going well. SEE ALSO: 3 Reasons Women Are More Likely to Have Insomnia Unfortunately, frequent or severe headaches can waylay these plans for many mothers-to-be. Here, neurologist and headache specialist Lauren A. Aymen, D.O., shares the medications, supplements, treatments and symptomatic red flags pregnant women should watch for. Is it common for pregnant women to have headaches or migraines during pregnancy?Aymen: Yes. Migraines are usually worse in the first trimester but can improve during the second and third trimester. Unfortunately, in 4 to 8 percent of women, migraines can worsen. Headache frequency typically returns back to the patient’s pre-pregnancy baseline after delivery. What’s the reason for this?Aymen: Pregnancy usually brings with it hormonal changes, stress, disrupted sleep, nausea and dehydration. And all of these conditions may worsen migraine in pregnancy. What can be done for pregnant women who have migraines?Aymen: You can’t use most of the over-the-counter (OTC) medications during pregnancy — with the exception of Tylenol (acetaminophen). Magnesium and riboflavin are OTC supplements that are safe and can be effective as well. Unfortunately, there are few prescription headache medications that are safe to use during pregnancy. However, there are certain procedures that are safe during pregnancy that can aid in preventing and stopping migraines. For instance, we commonly use nerve blocks to reduce the frequency and severity of headaches. One example is an occipital nerve block, which is very effective at reducing the burden of pain during pregnancy. SEE ALSO: The Best OTC Meds and Supplements to Treat Headache There is also a new procedure called a sphenopalatine ganglion nerve block, which involves placing a small rubber tube approximately 4 centimeters (about 1 1/2 inches) into each nostril and delivering medication to the sphenopalatine ganglion, a branch of the facial nerve. This is very effective for patients with frontal or retro-orbital head pain and certain facial pain syndromes. One advantage to this procedure is there are no needles involved, so it’s minimally invasive. In addition, the medication we use in both procedures acts locally and does not have systemic side effects. If effective, these procedures can be repeated during pregnancy without any known risk to the baby. Can a headache be a sign of something more serious?Aymen: Yes. A headache with any of the following symptoms — if you’re pregnant or not — could suggest something more serious. The red flags include:
Review Migraine in pregnancy: what are the safest treatment options?V Pfaffenrath et al. Drug Saf. 1998 Nov. AbstractThe occurrence of migraine in women is influenced by hormonal changes throughout the lifecycle. A beneficial effect of pregnancy on migraine, mainly during the last 2 trimesters, has been observed in 55 to 90% of women who are pregnant, irrespective of the type of migraine. A higher percentage of women with menstrual migraine find that their condition improves when they are pregnant. However, in rare cases migraine may appear for the first time during pregnancy. The positive effects of pregnancy on migraine and the possible worsening post partum are probably related to the uniformly high and stable estrogen levels during pregnancy and the rapid fall-off thereafter. Nondrug therapies (relaxation, sleep, massage, ice packs, biofeedback) should be tried first to treat migraine in women who are pregnant. For treatment of acute migraine attacks 1000 mg of paracetamol (acetaminophen) preferably as a suppository is considered the first choice drug treatment. The risks associated with use of aspirin (acetylsalicylic acid) and ibuprofen are considered to be small when the agents are taken episodically and if they are avoided during the last trimester of pregnancy. The 'triptans' (sumatriptan, zolmitriptan, naratriptan), dihydroergotamine and ergotamine tartrate are contraindicated in women who are pregnant. Prochlorperazine for treatment of nausea is unlikely to be harmful during pregnancy. Metoclopramide is probably acceptable to use during the second and third trimester. Prophylactic treatment is rarely indicated and the only agents that can be given during pregnancy are the beta-blockers metoprolol and propranolol. Similar articles
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How do I get rid of a migraine while pregnant?Common types of headaches and treatment options
Rest, a neck or scalp massage, hot or cold packs, and over-the-counter anti-inflammatory drugs such as Tylenol, aspirin, or ibuprofen can reduce the pain.
Which medicine is best for migraine in pregnancy?Nondrug therapies (relaxation, sleep, massage, ice packs, biofeedback) should be tried first to treat migraine in women who are pregnant. For treatment of acute migraine attacks 1000 mg of paracetamol (acetaminophen) preferably as a suppository is considered the first choice drug treatment.
Can I take Excedrin Migraine while pregnant?Excedrin Migraine also contains acetaminophen, which is considered safe to take throughout pregnancy.
What can I take for a headache while pregnant Besides Tylenol?Nonsteroidal anti-inflammatory drugs (NSAIDs)
NSAIDs are often used to relieve headache pain. These include over-the-counter (OTC) medications, such as ibuprofen (Advil), naproxen (Aleve), and aspirin.
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What can i take for migraine while pregnant
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