A headache during pregnancy may occur at any time, more commonly during the first and third trimesters. Most headaches are not bothersome and are often caused by hormonal changes and an increase in blood volume during pregnancy (1). These headaches are called primary headaches. However, pregnant women may also experience severe headaches due to underlying problems such as preeclampsia, stroke, and high blood pressure. Headaches due to these reasons are called secondary headaches (2). Read this post to learn more about the types, causes, symptoms, and treatments for headaches during pregnancy.
Types Of Headaches
Occasional headaches during early pregnancy are quite common and occur more frequently than usual. However, they generally become better as the pregnancy progresses (3). The following are the types of headaches experienced during pregnancy:
1. Migraine headaches
These headaches cause moderate to severe throbbing pain on one or both sides of the head. They usually last for four hours to three days. They may be accompanied by other migraine symptoms, such as nausea, vomiting, stomach upset, abdominal pain, and sensitivity to light and noise. The exact cause of these headaches during pregnancy is unknown, but it may be due to cerebral blood flow changes. They may be triggered by stress, biological and environmental conditions, certain foods, fatigue, and weather. Over 50% of pregnant women find that their migraine headaches improve after the first trimester; however, they may worsen in the postpartum period. Although severe, migraines do not harm the growing fetus. Some women with migraine headaches manage their condition with adequate rest and by avoiding headache triggers. Medications may be taken only after consulting a doctor (4) (5) (6).
2. Tension headaches
They are the most common type of headaches and are caused by lack of sleep, caffeine withdrawal, stress, depression, pregnancy-related hormonal changes, and tense muscles in the shoulders, neck, scalp, and jaw. Exercise, good sleep, and relaxation techniques may help in the gradual decrease of these headaches. A shoulder massage or placing a warm washcloth on the face also helps in relieving pain during pregnancy. Medications may only be taken after consulting your healthcare provider (4) (7).
3. Sinus headaches
These headaches are common in early pregnancy and are caused by a runny nose and nasal congestion (8). The symptoms of sinus headaches include facial pain and swelling, bad taste in the mouth, fever, mucus discharge, severe pain in the forehead and cheekbones, increase in pain with head movement, and fullness in the ears (6).
4. Cluster headaches
A cluster headache is a one-sided headache that usually occurs around the eye and lasts for around 15 to 180 minutes. The exact cause of these headaches is unknown, but they are believed to be related to activity in the hypothalamus. These aches may feel like a constant burning sensation. They rarely occur during pregnancy; however, if they do, treatment is difficult because medications may have adverse effects on pregnant women. Supplemental oxygen and sumatriptan injections are generally used to relieve such headaches (6) (9) (10).
Causes Of Headaches During Pregnancy
Apart from hormonal changes and increased blood volume, the common causes of headache during the first trimester are (1) (8)
Stress
Poor posture Changes in vision Dehydration due to nausea and vomiting Lack of sleep Low blood sugar Hunger
During the third trimester, headaches in pregnant women mostly occur due to (1)
Poor posture Weight of the growing baby Preeclampsia (high blood pressure during pregnancy)
In some cases, pregnant women develop secondary headaches due to underlying conditions such as (11)
Stroke during pregnancy Ischemic stroke (an artery leading to the brain is blocked or narrowed) Cerebral venous thrombosis (blood clot in the brain’s venous sinus) Meningitis Pituitary tumor
When To Call The Doctor
You may call the doctor if your headaches (1) (12) (13)
Do not reduce after trying different remedies Worsen over time Seem unusual Are accompanied by swelling in the face and hands, visual disturbances, pain below the ribs, heartburn, or weight gain Change in pattern Change with posture Are accompanied by seizures, trauma, and fever
You should also contact your doctor if you have a history of malignancy, pituitary disorders, elevated blood pressure, or human immunodeficiency virus (HIV).
Treatment For Headaches During Pregnancy
Home remedies
Home remedies are generally considered safe during pregnancy; however, you should consult your healthcare provider before trying them. The following are some common home remedies that may help relieve headaches in pregnancy (6) (12):
Practice good posture, especially during the third trimester when the baby’s weight increases. Cover your eyes and nose with a warm washcloth to relieve sinus infections and headaches. Treat tension headaches with a bath or place a warm or cold compress behind the neck. Get a massage for your neck and shoulders. A study has revealed that people who received weekly massages experienced decreased stress, anxiety, and heart rate. Massages were also proven to help in managing migraine headaches (14).
Strengthen the neck and shoulders through physical therapy. Perform gentle exercises and take a walk. Avoid chocolates, peanuts, bread, aged cheese, monosodium glutamate, and sour cream for migraine headaches. Avoid loud noises, computer or television screens, stress, and excessive exercise for migraine headaches. Herbal remedies such as inhaling the vapor of cumin and caraway seeds relieve headaches (15). Inhalation of lavender essential oil is considered safe to reduce migraine during pregnancy (16).
Non-pharmacological treatments
The following are some non-pharmacological treatments that are believed to help alleviate headaches (7): Acupuncture is considered safe during pregnancy, but only a qualified practitioner should do it. Some studies indicate that acupuncture may help relieve tension and migraine headaches; however, these positive results may also be due to expectations, beliefs, or placebo responses (17) (18). Many studies indicate that biofeedback helps treat tension and migraine headaches without adverse outcomes (19) (20). This technique may also cause side effects such as temporary headaches or discomfort in the manipulated area.
Medicines
If alternative treatment options do not help, medications may be taken with the advice of a healthcare provider. The following are some medications that are generally prescribed:
Prevention Of Headaches During Pregnancy
Some of the following lifestyle changes may help prevent pregnancy headaches to a certain extent (10) (21) (22) (23):
Eating small, frequent meals and sipping on water regularly. This may help since insufficient food and fluid intake may cause low blood pressure and dehydration, causing headaches. Getting adequate sleep. Ideally, eight hours of sleep is necessary to feel well-rested and rejuvenated. Eating a healthy and balanced diet to get proper nutrition. Keeping yourself relaxed with mindfulness techniques and yoga. Avoiding triggers such as strong-smelling chemicals, perfumes, and petrol to prevent cluster headaches. Giving up smoking also helps prevent cluster headaches. Avoiding strenuous exercises since they may overheat the body, causing cluster headaches.
