What can a pregnant lady take for a headache

Headache and migraines commonly affect pregnant women, often during the first trimester. An expert shares treatments to try and when to call your doctor.

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.

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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.

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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:

In addition, new headaches in people older than 50 could be a sign of a more concerning condition.

When should you contact your health care provider? 

Aymen: If any of these red flags are present or if headaches are not responding to OTC medications or supplements, you should see a medical professional.

Headaches are quite common in pregnancy. The most common are tension headaches and migraine headaches. Most headaches come and go, but others may be more bothersome or may be caused by other problems. It is important to talk with your healthcare provider about any headaches you have before, during, or after pregnancy.

Many pregnant women have migraine headaches. Over half of women find that their migraines happen less often in the last few months of pregnancy. But migraines may get worse after birth, during the postpartum period. Although migraine headaches may cause you severe pain, they do not harm your developing baby (fetus). 

What are migraine headaches?

Migraines are a type of headache that affects nerves and blood vessels (neurovascular). The 2 most common types of migraines are migraine with aura and migraine without aura.

• Migraine with aura. This type of migraine includes an aura. You may see flashing lights or zigzag lines or lose your eyesight for a short time. This usually happens 10 to 30 minutes before the migraine starts. The aura may also happen during the migraine. 

• Migraine without aura. This type of migraine generally does not have an aura. You may have other symptoms before it starts. 

How are migraine headaches managed in pregnancy?

Treatment of migraines in pregnancy may include things that soothe the pain. This includes cold packs, a darkened room, and sleep. Avoiding triggers such as certain foods and stress may also be helpful. Any medicines to treat pain, nausea, and vomiting must be carefully chosen. Here are some things to know about migraine treatment in pregnancy: 

• Many medicines pass through the placenta to your developing baby. You should not take these medicines in the first trimester.

• Other medicines can be harmful in later pregnancy.

• Generally, small amounts of acetaminophen and caffeine are safe in pregnancy. 

• Do not take nonsteroidal anti-inflammatory medicines (NSAIDs) such as ibuprofen.  

• Migraine headache medicine such as sumatriptan and opioid pain medicines such as morphine should be used only as directed by your healthcare provider. Opioid pain relievers can be addictive for both you and your baby.  

Talk with your pregnancy care provider about which migraine medicine can be used safely during pregnancy.  

What are possible complications of migraines?

If you have a history of migraine headaches, and have no other health problems, migraines during pregnancy are not usually a concern. 

But if a first-time migraine-like headache occurs in pregnancy, it is important to check for any other type of condition that may be dangerous. This includes bleeding in the brain, meningitis, high blood pressure, or tumors. You may need further testing to find the cause of the headache. This testing may include urine and blood tests.