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Migraine In Pregnancy – Can Your Pregnancy Make Your Migraine Worse?
You’ve just received the good news – a little bundle of joy will grace your household soon. This journey is one that many people undertake, with all the trials and tribulations that come along with it. How is pregnancy like when you also suffer from a migraine headache?
Pregnancy significantly changes your chemical make-up. In preparation for the child, your body will increase the progesterone and estrogen levels. This change in hormonal level does not truly stabilize until the second trimester, which means that mothers may tend to have more migraine headaches in the first trimester.
People who take medication during their pregnancy to manage their migraines can also join a pregnancy registry, to help other future parents make informed choices about the medications that they can take during pregnancy. It’s FDA-approved too!
Does Pregnancy Change Your Migraine Attacks?
An increase in migraine attacks is concerning for pregnant people, as they are normally not allowed to take non-essential medication during pregnancy. This means that some people who choose to abstain from their normal migraine pain relievers will have a tougher time managing their migraines. It’s especially difficult if you have chronic migraine and rely heavily on preventives to manage your migraine headaches and function normally.
If you are planning on getting pregnant, do be aware of how your current condition can affect your pregnancy journey.
What Impact Does Pregnancy Have On Your Migraine?
An increase in migraine attacks is concerning for pregnant people, as they are normally not allowed to take non-essential medication during pregnancy. This means that some people who choose to abstain from their normal migraine pain relievers will have a tougher time managing their migraines. It’s especially difficult if you have chronic migraine and rely heavily on preventives to manage your migraine headaches and function normally.
If you are planning on getting pregnant, do be aware of how your current condition can affect your pregnancy journey.
What Impact Does Pregnancy Have On Your Migraine?
Migraine Buddy surveyed our pregnant users, and over 70% of the respondents reported migraines during their pregnancy. 50% said that their migraines got better during their pregnancy, while 35% said that they got worse.
The change in hormone levels and blood volume can affect your sensitivity to potential triggers. It’s common for many people to report a change in their food tastes when they become pregnant, such as a new preference for saltier and sweeter foods. Pregnant people also tend to have a higher tolerance for stronger flavors like sour, salty, and sweet flavors. All these new preferences and taste changes may contribute to food triggers during pregnancy. Other triggers that you could be sensitive to are smell and noise. It’s even possible that you could gain a whole new trigger after pregnancy!
A pregnancy migraine attack feels similar to a normal migraine attack. Its intensity and frequency may differ, though that does not necessarily mean it will become worse than normal. You may experience symptoms like nausea (aside from morning sickness), pain on one side of the head, throbbing headaches, or even aura.
What Can You Do To Manage Migraine Headaches During Pregnancy?
It’s important to manage your migraines during pregnancy because you can be limited in what you can physically do to prevent it. For example, you may be abstaining completely from any medication, such as preventives or acute treatment for migraines. This includes injections like Ajovy or even over-the-counter painkillers and various other remedies.
Instead, consider making lifestyle changes, such as diet changes or adding in a new routine to manage your migraine during pregnancy. It’s important to keep to a normal, migraine-friendly lifestyle, and using ice packs and acupuncture treatment can also help. This includes:
- Getting enough sleep
- Staying hydrated
- Reduce exposure to bright light, especially flashing lights
- Reduce exposure to unpleasant or strong odors
- Retreat to a dark room if you feel an attack coming on
- Have an emergency kit on hand at all times for migraine relief
It’s less known, but hunger and low blood sugar can cause a headache, as well. The symptoms of pregnancy like morning sickness can trigger a headache, too – so you must consult the doctors if it gets too bad.
Talk to your doctor if your symptoms get too severe or the headache doesn’t seem to go away. That is – if you experience changes in the field of vision, blurry vision, or dizziness, go to the doctors immediately.
Sometimes, the headaches during pregnancy are a sign of high blood pressure. High blood pressure when you’re with child can cause various complications, like preeclampsia, and every person wants to avoid the emergency room if they can!
