Headache and Pregnancy

By Laura Cone

Jennifer Klemp of Land O’ Lakes, Fla., had numerous headaches when she was pregnant with her first son, Lucas. Now she lets her 2-year-old son comfort her by patting her on the back when she feels nauseated and frazzled by headaches so common during the first trimester. Klemp is expecting her second child soon.

“I had more headaches with Lucas than I did with this one,” says Klemp, who has been in the hospital twice for extreme vomiting. “I started getting headaches right away with the first pregnancy. They were tension headaches across the forehead. They get so bad they feel like migraines.” When she feels a headache coming on, Klemp lies down to rest. “Getting hungry and not eating brings on headaches,” she says. “My hormone levels are going down and I’m starting to feel better.”

Plan Alternative Treatments for Headaches During Pregnancy

Dr. Dawn Marcus, an associate professor at the University of Pittsburgh, says women tend to have more headaches during their pregnancies because of high estrogen levels. Their blood vessels are more likely to constrict, and their joints are more flexible due to the increase in estrogen, which increases the odds of getting a headache.

“Ideally, women should talk to their doctor to plan headache treatment strategies before planning a pregnancy,” Dr. Marcus says. “This allows time to receive instruction in effective non-medication techniques, such as relaxation and biofeedback, and change medications to regimens that are safe for the baby.” She says pregnant women should avoid using headache relief medications too frequently or they may develop rebound headaches. According to Dr. Marcus, two recent studies in Denmark and California linked nonsteroidal anti-inflammatory drugs such as ibuprofen, naproxen and aspirin with a higher risk for miscarriage.

Experts say a few of the most common causes of headaches during pregnancy include:

• Blood Sugar Fluctuations: Your body is trying to supply your baby with glucose, which may cause your own blood-sugar levels to fluctuate.Solution: Eat regular meals, and include at least a small amount of protein, such as a glass of milk, at every meal.
• Dehydration: During your pregnancy you may urinate more frequently or lose fluids by vomiting. You need more water when you are pregnant because you are producing extra blood and amniotic fluid.Solution: Drink plenty of water, at least 48 ounces a day, and eat plenty of fruits and vegetables.
• Stress: Loud noises, arguments and too much stress on the job may trigger tension headaches. Solution: Listen to soothing music, maintain a regular sleep pattern and enjoy lavender aromatherapy candles.
• Caffeine Withdrawal: Most experts suggest women who are pregnant avoid caffeine and recommend limiting caffeine consumption to between 150 and 300 milligrams a day, which is the equivalent of about two cups of coffee. Solution: Gradually cut back on your caffeine use.
• Estrogen Changes: Under the influence of higher levels of estrogen, your blood vessels will constrict and cause headaches.

Solution: Try to relax and discontinue nicotine, alcohol and caffeine consumption. If eating regularly and sleeping does not help, try headache relief medications such as acetaminophen (Tylenol is one brand name), but take it no more than two days per week. read here more about cause of headaches during pregnancy

Breastfeeding and Headaches

Dr. Marcus says women who are breastfeeding will also need to restrict their use of medications. Women who are breastfeeding may notice a return of their headaches within a few days to weeks after delivery, she says. “Talk to your doctor while still pregnant to make plans for postpartum treatment,” Dr. Marcus says. She says most medications that are safe during pregnancy are also safe for women while they are breastfeeding. Check with your doctor before taking any medication.

Understanding Migraines

About 15 percent of women have their first migraine, a more debilitating headache, during pregnancy. Although migraines hurt, they don’t cause any long-term damage to your baby. Some experts say migraines are caused by hormone changes, while others believe they are related to an inherited disorder in the central nervous system.

“Although migraines improve for about 50 to 80 percent of women with pregnancy, migraines are not likely to improve if they haven’t done so during the first trimester,” Dr. Marcus says. “There are effective treatments that can be used safely during pregnancy to minimize migraine-related disability. Even when headaches improve with pregnancy, they often worsen after delivery.”

Dr. Morris Papernik, an associate professor of medicine at Rush Medical College in Chicago, says headaches may often simply be annoying or may be the body’s way of giving a warning when there is a major problem such as aneurysm. “When a physician looks at a patient coming in with a headache we divide headaches into two types,” says Dr. Papernik. “One is a primary headache, which are benign headaches such as migraines and tension headaches, versus secondary headaches, which are headaches which are potentially malignant such as brain tumors [and] aneurysms. We have to, as physicians, ask certain questions and figure out what the patient has. If we are satisfied with their screening exams and say this is a primary or benign headache, we look at what could be causing the headaches the patient is complaining about.”

Dr. Papernik says estrogen levels in a state of fluctuation cause most migraine headaches. “The biggest problem is to find something you can take when you are pregnant and having a headache,” he says. “If you are dealing with sinus headaches, they can get by with Tylenol or antibiotics. If you are dealing with tension headaches, we tend not to use any medications. Most of the medications you would use would have a negative effect on the fetus.”

Because migraines for some people are triggered by secondhand smoke or noises, he advises staying away from whatever triggers your migraines. “Patients who have migraines like consistency,” Dr. Papernik says. “Patients who have migraines should eat at the same time every day, go to bed at the same time every day, wake up at the same time every day, do the same things every day. Routine is very important to prevent migraine headaches. The best advice for the pregnant woman with migraines is to try to maintain a consistency in their daily activities.”

In terms of dietary changes, Dr. Papernik says most people connect chocolate with causing migraines, but he remains skeptical. “The theory is it causes headaches because of the caffeine,” he says. “Most people say chocolate triggers their migraines. Any food can trigger migraines in different people.”

Identifying Your Headache

Some experts recommend keeping a headache diary, which you can share with your physician. Before you try to treat your headache, see if you can identify what kind of headache you have. In addition to migraines, Dr. Papernik says the following types of headaches are most common:

• Tension headaches feel as though you have a tight band around your head. It’s a steady, constant, dull pain that starts at the back of the head or forehead.
• Sinus headaches feel like a dull, continuous pain around the eyes or cheekbones that worsens when you bend over. Sinus headaches are often seasonal or can be caused during pregnancy by increased swelling of nasal tissues and heavier mucus production.
• Cluster headaches feel like excruciating pain over the eye and forehead, usually just on one side of the face. The headaches last from 15 minutes to an hour.

Finally, pay attention to the pattern of your headaches during pregnancy so your obstetrician can keep an eye on and prevent complications. Also, use the times when you can’t get rid of a headache as a chance to practice pain management, relaxation and visualization techniques that will help you get through the pain of childbirth.