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Is it common to get headaches during pregnancy?
It's normal to get tension headaches when you're pregnant, especially in the first trimester. Migraine sufferers usually get some relief during pregnancy – although some women get their first migraine headache when they're pregnant.
If you have headaches in your first trimester, you'll probably find that they diminish or even disappear during the second trimester, after the flood of hormones stabilizes and your body gets used to its altered chemistry.
What causes headaches during pregnancy?
Experts don't know exactly what causes headaches during pregnancy, but the hormonal free-for-all that's taking place in your body probably has something to do with it. Your increased blood volume and circulation may also play a part, especially in early pregnancy. Quitting caffeine abruptly can also make your head pound.
Other possible causes of headaches during pregnancy include:
- Lack of sleep or general fatigue
- Sinus congestion
Can headaches during pregnancy be a warning sign of something more serious?
Yes, sometimes. In the second or third trimester of pregnancy, a headache could be a sign of preeclampsia, a serious pregnancy-induced condition marked by high blood pressure. Other symptoms of preeclampsia include an unusual amount of protein in the urine, vision changes, and liver and kidney abnormalities.
If you have a migraine or another severe headache for the first time and taking acetaminophen doesn't bring relief, call your healthcare provider. You may need a full medical evaluation to be sure nothing else is going on.
How can I tell if I have a migraine or another type of headache?
It isn't always easy to tell what kind of headache you have. Here's how to tell them apart:
Tension headaches are the most common kind of headache. They can feel like a squeezing pain or a steady dull ache on both sides of your head or at the back of your neck. If you've always been susceptible to tension headaches, pregnancy can make the problem worse.
Migraine headaches cause moderate to severe throbbing pain, typically on one side of the head. They can also be accompanied by other symptoms, such as nausea, vomiting, or sensitivity to light and noise. If untreated, they can last from four to 72 hours and may be aggravated by physical activity as well as many of the same factors that trigger more typical headaches.
Some migraine sufferers have a condition known as migraines with aura – that is, headaches that are preceded by symptoms that may include visual changes (such as bright flashing lights or blind spots), sensations of numbness or "pins and needles," weakness, and speech disturbances. These symptoms may start up to an hour before a migraine starts and may last as long as an hour.
Sinus headaches typically feel like pressure or pain in your cheeks, around your eyes, and in your forehead. They typically occur after a cold or respiratory infection, and they aren't as common as you might think.
People commonly mistake migraine headaches for sinusitis – if you're getting more headaches but otherwise have been healthy, you might be having migraines. But if you're feeling congested, you might have a sinus infection requiring treatment.
Cluster headaches are much less common, and they don't seem to be affected by pregnancy. Cluster headaches are marked by sudden, severe pain usually around one eye or temple, sometimes with tearing eyes or a stuffy nose. They tend to occur at the same time each day, often a few hours after falling asleep, over weeks or months.
How common are migraines during pregnancy?
This varies a lot from woman to woman. Experts estimate that about 1 in 5 women has a migraine headache at some time in her life, and up to 16 percent of those women get migraines for the first time when they're pregnant (most often in the first trimester). On the other hand, most women already suffering from migraines have fewer problems during pregnancy.
Also, about two-thirds of women who are prone to migraines notice that they improve during pregnancy. (This is more likely if migraines tended to be worse around the time of your periods or started when you first began menstruating.) Others notice no change or find that their headaches become more frequent and intense.
Can migraines cause problems during pregnancy?
Migraines don't appear to increase the risk of most pregnancy complications, even if you're in the unlucky minority whose migraines don't improve or get worse.
However, women who have migraines tend to have higher rates of preeclampsia (especially if they didn't get migraines before pregnancy), so it's important to let your healthcare provider know if you start to have them.
Can I take pain medication to treat headache pain during pregnancy?
Acetaminophen is safe to take as directed on the package label, but many other headache medications – including aspirin, ibuprofen, and most prescription migraine drugs – aren't recommended for pregnant women unless approved by a healthcare provider. If you're prone to severe migraines, ask your provider which medications you can take.
If you have frequent, debilitating headaches, the benefits of certain medications may outweigh any possible risks to your baby (although some drugs will remain strictly off-limits). You may be referred to a maternal-fetal medicine specialist (MFM) or a neurologist to help with your migraines if they persist.