If the frequency or severity of your headaches is persistent after 20 weeks of pregnancy – talk to your doctor. Strokes during pregnancy are not common, but having migraines is considered a risk factor for having a stroke. As a preventive, measure your blood pressure each day to stay on top of your health.
What Headache Medications Are Safe For Use During Pregnancy?
Just because you experience migraines during pregnancy, that doesn’t mean you have no options for pain management. Of course, the options are more limited because the effect of some drugs isn’t studied (yet) on pregnant people, or the drugs have shown to have a negative effect.
Do note that we don’t recommend using any of the following medication for headaches. For any doubt or question, consult with your doctor or midwife about the best course of action.
However, some medications are safe to use, like:
Aspirin
Aspirin, the acetylsalicylic acid, in low doses, is one of the most common things to use to reduce migraine headache. The low doses haven’t shown any negative effects on the pregnancy or the child – but larger doses should be avoided.
Also, restrict the use of aspirin to the second trimester of the pregnancy and avoid it during the last trimester, because it could increase the risk of neonatal bleeding. Do note that using Aspirin during breastfeeding is highly discouraged as well, due to potential toxicity.
Non-Steroidal Anti-Inflammatory Drugs
Various non-steroidal anti-inflammatory drugs are safe for headache treatment during pregnancy. Non-selective COX-inhibitors like diclofenac, ibuprofen, and naproxen are the safest options for treating headache in the second trimester. For the third trimester, you should avoid NSAIDs, because they can harm the pregnancy.
These drugs are safe to use during breastfeeding – with ibuprofen being the best option. Ibuprofen is the preferred treatment during breastfeeding because it has low excretion in human milk and will not harm the baby.
Paracetamol
Paracetamol has been the number one treatment for migraine for decades now. Studies show that it has no negative effect on the pregnancy or the baby, and many doctors advise pregnant women to treat their migraine pain with paracetamol. The use of paracetamol during pregnancy is widely spread because it’s safe to use during each trimester of pregnancy.
What Research Is There On Migraine During Pregnancy Right Now?
There is only a minimal amount of medical literature on how migraines or tension headaches in pregnancy work. However, what is out there is encouraging for those who suffer from migraines. A 2010 study on triptans and usage during pregnancy published by the College of Family of Physicians of Canada noted that “accumulated data suggest that exposure to sumatriptan during pregnancy does not increase the risk of birth defects…”
Nevertheless, as the interaction between most migraine pain medication and pregnancy has not been extensively studied, please consult your doctor before you start or continue your current treatment while you are pregnant. The FDA also classifies medication in terms of risk during pregnancy. If you need further health information, you may visit their website.
You may also choose to continue your medication under the supervision of your doctor or neurologist. If you are continuing to administer your migraine medication, please consider joining a pregnancy registry.
What are pregnancy registries?
Before any medications are approved for public use, it goes through stringent clinical trials to ensure it is safe for human use. However, most clinical trials do not include pregnant to reduce the risk to the pregnancy and the child.
Pregnancy registries are meant to examine the effects of medications on pregnant people and the baby. Registries are made up of people who take pain remedies – among others, during their pregnancy and often follow the person during their pregnancy and post-pregnancy to see the outcomes. It also includes studying the baby as well. The information gathered is used to ensure that people are informed about safe medications during their pregnancy.
How can I join?
It is an FDA (United States) requirement to have a pregnancy registry for every medication released. You can visit the FDA website to search for the medication that you are on, and join the registry.
For migraine, there is currently one study on the FDA website, and it is related to the use of Ajovy during pregnancy. You can also use Migraine Buddy to track your medications, and retroactively report them to the registry if you are joining it later in your pregnancy.
Bottom Line
Pregnancy can definitely affect your migraine in ways that you can’t anticipate. Besides the change in hormones, the lifestyle changes, and the possible weaning off normal medication, your life certainly is turned upside down! Nevertheless, it’s an exciting time in a new mother’s life.
A safe way to help future parents like yourself is to join a trial to collect more data. Any information you give to the medical community will make the medications safer for all people in the future!
