You were warned about the morning sickness, the achy back, the breast tenderness and other pregnancy problems. But that throbbing head might have caught you off guard.
Turns out, headaches during pregnancy aren’t that uncommon—especially if you were already prone to them. But treating pregnancy headaches can be a lot trickier than you’d think. Here’s what you need to know about what causes headaches during pregnancy, when to see a doctor about pregnancy headaches, how to treat them and perhaps most importantly, how to prevent pregnancy headaches from happening in the first place.
What Causes Headaches During Pregnancy?
If you’re dealing with pregnancy headaches, you’re hardly alone: 1 in 4 women regularly experience headache pain. “Headaches are very common,” says Rebecca Erwin Wells, MD, associate professor of neurology at Wake Forest Baptist Medical Center in Winston-Salem, North Carolina. “There are over 200 different types of headaches, defined and diagnosed. Some have no underlying cause aside from genetics. But there are definitely factors during pregnancy that can trigger headaches.”
One major factor is whether you were already prone to getting headaches—and if you’re experiencing headaches while pregnant (especially migraines), chances are you were, even though you might not have known it. Some other factors? “Pregnancy can throw [your eating, sleeping and exercise] routines out of whack," says Matthew Robbins, MD, FAAN, FAHS, director of inpatient services at Montefiore Headache Center and chief of neurology at the Jack D. Weiler Hospital at Montefiore. "Plus, you may experience sleep deprivation, nausea and vomiting in the first trimester, as well as other stressors. This can then trigger your existing sensitivities, and headaches and migraines can declare themselves.”
What exactly is a migraine? “Migraine headaches more often feature pain that’s throbbing, often one-sided, worsened by movement and accompanied by features like nausea, vomiting, achiness, irritation, auras (visual disturbances), numbness or tingling and other symptoms,” Robbins says. But there’s good news for women already prone to migraines: During pregnancy, increased estrogen levels may actually mean a bit of relief from migraines.
Other common causes of headaches during pregnancy include:
- Surging hormones
- Drops in blood sugar
- Increased blood volume and circulation
- Lack of sleep
- Caffeine withdrawal
- Vision changes due to pregnancy hormones
Are Headaches Normal During Pregnancy?
With so many common causes out there, you may be wondering: Are headaches normal during pregnancy? The answer is actually no. “Headaches, no matter when they happen, are never normal,” Wells says. “If there’s a headache, then there’s something that needs to be evaluated, diagnosed and treated.”
Pregnancy Headache Relief
Luckily, if you’re dealing with pregnancy headache pain, you do have treatment options. “First and foremost, talk to your doctor about your pregnancy headaches and treatment options,” Wells says. “That should include non-drug treatment options.”
Natural headache remedies during pregnancy
Most doctors will recommend non-medicinal remedies first. If you get a headache, you can try some of these at-home remedies for pregnancy headache pain relief:
- Apply a warm compress to your face or a cold compress to the back of your neck
- Rest in a dark, quiet room
- Eat small, frequent meals to make sure your blood sugar levels don’t drop
- Take a warm shower
- Sleep it off.
Other non-medical approaches to treating headaches during pregnancy (especially migraines) might work too. Cognitive behavioral therapies, relaxation strategies and biofeedback—a process in which you electronically monitor your body functions to help you gain more control over your body and your pain levels—are all possible treatments for pregnancy headaches, Robbins says. “Even treatments that don’t have the highest degree of scientific evidence to promote them might work for an individual—things like acupuncture and yoga can largely be done safely during pregnancy," he says. "These forms of headache relief are a great place to start before going straight to medication.”
Before taking any herbal remedies, talk to your doctor to make sure they’re pregnancy-safe. “Anything that a pregnant woman consumes will affect the baby,” Wells says. “It’s not worth the risks.”
Safe headache medicine while pregnant
If natural methods don't relieve the pain, what can pregnant women take for headaches? Always talk to your doctor about headache medicine during pregnancy before taking it to make sure it’s safe for you and baby.
Over the counter dosages of acetaminophen (Tylenol) are usually okay to use, but it's generally recommended that pregnant women steer clear of meds like aspirin and ibuprofen (Advil and Motrin), and never pop any pills or supplements without your doctor's approval. “Talk to your doctor about headaches and the risks of the medication,” Wells says. “Sometimes, dealing with the chronic pain is more of an issue than small risks associated with the medication.”
As for dealing with migraines during pregnancy, you have medication treatment options too, including a class of medication called triptans, like Immitrex. “The thought used to be that those weren’t safe to use during pregnancy, but the more studies have been done on pregnant women over the years, the more safety data has emerged,” Robbins says. “So sometimes, we do use those medications in pregnant women who haven’t responded to other treatments.” He also suggests nerve blockers for pregnant women suffering from a bad cycle of migraines during pregnancy.
How to Prevent Headaches During Pregnancy
Of course, the best cure for pregnancy headaches is prevention. “One of the most important pieces of advice I give to women who are planning to become pregnant or have become pregnant is to be mindful of keeping their routines regular,” Robbins says. Here, his top tips for how to prevent headaches during pregnancy:
“Especially during pregnancy, when the medical treatment options for headaches and migraines become much more limited, those preventative measures become much more important," Robinson says. "These triggers can be very individualized, so it’s best to know your triggers and avoid them.”
Wells agrees. “Regular sleep. Regular hydration. Regular, consistent meals. Consistency is key,” she says. “Maintaining a healthy lifestyle during pregnancy is so important. Prevention is priceless when it comes to headaches during pregnancy. It’s a simple solution, but it can have a profound effect.”
When to See the Doctor About Headaches During Pregnancy
Most headaches during pregnancy aren’t a big deal, but sometimes they can be a sign of a serious problem. Pregnancy headaches can be a sign of certain conditions like anemia, asthma, cold, flu, HELLP syndrome (hemolysis elevated liver enzymes and low platelet count), migraine, preeclampsia, sinusitis, toxoplasmosis and varicella (chicken pox).
Migraines during pregnancy in particular can indicate a slightly increased risk of more serious conditions, Wells says. “Women who are predisposed to migraines may also be predisposed to other risks during pregnancy,” she says. “Preeclampsia, blood clots, strokes and even heart attack are more common in people who also suffer migraines.”
“One of the key things for all patients, but especially pregnant women, is that when there are new symptoms or worrisome symptoms, talk to your doctor,” Wells says. “Anything that you haven’t experienced before, or if you’ve had headaches that were stable but have changed in frequency, severity or in character. If there’s something different, talk to your doctor, because it can signal a problem.”
Other red-flag symptoms include pregnancy headaches accompanied by fever, neurological deficits including consistent visual or speech disturbances that are not subsiding, leg swelling or measured high blood pressure. If you experience any weakness, numbness or changes in speech or vision, head to the hospital. Because as Wells says, during pregnancy, safe is definitely better than sorry.
Updated August 2017