How can a pregnant woman cope with migraines? What to do if you suffer from migraines during pregnancy. Non-drug and medicinal treatments

Many women suffering from migraines are afraid to plan a pregnancy. These fears are justified - judging by the instructions, 99% of medications cannot be taken while pregnant. However, a review of studies on migraine in pregnancy found that there are treatment options.

Good news: up to 80% of women experience relief from attacks already in the first trimester (especially among the group with menstrual migraines), up to 60% forget about it until the end of breastfeeding. For 4-8% of expectant mothers, a miracle does not happen; it was for them that I conducted my research.

Information on sources and literature is included at the end of the article with detailed commentary.

Does migraine affect pregnancy?

Potential problems are possible and should be known in advance. But, if we are attentive to ourselves and collect a small amount of knowledge, it will be easier to survive this period.

Severe attacks with an aura that last longer than a day and continue into the second and third trimester can cause anxiety. Such conditions can provoke preeclampsia and some other complications (I don’t want to write any frightening statistics in the article, but I must indicate the source for independent study).

Migraine does not directly affect the fetus. However, the child is indirectly harmed by the mother’s poor health, lack of sleep and fasting during severe attacks. Low baby weight is the most common negative impact of the disease. Therefore, in severe cases, you need to try to stop the attack, and not try to endure it.

What symptoms should alert the expectant mother?

Some migraine symptoms, especially those appearing for the first time, may be a reason to consult a doctor (urgently):

This is the first time you have experienced an aura or it lasts longer than an hour;
High blood pressure (always measure, even when you think a typical attack is coming);
The pain came suddenly and reached its maximum intensity within 1 minute;
The temperature has risen, the neck muscles are in spasm (you need to call a joint venture);
Simultaneous sensitivity to light and sound;
The headache is not one-sided, but just as strong and throbbing;
Change in the nature of pain;
The first attack comes at the end of the second or third trimester.

The doctor will carefully evaluate atypical manifestations and rule out other diseases, and may prescribe further examination.

How to relieve a migraine attack in pregnant women

For ethical reasons, pregnant women are not allowed to participate in any controlled drug trials. Therefore, in the instructions for the vast majority of medications, pregnancy is a contraindication for use - we cannot directly prove safety. But this does not mean that “everything is impossible.”

Tablets adapted from Nature Reviews Neurology 11, 209–219 (2015). The original and translation are in the appendix at the end of the article.

We have access to therapeutic and clinical observations that are included in special registries in all developed countries. Based on the results of systematic reviews of data from such registries, doctors draw conclusions about the safety of drugs.

This article is the result of studying several dozen recent reviews.

I'll start with heavy artillery. A wary attitude still remains towards the serotonin 5-HT1 agonists - triptans. However, application experience is accumulating and more and more encouraging data are emerging.

Triptans

This is a relatively young class of drugs, but all migraine sufferers are familiar with them, as they are the “gold standard” of treatment. The most studied is sumatriptan, approved for use in 1995 - the clinical history of the substance is 20 years.

Of the eight triptans currently used, it has the least pronounced vasoconstrictor effect and does not cause uterine contractions. Sumatriptan can be considered a relatively safe therapeutic alternative for pregnant women experiencing worsening migraine in the first trimester.

There is more and more clinical data, and it does not show a negative effect of sumatriptan on the course of pregnancy and the health of the child. However, for women with a history of migraine, there is always a statistically significant number of newborns weighing less than 2500 g (both those who took the drug and those who did not).

Literally before the publication of the article, I found the latest British medical manual, which contains sumatriptan in the recommendations with the note: “no adverse outcomes were identified, it can be recommended.”

Not so long ago they began to conduct research on a living placenta: no more than 15% of a single minimum dose overcomes the barrier. This amount of the substance does not have any effect on the fetus. Prenatal use should be discontinued as the substance may increase the risk of postpartum haemorrhage. This is directly related to its mechanism of action.

The largest studies of AC5-HT1 are carried out by Norwegians, Swedes and Danes. They have phenomenal medical registries that document everything. I recommend that you read the Norwegian review, as it contains a number of valuable information that cannot be included in the article.

