Migraine and Pregnancy: What moms-to-be need to know

Women are more prone to migraine and severe headaches than men; they are three times more common in females than in males with the highest rates of prevalence during childbearing years, between the ages of 18 and 44. Hormonal fluctuations and changes that accompany pregnancy also often have a big impact on the frequency and intensity of migraine attacks. It is important to speak with your healthcare provider about any headaches you have before, during, or after pregnancy.

There have been studies showing that pregnancy eases symptoms of a migraine headache for many women. The relative hormonal stability in pregnancy is thought to be the reason for improvements in headache but the physiological details behind it are not understood.

However, some women do experience migraine for the first time during pregnancy, and others with a history of migraine might find themselves facing more severe attacks, especially during the first trimester.

If you develop symptoms of a migraine headache, work with your obstetrician and headache doctor to establish a safe treatment plan.

What does a migraine headache feel like?

Migraine isn't typical headaches, it can cause severe throbbing or pulsing pain that usually occurs on one side of the head. It’s often accompanied by one or more of these symptoms:

• Nausea
• Vomiting
• Numbness or tingling
• Sensitivity to sound and light

What causes migraine headaches during pregnancy?

The exact cause of migraine headaches is still a mystery. Migraine affects nerve pathways, blood vessels, and neurochemicals in the brain.

Researchers find that overly stimulated brain cells flood the brain with chemicals which affect nerve signaling and cause blood vessels to swell, stimulating a pain response.

Estrogen is believed to play a role in migraines which is why women often experience a change in migraine headache patterns through menstruation, pregnancy, and menopause.

Hormones, however, are just one factor that can affect migraine headaches. More often than not, attacks are brought on by a combination of triggers such as stress, lack of sleep, dehydration, certain foods or skipped meals, among others.

Does migraine affect pregnancy?

Migraine has long been suspected as a possible cause of complications in pregnancy but because it is so common in females, researchers have found it a challenge to establish a link between the two.

Inconclusive associations between migraine and pregnancy include pre-eclampsia, congenital abnormalities, and low birth weight. Not that none of these associations are backed by well controlled studies.

If you experience your first migraine attack during pregnancy, or a change in migraine pattern, it is important to speak with your doctor and check for any other conditions that may be dangerous.

Some commonly reported migraine triggers include:

• Bright lights Many migraine patients suffer from a condition called Photophobia. The are sensitive to natural, bright light and fluorescent bulbs, making it difficult to be both outdoors or in an office.

• Dehydration Roughly 30% of migraine patients have reported dehydration as a trigger and often just the slightest sign of it can contribute to headaches.

• Excess stress Stress is one of the biggest contributors to migraine activity and has the highest association in 50-70% of people who suffer migraine attacks.

• Changes in the weather Extreme changes in the weather, heat, storms, and changes in barometric pressure, are commonly associated with migraine attacks. [Link to webinar on weather triggers]

• Change in, or an irregular, sleep schedule Irregular sleep patterns prevent your body, including the brain, from being able to repair and renew itself. There is a high correlation between the lack of sleep and the probability of a migraine attack.

• Hormones Changes and fluctuations in the hormones, estrogen and progesterone during menstruation, pregnancy or menopause can trigger attacks. Many women experience attacks around the time of the menstrual period, this is known as “menstrual migraine”.

• Diet There is a laundry list of foods that is known to trigger a migraine attack, the most common ones being foods that contain histamine and MSG. [Link to webinar on food triggers]

• Caffeine and alcohol Many migraine patients report caffeine or alcohol having adverse effects on their symptoms. The effects of an alcoholic migraine trigger are not limited to red wine, despite most patients’ beliefs. However, some migraine medications do contain a small dose of caffeine that is thought to fend off migraine pain.

• Smells Certain scents or odors may activate receptors in the nasal passages and worsen symptoms of an ongoing attack or trigger one.

Migraine is often set off by a combination of factors and triggers are personal, so it helps to keep track of the before, duration, and after of an attack to work out what your individual sensitivities are. Once you’ve identified them it becomes easier to build balance into your routine ways to manage your exposure to these triggers and keep your migraine attacks at bay.

Here are some basics you can start with:

• Avoid skipping meals.
• Make sleep a priority; focus on getting quality sleep
• Stay hydrated
• Reduce stress in your life
• Exercise regularly

What are safe treatments for migraine during pregnancy?

Many medicines pass through the placenta to your developing baby. It is important to ensure that your migraine treatment plan is right for you and your stage of pregnancy.

Certain medicines are not considered safe for expecting mothers, this sometimes includes aspirin. Speak with your pregnancy care provider to make sure your migraine medication is safe for use during pregnancy.

Here are a few easy remedies to try at home to head off the pain:

• Lying down in a dark and quiet room
• Applying a hot or cold compress or cloth on your forehead or behind your neck
• Massaging your scalp or temples

How do I cope with migraine while pregnant?

In addition to all the other physical and emotional changes that pregnancy brings about, having to work through it while living with migraine is a whole new challenge.

Ask for help and support from your family and friends. If you’re feeling overwhelmed and anxious, join a support group and speak to someone about what you’re going through.

If you need additional support or resources to work through what your triggers are and how to strive for balance while living with migraine, Good Days Program has expert coaches that can guide you through migraine management and taking control of the pain.