Migraine Headache Facts for Women During Pregnancy

This blog post  has been reproduced with the explicit permission of YourDoctors.Online 

Migraine headaches are no fun for women, especially during pregnancy. There are many concerns moms to be need to know!

Migraine headaches are very common for women to have. Therefore, pain management during pregnancy is a serious concern that’s very important for women who usually get a migraine headache.

“It is also normal to experience your first migraine when you are pregnant. Some studies have found a slight correlation between migraines and hormones. Women tend to get migraines more often than men,” according to the APA.

It is most ideal to manage the condition even before the patient considers pregnancy. It is also imperative for women to discuss their pregnancy plans with the practitioner treating their migraine headache. This is to avoid any contraindications with medications during pregnancy, especially during early gestation.

Is Treatment for Migraine Headaches Not Good for Pregnancy?

Most treatments are contraindicated before conception or during pregnancy whether it’s preventive or mechanism-specific. The simple reason is the definite however small risk to the fetus.

In 2009, the US FDA (Food and Drug Administration) posted a statement on their MedWatch website where they highlighted the risks of valproate sodium and related products. They also encouraged people to consider alternate therapies if using valproate to treat migraine headache will pose risks to anyone.

60 to 70 Percent of Women Improved Migraine Headache Conditions During Pregnancy

For women who have experienced a migraine headache, there are about 60 to 70 percent who experienced improved conditions during the third or fourth month of pregnancy. Sometimes, the first migraine headache attack occurs during the first trimester.

The new onset of aura could occur during the second and third trimesters. Then, the headache usually returns during the first week postpartum. Lactation may also be the cause of your headache.

For women, postpartum headaches usually occur in around 34 percent of women, and mostly from days three to six. Postpartum headache is mostly less severe than the typical migraine. It is also usually bifrontal, prolonged, and linked with photophobia, nausea, and anorexia.

Tell a Doctor Immediately if Migraine Headache If it’s a New Condition

If there is a new onset of another severe headache, especially for women who have never had a migraine, tell your doctor immediately so you can be evaluated further for other diagnoses like intracranial hemorrhage, temporal arteritis, internal carotid dissection, cerebral venous thrombosis (CVT), reversible posterior leukoencephalopathy (RPLE), meningitis, and pituitary apoplexy.

If there is a new onset of migraine with aura, it can be caused by vasculitis, brain tumors, and occipital arteriovenous malformations.

Brain Tumors Grow Quickly for Women During Pregnancy

For women, there are brain tumors that grow quickly during pregnancy like meningiomas, choriocarcinomas, and pituitary tumors. Arteriovenous malformations are actually common during pregnancy and then tend to bleed in the middle toward the end of the pregnancy.

Aneurysms are also most likely to bleed between weeks 30 to 40. CVT frequently occurs in the peripartum period.

According to several past studies, for women who have migraine headache, there are no increased risk of miscarriage, toxaemia, congenital malformations, and stillbirths.

A following study found that 3.1 percent of women who never had a migraine and nine percent of women who have migraine headache had hypertensive disorders during pregnancy. There was also a trend of low birth weight infants from those who have migraines.

Treatment Options for Migraine HeadAches are Limited During Pregnancy

Treatment options for headache during pregnancy are limited and should actually be avoided, if it’s possible. Those that are acceptable for acute attacks are acetaminophen, caffeine, and opioids. Ibufropen and Naproxen are also allowed before the third trimester.

Caffeine will be effective for women who do not usually consume caffeine and for women who have caffeine withdrawal that does not involve or trigger migraine. Antiemetics that could be considered for use during pregnancy are prochlorperazine and promethazine.

Treatment options for a severe acute attack termed migrainosus are intravenous hydration, antiemetics, analgesics, and steroids. Ergotamines are contraindicated and triptans are not recommended. As of 2011, the sumatriptan and naratriptan registry did not find any increased risk of first trimester birth defects.

There are many different types of medications available that are used to prevent migraines and these usually come with varying levels of risk during pregnancy or even breastfeeding. To be completely sure and safe, consult your doctor before taking any kind of medication.


Dr. Scott Kramer Bio: Since completing my training at UCSF I continue to be a passionate leader in the evolution of minimally invasive gynecologic surgery, foremost by introducing new procedures to patients in Northern California, as well as teaching doctors throughout the western United States. A six-time recipient of the “Patient’s Choice Award”, Dr. Scott Kramer has spent over 26 years providing comprehensive, contemporary and compassionate medical care for women in the San Francisco Bay Area. Voted by fellow physicians as one of the “Best Doctors in America”, Dr. Kramer is a leader in the revolutionary field of minimally invasive gynecologic surgery; applied to heavy menstrual periods, female bladder disorders, and pelvic organ prolapse. Dr. Kramer strongly believes that information empowers you to make better health care decisions.

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