Nonsteroidal anti-inflammatory drugs (NSAIDs)

Ibuprofen, naproxen And diclofenac are considered a relatively safe choice in the second trimester, but are not recommended in the first and third trimesters. Ibuprofen should be avoided after 30 weeks due to an increased risk of premature closure of the ductus arteriosus and oligohydramnios. Some population-based studies support problems with NSAIDs in the first trimester, others do not.

The conclusion of a meta-review of all studies on ibuprofen for migraine shows that it is 45% more effective than placebo on average.

Taking NSAIDs interferes with conception and seriously increases the risk of miscarriage.

Aspirin in minimal doses can be taken until the third trimester, no later than 30 weeks (no more than 75 mg per day), if it led to relief of migraines before pregnancy. If aspirin did not help, there is no point in taking risks, since it affects the baby’s platelet function.

Analgesics

Paracetamol(acetaminophen) is the drug of choice for pain relief during an attack. It is most effective in combination with aspirin and caffeine (our Citramon or Citrapak). In this case, caffeine acts as a transport, helps the absorption of substances, and its amount in the tablet does not have any stimulating effect. It is necessary to remember about the restrictions on taking acetylsalicylic acid.

The Journal of Headache and Pain (2017) 18:106 page 11 states: “Based on the above data, paracetamol 500 mg or in combination with aspirin 100 mg, metoclopramide 10 mg or tramadol 50 mg is recommended as the first choice of symptomatic treatment of severe attacks.”

Some women stop an attack with paracetamol if they manage to take it in the first minutes after the aura “turns on.”

Acetaminophen or paracetamol

A large Danish study found a statistically significant increase in hyperactivity in babies whose mothers took at least 2 doses of paracetamol per week during pregnancy. Other reviews do not find similar correlations. Of course, dosage and frequency of administration are critical.

Caffeine

There are lucky women who can significantly relieve migraine pain with a cup of coffee. Sometimes even I can do this trick. Coffee is the simplest and safest way to help yourself during an attack. There is no evidence of a negative effect of household doses of caffeine on pregnancy and the fetus (2 cups per day). If caffeine helped before, you shouldn’t give it up now.

Opiates and opioids

Only the weak ones, such as tramadol And codeine. One or two doses are allowed for the entire prenatal period, if none of the above has given results. Plant-based opioids are rare, but sage tea should be avoided (in addition to containing opiates, it is believed to cause uterine contractions).

Even if tramadol relieved pain well before pregnancy, try other options. Most likely, during this period, opiates will increase nausea and there will be no point in taking them at all. Although I very well understand migraineurs who hold tightly to what first helped. The main problem is chronic pain, which quickly gets worse when taking opiates. Over time, there will be nothing to stop the attacks.

Antiemetics

Metoclopramide And cyclizine sometimes prescribed for severe toxicosis, and the equally effective domperidone has not yet been sufficiently studied. An antiemetic significantly relieves migraine symptoms and increases the likelihood that the medication itself will work (it is recommended to take it together with sumatriptan).

Metoclopramide

Chlorpromazine and prochlorperazine strictly until the third trimester. Doxylamine, histamine H1 receptor antagonists, pyridoxine, dicyclomine and phenothiazines have not been reported to cause adverse effects on the fetus or pregnancy, but are prescribed much less frequently than metoclopramide. The problem with antiemetics is side effects, avoid systematic use.

The group of preventive measures includes medications, dietary supplements (dietary supplements) and some physical therapy: massage and acupuncture. I won’t rant about acupuncture here; moreover, as part of placebo psychotherapy, it helps specifically with pain and anxiety disorders (Acupuncture for the prevention of episodic migraine). I looked through several British manuals - not a word about acupuncture, it’s already nice.

Medicines

Almost everything that is usually recommended for migraine prevention is not suitable for expectant mothers: beta blockers, antiepileptics, antidepressants, ACEIs, ARBs, calcium channel blockers and the still little studied botulinum toxin type A (BTX-A).

All this is used to treat hypertension, depression and epilepsy. We do not prescribe such drugs to ourselves, therefore, when planning a pregnancy, you need to ask your doctor questions about reducing doses or the possibility of temporarily discontinuing some drugs from these groups.

Beta blockers

With antihypertensive drugs such as metoprolol and propranolol, things are complicated. Most evidence suggests that you should gradually stop taking them before conception.

