Migraine and Pregnancy
For the most part, the majority of females who have been diagnosed with a migraine get a relief during pregnancy. Unlike premenstrual syndrome which triggers a migraine, the hormonal changes that occur during pregnancy are known to quieten the disorder. Unfortunately, pregnancy does not always diminish migraine episodes in all women. For some unknown reason, there are still a significant number of women who do develop a migraine during pregnancy. In these women, it is believed that something other than hormones maybe the trigger factor like lifestyle, food or the environment.
When does a migraine occur during pregnancy?
A migraine during pregnancy can occur at any time but is most common during the first and second trimester. It is believed that the sudden changes in hormones, gain in body weight, type of diet, stress, lack of sleep, and blood flow that occur during pregnancy may be the trigger factors. Sometimes the migraine is brought on by the morning sickness. In most cases, the migraine lasts several hours but in some cases may persist for a lot longer. A migraine during pregnancy, otherwise, has many of the same features that one would see in a non-pregnant patient.
A migraine changes little in the first trimester of pregnancy, up to 80 percent of women with a migraine will experience fewer attacks compared with pre- pregnancy during the second and third trimesters. Women with a history of menstrual or menstrually-related migraine improvement are more likely. A migraine has no adverse effects on the aftermath of pregnancy in otherwise healthy women. Breastfeeding should be encouraged as it generally sustains the benefits of pregnancy on migraine.
What is unique about a migraine in pregnancy?
The one key feature about a migraine during pregnancy is the unpredictability. The female may be feeling perfectly fine and then suddenly without any aura, the migraine strikes. While some pregnant women may get one or two attacks during the entire pregnancy, others may get one attack every week. The quality of life is seriously affected by migraine attacks during pregnancy.
What should I do if I get a migraine during pregnancy?
Fortunately, there is treatment available for women who develop a migraine during pregnancy. The first thing to do is keep a diary of what you eat and drink (e.g. chocolate, coffee, alcohol), note the amount and types of stress, the amount of sleep, how many attacks, the time, duration, any associated symptoms and what makes it better or worse. The diary can help the healthcare provider determine if there are any trends and this allows for the introduction of preventive measures. Secondly, once any trigger is identified then it is easy to avoid them for the rest of the pregnancy.
Also read about: Migraine in Women
How is a migraine diagnosed during pregnancy?
In most cases, the diagnosis of a migraine is based on the clinical history and physical exam. However, because during a pregnancy there are many other physiological changes occurring, the healthcare provider may order a urine and blood test to look for any infection, look for abnormalities in electrolytes and ensure that your kidneys and liver are functioning normally. Since a headache can also be caused by eclampsia, the condition is always ruled out by doing some blood tests. Because of pregnancy, imaging tests are usually not done unless something very serious is suspected. Imaging tests generate radiation which may not be safe for the fetus especially during the first trimester.
How is a migraine treated during pregnancy?
Once the diagnosis is made, the treatment of a migraine during pregnancy is chiefly focused on non-medical therapies, eliminating triggers and supporting a healthy lifestyle. It is important to know that the use of anti-migraine medications during pregnancy is not recommended as these agents may have an adverse effect on the fetus.
Thus, the treatment of a migraine during pregnancy requires the following:
- Try and eliminate any trigger factors like specific foods, bright lights or too much noise.
- Eat a healthy diet that consists of fruits and vegetables.
- Get adequate sleep and rest. Sometimes this may be difficult if you are alone at home but try and ask some of your family members to help.
- Remain hydrated.
- If you are stressed, try deep breathing exercises, yoga or acupuncture. These remedies work best for prevention of a migraine.
- If you do develop a migraine, apply an ice pack, remain in a quiet dark room and ask for a gentle massage.
- There is some evidence that non-drug therapies, such as relaxation, biofeedback, and physical therapy, are safe and may be effective in pregnancy.
What medications can be taken?
If a migraine is severe and a medication is needed, then one should use acetaminophen because it is considered a low risk to a pregnancy. Non-steroidal drugs like ibuprofen or aspirin should be avoided as they may lead to miscarriage or bleeding. All opiates should be avoided as there is a risk of addiction in both the fetus and the mother. For nausea, one may try ginger.
Paracetamol is the treatment of choice for mild to moderate pain throughout pregnancy and lactation. NSAIDs can be used during lactation but aspirin should be avoided. If no other treatment is effective, sumatriptan is the triptan of choice during pregnancy and breastfeeding.Low-dose propranolol is the prophylactic of choice for a migraine during pregnancy and lactation.
Also read about : Migraine Treatment
Since, there is a restriction in the medicines to be taken during pregnancy, natural and home remedies are the best option to avoid migraine headaches during pregnancy. Here are some of them:
- Caffeine is considered as a major migraine trigger, having a healthy and hot caffeine drink can relieve your migraine pain during pregnancy.
- Taking Ginger and Chamomile tea also gives relief to the migraine pain in pregnancy but do not drink them in excess
- Even, you can drink a glass of warm milk with little honey or without honey or Cinnamon powder is also often added to the warm milk to get relieved from a migraine during pregnancy naturally.
- Over the centuries some foods are proved to be effective and also useful in reducing migraine which is fish, tomato, whole wheat, nuts, green leafy vegetables all these are rich in Niacin that helps in reducing migraine during pregnancy naturally.
- Carrot juice and also concentrated grape juice also help in reducing migraine during pregnancy.
- You can apply Sandalwood paste on the forehead to relieve migraine pain during pregnancy as it has a cooling and soothing effect.
- Horseradish oil can also be used to treat a migraine during pregnancy
- Cut a raw potato and keep on the forehead for some time to get relief from migraine pain
- Grinded lemon peel can be applied on the forehead to relieve the pain.
- There is some evidence that non-drug therapies, such as relaxation, biofeedback, and physical therapy, are safe and may be effective in pregnancy.
How to prevent a migraine during pregnancy?
For a severe and recurrent migraine during pregnancy, one should see a neurologist who specializes in the treatment of pregnant women. There are some medications like the beta-blockers and calcium channel blockers that can be used safely at low-doses and they can prevent recurrent attacks. However, it is important to speak to a neurologist first before you take any medication during a pregnancy.
For pregnant women who can’t or do not wish to take medications, another option is to try Cefaly, which is a relatively new portable hand-band like device that can prevent a migraine. The device generates electrical impulses and when used once a day for 20 minutes, can prevent migraine attacks.