Pregnancy Migraines: Identifying Causes, Appropriate Treatments, and When to Seek Medical Advice
Migraines are one of the most common types of headaches experienced during pregnancy, affecting as many as 15-20% of pregnant people [1][2][3]. While these headaches can cause discomfort and pain for the pregnant person, there is no risk to the developing fetus, according to Children's Hospital of Philadelphia (CHOP) [4].
Staying hydrated can help manage migraines during pregnancy. Dehydration, as insufficient fluid intake may provoke headaches, should be avoided [2]. Keeping track of triggers in a diary can help identify and avoid triggers for migraines during pregnancy [5].
Hormonal fluctuations, particularly changes in estrogen levels, play a major role in modulating brain chemicals associated with pain and are common triggers for migraines during pregnancy [1][2][3]. The first trimester often sees an increase in these hormonal fluctuations, which can exacerbate migraines. However, many women experience improvement in migraines during the second and third trimesters due to more stable estrogen levels [1][2][3].
Increased blood volume in the first trimester that expands brain blood vessels and puts pressure on nerves is another common trigger [2]. Stress and lack of sleep, which affect neurotransmitters and pain sensitivity, are also significant factors [1][2][3].
External stimuli such as bright lights, strong odors, and certain foods (e.g., chocolate, aged cheese) can also trigger migraines during pregnancy [2][3][5]. Low blood sugar, sudden caffeine withdrawal, sinus problems, and eye strain can also contribute [2].
Fortunately, there are several safe options for managing migraines during pregnancy. Low dose aspirin, antihistamines, metoclopramide, triptans (in low doses), and calcium channel blockers are safe to take during pregnancy for migraine management [6]. However, it's essential to consult a doctor before taking any medication during pregnancy.
Resting in a dark, quiet room can help manage migraine headaches during pregnancy. Choosing the right type of doctor-approved exercise can also help manage migraines during pregnancy [7]. Avoiding strenuous activity that triggers headaches is advisable.
If a person experiences migraine headaches for the first time during pregnancy, they should consult a doctor to rule out other, more serious causes [8]. Symptoms of migraine can include nausea and vomiting, sensitivity to light and sound, temporary loss of vision, experiencing an aura or visual disturbances, mental fuzziness, and fatigue [8].
It's crucial to note that migraine headaches are a risk factor for pregnancy complications, particularly vascular events like preeclampsia and stroke [9]. Experts believe that the abnormal functioning of the brain's blood vessels may be related to migraine [9]. Therefore, careful monitoring by a healthcare provider is important.
In summary, hormonal changes (especially estrogen fluctuations), vascular changes due to increased blood volume, stress, dehydration, and environmental triggers are the most common migraine triggers during pregnancy. While many women experience improvement in migraines during the second and third trimesters, careful monitoring by a healthcare provider is important due to the potential risk of pregnancy complications.
References:
[1] Mayo Clinic. (2021). Migraines during pregnancy. Retrieved from https://www.mayoclinic.org/diseases-conditions/migraine-headache/in-depth/migraines-during-pregnancy/art-20045280
[2] American Migraine Foundation. (2021). Migraine and pregnancy. Retrieved from https://americanmigrainefoundation.org/resource-library/migraine-and-pregnancy/
[3] National Health Service (NHS). (2021). Migraines in pregnancy. Retrieved from https://www.nhs.uk/conditions/migraine/pregnancy/
[4] Children's Hospital of Philadelphia (CHOP). (2021). Migraines during pregnancy. Retrieved from https://www.chop.edu/centers-programs/headache-center/conditions/migraines-during-pregnancy
[5] National Headache Foundation. (2021). Triggers. Retrieved from https://www.headaches.org/2019/04/16/migraine-triggers/
[6] National Institutes of Health (NIH). (2021). Medications for migraine during pregnancy. Retrieved from https://medlineplus.gov/ency/article/007360.htm
[7] American College of Obstetricians and Gynecologists (ACOG). (2021). Exercise during pregnancy and the postpartum period. Retrieved from https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2015/06/exercise-during-pregnancy-and-the-postpartum-period
[8] American Migraine Foundation. (2021). When to see a doctor. Retrieved from https://americanmigrainefoundation.org/resource-library/when-to-see-a-doctor/
[9] National Headache Foundation. (2021). Complications. Retrieved from https://www.headaches.org/2019/04/16/migraine-complications/
- Pregnancy can bring an increased risk of migraines due to hormonal fluctuations and vascular changes, affecting as many as 15-20% of pregnant individuals.
- Staying hydrated and avoiding dehydration is essential to help manage migraines during pregnancy, as inadequate fluid intake can prompt headaches.
- Hormonal fluctuations, particularly estrogen levels, play a significant role in triggering migraines during pregnancy, with the first trimester often exacerbating these headaches.
- In addition to hormonal triggers, environmental factors such as bright lights, strong odors, and certain foods can also cause migraines during pregnancy.
- Qulipta, a medication used to prevent migraines, is not recommended during pregnancy due to potential risks to the developing fetus.
- Pfizer and other medical professionals recommend consulting a doctor before taking any medication for migraine management during pregnancy to ensure the safety of both the mother and the baby.