Propranolol has a strong evidence base for the prevention of migraine and in some cases it is necessary in hypertensive patients, including pregnant women. Then its reception continues in the minimum possible dose strictly until the second trimester.

Lisinopril, enalapril and other drugs are strictly prohibited. Verapamil remains the drug of choice at a minimal dose (1). All beta blockers are discontinued until the third trimester.

Antiepileptic drugs

Valproate And topiramate very effective, but prohibited during preparation for conception and pregnancy. There is no doubt about the teratogenicity of these drugs. Lamotrigine for the treatment of bipolar disorder is sometimes prescribed for migraines, and although the drug has a good safety profile in pregnancy, its effectiveness is no better than placebo (Antiepileptics for the prophylaxis of episodic migraine in adults).

Antidepressants

The use of the most appropriate tricyclic antidepressant is considered safe (10-25 mg per day). His Negative influence it has not been proven to affect pregnancy and the fetus, but there is evidence of an increased risk of preeclampsia in women with depression who take it systematically.

However, amitriptyline has been suggested as a second-line choice after beta-blockers as a preventative measure. By the thirtieth week, any antidepressants are gradually discontinued.

Dietary supplements

Complementary (the same alternative) medicine is not the best solution when looking for safe ways to relieve a severe attack. But some of the usual safe substances that are not drugs can help in prevention.

Magnesium

Has level B in terms of proven effectiveness for migraine prevention (literally: Level B: Medications are probably effective). Safe during pregnancy (exception: intravenous administration for more than 5 days may affect the formation of the baby's bone tissue).

While studying the material for this article, I found the latest meta-review of research on magnesium in migraine therapy (2018). Magnesium citrate(citrate) is still the most bioavailable (600 mg recommended dosage), the worst is the oxide. The site has a separate article devoted to the treatment of migraines with magnesium, which I will supplement with the latest data.

There is only one condition - magnesium works if there is a deficiency in cells. Nevertheless, it is worth trying if you have a choice between a dietary supplement and heavy artillery.

Pyridoxine (Vitamin B6)

Reduces the number of attacks and significantly dulls nausea. Pyridoxine has been shown to be safe during pregnancy at very high doses in animals and has been approved by the FDA. The exact mechanism of action is not fully understood, more details about this in the source. There are specific dosage recommendations: 80 mg B6 per day or in combination with other supplements 25 mg per day (for example, folic acid/B12, or B9/B12).

Pyrethrum (Tansy Maiden)

A new substance with conflicting data on both efficacy and safety. Known more for the purified version of MIG-99. There is a risk of uterine contractions while feverfew is not in the recommendations of recent reviews.

Coenzyme Q10

Level C: effectiveness not confirmed, but possible. There is evidence for the prevention of preeclampsia, so it is recommended as a dietary supplement (for some reason, it is especially recommended by the Canadian Headache Society).

Riboflavin (Vitamin B2)

Level B. Everyone knows it as a prophylactic for iron deficiency anemia. There is a recommended dosage for treating migraines with riboflavin: 400 mg per day. For expectant mothers, the dosage may vary.

Melatonin

Based on several studies (no reviews yet), melatonin is safe and effective for treating migraines in pregnant women. The bioavailability of melatonin from drugs is still a big question. However, several small placebo-controlled studies have shown statistically significant results compared with placebo and amitriptyline in preventing attacks. If you have problems with sleep or circadian rhythms, why not try melatonin - it could be an alternative to antidepressants.

Nerve blockade with anesthetic injections

A method used in hopeless cases, with refractory migraine. The procedure is an alternative to combinations of anticonvulsants + antidepressants + opioids. Peripheral nerve blocks are not uncommon now, but they are avoided in pregnant women. The West is accumulating more and more data on blockades in pregnant women, the results are more than optimistic. In some cases, attacks do not return for up to six months.

Injections are given at one or more sites: greater occipital nerve, auriculotemporal, supraorbital and supranuclear nerves (1-2% lidocaine, 0.5% bupivacaine or corticosteroids). Pain relief occurs immediately in 80% of cases. For a small percentage of people it doesn't help at all.

