Written by Dr. Joel M. Bernstien, M.D.
Are Headaches Common in Pregnancy?
Lots of women suffer with headaches in pregnancy, even if they were not “headache people” before they got pregnant. Fortunately, there are many safe and effective headache treatments in pregnancy available, including natural remedies and medications when necessary. Most headaches during pregnancy are benign, but at times they may be a sign of hypertension, or some other medical or structural problem, which I will cover at the end of the post.
Why Do Headaches Happen During Pregnancy?
First off, headaches often bother women more earlier in pregnancy (first trimester), as their bodies experience changes such as increased intravascular fluid volume, new nausea and vomiting, blood sugar alteration, hormonal shifts, sleep disturbance, etc. Other lifestyle changes, like caffeine reduction or cessation of pre-pregnancy medications, can also lead to more frequent or severe headaches.
Natural Remedies for Headaches in Pregnancy
Generally, it’s best to try natural remedies for headaches in pregnancy first. Hydration is very important throughout pregnancy, so drinking plenty of water and perhaps incorporating electrolyte beverages should be first line.
Keeping your blood sugar balanced is also important, so aim for frequent smaller meals and prioritize protein sources. Nausea and vomiting can throw a wrench in your efforts to prevent headaches, so for those who are struggling to keep anything down at home, your team at Kamm McKenzie can help. We can review supplements and over the counter treatments that can help, and prescribe medications as needed. We can also do IV fluids in the office when necessary. Some of the anti-nausea medications we recommend can also help with headaches. I am a huge fan of magnesium (magnesium oxide or magnesium glycinate) and vitamin B2. I even suggest that women who have frequent headaches take 400mg of each, twice daily. Other helpful remedies include warm or cold compresses, Epsom salt baths, essential oils, and massage therapy.
Medications That Are Safe for Headaches in Pregnancy
Over the counter medications can be useful if the above remedies are not sufficient. The American College of OBGYN (ACOG) recommends starting with acetaminophen (Tylenol) for headaches in pregnancy. If that does not work, you can try something like Excedrin Migraine, which is just a combination of acetaminophen, aspirin, and caffeine (all of which are okay to take in pregnancy). Some women find relief from adding diphenhydramine (Benadryl).
If you have bad allergies, especially with the North Carolina pollen, feel free to take over the counter remedies like Zyrtec, Claritin, or Allegra; Flonase can also be helpful. Beyond that, you should reach out to us to discuss prescription medications that are safe in pregnancy.
When Are Headaches in Pregnancy Concerning?
If you are past the halfway point in pregnancy (more than 20 weeks) and are getting severe headaches, especially if associated with a sudden onset of increased swelling, you should have your blood pressure assessed. This can be done either by checking it at home or calling us for an appointment.
Sometimes, headaches later in pregnancy can be associated with preeclampsia or gestational hypertension. Rarely, frequent headaches in pregnancy can indicate an underlying medical or neurologic condition, so if the above discussed remedies aren’t helping, be sure to communicate with your doctor or nurse practitioner so we can do additional workup if needed.
Final Thoughts: You Don’t Have to Suffer From Headaches During Pregnancy
Remember, there is no need to suffer from headaches while pregnant. There are many safe and effective treatments for headaches in pregnancy, including natural remedies, over the counter medications, and prescription options. We are here for you if you need it.
