Are Menstrual Migraines Taking the Joy Out of Your Pregnancy?

You probably expected pregnancy to be a time of joy, but if you get migraines, it can cast a shadow of pain and frustration over this happy occasion. Your migraines — which are often similar to menstrual migraines — are triggered by the change in your hormone levels. It’s one of the more challenging issues that we face in obstetrics.

Migraines during pregnancy can really ruin what should be a joyful time, but some treatments may help you manage them. Dr. Darin Weyhrich explains more about migraines during pregnancy and how we can treat them.

How pregnancy migraines differ from menstrual migraines

Pregnancy generally offers relief from migraines that occur during your period. Between 50-80% of women who regularly suffer from headaches find that they have fewer of them during pregnancy. 

If you’re not in this lucky percentage of women, however, this statistic may offer little comfort. Some women who have a history of migraines find that they get worse during pregnancy or even that they have their first migraine attack during pregnancy.

Menstrual migraines and pregnancy migraines are similar in that both are a reaction to increased levels of estrogen. In pregnancy, your estrogen levels reach 100 times the normal level, while your progesterone level plummets. Although this usually causes a reduction in migraines, it doesn’t always. We don’t know why some women get pregnancy migraines and others don’t, but we take them seriously.

Why pregnancy migraines are serious

Migraines during pregnancy aren’t just uncomfortable — they can be serious. Migraines during pregnancy may contribute to the following symptoms:

• Preeclampsia
• High blood pressure
• Other vascular conditions

If you’re having migraines during pregnancy, it’s important that you tell Dr. Weyhrich right away. If you don’t already have a migraine specialist, it may be a good idea to get one now. Dr. Weyhrich and your migraine specialist can work together to oversee your care during your pregnancy.

How we treat pregnancy migraines

Although we usually tell pregnant women to limit the use of medication, that’s not always realistic when you’re dealing with migraines. 

You can take acetaminophen (Tylenol®) as directed on the packaging with little worry about its safety. However, you should use caution in combining medications that may contain acetaminophen, such as over-the-counter migraine medications, to make sure you don’t exceed the daily dosage.

You may decide to take prescription migraine medications, such as sumatriptan, on an emergency basis. Talk to Dr. Weyhrich and your migraine specialist to see if this is an option for you.

Other things we do to treat pregnancy migraines include:

Lifestyle modifications

It’s important to avoid triggers for your migraines if you’ve identified them. Some common triggers include:

• Smoking or cigarette smoke
• Strong odors and perfumes
• Processed foods
• Chocolate
• Caffeine (which is a good idea to avoid during pregnancy anyway)

Biofeedback

A common biofeedback technique used for migraines is to use temperature to soothe yourself. Putting your finger in a cup of water that is warmed to 96° F for 10 minutes is as effective as a beta-blocker if used early in your migraine.

Relaxation techniques

You may want to learn some relaxation techniques to try to help you deal with and maybe even prevent your migraines. Some of these techniques include meditation and learning how to be more intentionally calm during your migraines.

Sleep therapy

You need to get good sleep to prevent migraines, but pregnancy itself often makes it difficult to get a good night’s sleep. Sleep therapy is an essential component of migraine treatments.

Vitamin supplements

Some studies have shown that taking over-the-counter vitamin supplements of magnesium may prevent migraines. Riboflavin and coenzyme Q10 may also help, although there is less support for their use. There is no pregnancy risk from taking these supplements, but you should ask Dr. Weyhrich if he recommends them for you.

If your pregnancy migraines are severe enough that you are unable to eat or drink sufficiently, you definitely need to call the doctor right away. Contact Dr. Darin Weyhrich if you have migraines during pregnancy or request an appointment online.