How can I relieve headache pain without using medication?
Here are some ways you may avoid or get relief from a headache during pregnancy:
Figure out your headache triggers. Headache specialists often recommend keeping a "headache diary" to help you identify specific triggers. The next time you get a migraine or headache, write down everything you ate for the 24 hours prior and what you were doing when it started.
Some common migraine triggers include food that contain:
- Monosodium glutamate (MSG)
- Nitrites and nitrates (common in processed meats like hot dogs, salami, and bacon)
- Artificial sweeteners
Other food that can trigger a migraine include:
- Certain beans and nuts
- Aged cheese and cultured dairy products (like buttermilk and sour cream)
- Certain fresh fruits (including bananas, papayas, avocados, and citrus)
- Smoked fish
- Chocolate and carob
- Fermented or pickled foods (like soy sauce or sauerkraut)
Other triggers may include:
- Glaring or flickering lights
- Loud noises
- Excessive heat or cold
- Strong odors
- Tobacco smoke
Use a compress. For a tension headache, apply a warm or cool compress to your forehead or the base of your skull. Cold compresses tend to work best for migraines.
Take a shower. For some migraine sufferers, a cold shower brings fast – if temporary – relief. If you can't take a shower, splash cool water on your face. A warm shower or bath can soothe tension headaches.
Don't go hungry or thirsty. To prevent low blood sugar (a common headache trigger), eat small meals frequently. When you're on the go, take along some snacks (crackers, fruit, yogurt). Avoid straight sugar, like candy or soda, which can make your blood sugar spike and crash.
And don't forget to drink plenty of water to stay hydrated. Sip water slowly if you have vomited from a migraine.
Avoid fatigue. Get plenty of sleep at night. When you're having a migraine, sleep in a quiet, dark room.
Exercise. Some evidence shows that regular exercise can reduce the frequency and severity of migraines and reduce the stress that can cause tension headaches. If you're prone to migraines, get started slowly – a sudden burst of activity could trigger one. (And don't exercise once a migraine has started because it will aggravate the headache.)
Exercises to help you maintain good posture may be especially helpful with headaches during the third trimester.
Try relaxation techniques. Biofeedback, meditation, yoga, and self-hypnosis may be helpful for reducing stress and headaches in some sufferers.
Get a massage. Some women who suffer from tension headaches swear by massage, although it's unclear whether it's effective in preventing or relieving headaches. A full-body massage (ideally from a therapist who specializes in prenatal massage) can release tension in the muscles of your neck, shoulders, and back.
If a professional massage isn't an option, ask your partner to rub your back and head.
Consider acupuncture. Acupuncture treatment is most likely safe during pregnancy, although whether it's effective for headaches is a topic of debate. If you'd like to try it, ask your healthcare provider for a referral and keep her posted on your treatments. If you prefer to see an acupuncture practitioner who's also an M.D., check out the American Academy of Medical Acupuncture website.
Which headache symptoms are signs I need to call my healthcare provider?
Call your provider right away if:
- You're in your second or third trimester and have a bad headache or a headache for the first time. It may or may not be accompanied by visual changes, sharp upper abdominal pain or nausea, sudden weight gain, or swelling in your hands or face. You'll need to have your blood pressure and urine checked right away to be sure you don't have preeclampsia. (If you've been having any problems with high or rising blood pressure, call even if you have only a mild headache that persists after taking acetaminophen.)
- You have a sudden "explosive" headache. This type of headache is a violent pain that wakes you up, doesn't go away, or feels unlike any you've ever experienced.
- Your headache is accompanied by a fever or a stiff neck.
- Your headache gets worse and you have other problems, such as blurry vision or other visual disturbances, slurred speech, drowsiness, numbness, or a change in normal sensation or alertness.
- You have a headache after any kind of head injury.
- You have congestion in your nose, as well as pain and pressure underneath your eyes or other facial or even dental pain. This could signal a sinus infection that needs to be treated with antibiotics.
- You notice that that you get headaches after reading or looking at a computer screen.
In any case, don't hesitate to call your provider whenever you're worried about a headache. Even if you've had headaches before, talking to your provider can help you decide which evaluation and treatment might be best for you during your pregnancy.
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