Migraine & Moms-to-Be: Making The Right Treatment Choices For Your Baby

Over 25% of women experience migraine during their lifetime, and hormone fluctuations, especially changes in estrogen levels, can have a big impact on the frequency and intensity of migraine attacks. That’s especially true of the hormonal changes that accompany pregnancy. If you are pregnant or plan to become pregnant soon, what do you need to know?

Pregnancy can have a significant impact on migraine symptoms and how women should treat them. Here’s what experts have to say.

First, the good news: Between 50 and 80% of pregnant migraine patients actually experience a reduction in migraine attacks during their pregnancy, according to David Dodick, a professor of medicine at the Mayo Clinic School of Medicine in Arizona. Many doctors believe rising estrogen levels help reduce migraine frequency and intensity. Hormone replacement therapy that mimics pregnancy’s effect on the body is increasingly being used in migraine treatment plans, especially for those who experience migraines around the time of menstruation. Caution does need to be used however in women who have migraines with aura, as the increased risk of stroke may further be increased by the addition of an estrogen-containing oral contraceptive pill.

However, some women experience migraine for the first time during pregnancy and some experience an increase in migraine symptoms especially during the first trimester. The appearance or worsening of migraine in pregnant women should be taken very seriously:  Studies show that migraine symptoms, when accompanied by high blood pressure, can increase the risk of developing preeclampsia or other vascular complications. Women whose migraine symptoms don’t decrease during pregnancy should be particularly vigilant. It’s important to work with your obstetrician and your headache doctor when you have migraine to establish a safe treatment plan.

Although doctors generally advise pregnant women to avoid medications when possible, two-thirds of women take medications during pregnancy, and 50% take them during the first trimester. If you are pregnant or plan to become pregnant, you may need to reevaluate your migraine treatment options. Here’s what some experts recommend:

  1. Identify and avoid your triggers. Experiment by avoiding foods like chocolate, caffeine, and processed foods, to see if it affects your migraines.
  2. Make sleep a priority.  Follow consistent sleep and wake times. Purchase and practice using earplugs and a sleep mask, if necessary.  Use good sleep hygiene.
  3. Stay hydrated. If you’ve ever gone to the emergency room with a migraine, you’ll remember that the first thing they do is to administer intravenous saline to combat dehydration.  Your body needs far more water when you’re pregnant. Keep drinking, and consider incorporating electrolyte-rich supplementary fluids like Pedialyte.
  4. Have a treatment plan—and a backup plan. What medications work for you, and when and how do you take them? What non-pharmaceutical treatments offer you relief? It’s good to become familiar with and discuss pain plans and pain medications with both doctors before you need them.

Migraine Medication and Pregnancy

What migraine medications are safe to take during pregnancy?

The Food and Drug Administration (FDA) sorts migraine treatments into various safety categories. The FDA classifies both prescription and non-prescription drugs into various categories based on each medication’s potential to cause birth defects. Please click here to read the FDA’s safety guide when taking medications during pregnancy. 

As with any treatment plan, it’s essential that you consult with a doctor before moving forward. If you are a migraine patient and are expecting a child, make an appointment with your physician to discuss the best course of action.