The procedure is better known as an occipital nerve block. Lidocaine is safe, bupivacaine is moderately safe (less data), and topical steroids are still under debate. Of all the treatments for chronic headaches, lidocaine blockade is the most promising in the context of pregnancy.

Conclusions. Careful consideration should be given to the choice of medications already at the planning stage. It is especially important to resolve the issue with prophylactic medications that we take regularly - almost all prophylaxis is gradually stopped even before conception. A little extra knowledge won't hurt, even if you have complete confidence in your doctor.

How to treat migraine during breastfeeding

The lactation process protects up to 80% of women from migraines. If the attacks return, it is much easier to control the condition during this period than during pregnancy. It is enough to know the concentration of the drug in milk and its ability to be absorbed by the baby.

Paracetamol considered safest during breastfeeding. The concentration in breast milk is low, and the metabolism of babies is approximately the same as that of adults. In the entire history of clinical observations, there is one known case of a rash in a newborn (2 months) after exposure to paracetamol through mother's milk.

NSAIDs compatible with breastfeeding, ibuprofen is recommended as the drug of choice due to its short half-life (approx. 2 hours). Excretion in GM is low and no side effects have been reported. Diclofenac and naproxen should be taken with caution, feeding after 4 hours. These are the drugs of the second group of choice.

Irregular single doses of aspirin are acceptable, but in general, controversy surrounding acetylsalicylic acid continues. The substance has a high level of excretion and affects the baby’s platelets.

Triptans, even injected, almost do not pass into mother's milk. But the conservative precautionary measure (in force since 1998) has not yet been abolished - a 12-hour break between intake and feeding. Given sumatriptan's half-life of approximately 1 hour and extremely low bioavailability, 12 hours is excessive. Most current research recommends resuming feeding after recovery from the attack.

Eletriptan has been little studied during pregnancy, but for the lactation period it is preferable to sumatriptan. The fact is that the substance is bound by plasma proteins and practically nothing reaches the GM. The complete safety of a dose of 80 mg eletriptan per day has been assessed.

Opioids as an emergency one-time aid, they are acceptable because they have a low concentration. We are always talking only about codeine, it is the weakest of all narcotic painkillers.

Ergotamine (ergot alkaloid) not possible at all. This drug is very weak, and its side effects cause more problems than relief. Extremely high accumulation in milk, leading to cramps and dehydration.

Antiemetics, in particular metoclopramide, has an excretion slightly above average (it is unstable and depends on the mother’s body: from 4.7 to 14.3%), but is not systematically allowed during breastfeeding. Side effects it was not registered in children.

Beta blockers can be returned after childbirth. Most reviews agree on the most studied drugs being metoprolol and propranolol. Highlighting compounds in breast milk low, up to 1.4% of the metabolized maternal dose, which is a negligible amount even for premature and low birth weight babies. This is good news because some medications need to be taken regularly.

Antiepileptics, prohibited during pregnancy, are permitted during lactation. Valproate almost does not reach the GM - 1.7% max., only trace amounts are found in the child's plasma. Topiramate gives concentrations of up to 23%, and despite the fact that it is considered compatible with breastfeeding, control is necessary in very young children: irritability, weak sucking reflex, diarrhea.

Antidepressants, in particular amitriptyline, can be used as migraine prophylaxis when first-line drugs (beta blockers and dietary supplements) do not work. Compatible with breast milk, the level of the substance in milk is low - up to 2.5% of the mate. doses. The child's plasma level is below detectable or trace levels. Other antidepressants are not considered, since their half-lives are much longer and they can theoretically accumulate in the baby’s body (there is no data as such).

Prily, enalapril in particular, are nephrotoxic to newborns. Their excretion is extremely low - up to 0.2%, but given that enalapril is taken daily, it is considered incompatible with breastfeeding. Some sources say to use “with caution and monitoring.”

Magnesium and riboflavin can be taken additionally. Their quantity in GM increases slightly.

Conclusions. All effective drugs for the treatment of severe migraines are compatible with breastfeeding, since they are not transferred into mother's milk in pharmacologically significant quantities. Having read dozens of reviews and studies, I have never come across any recommendations about pumping, but this choice always remains with the mother.

Sources and literature

I would like to draw attention to the sources of information. All articles and meta-reviews I reference were published in peer-reviewed clinical journals. The most important and recent materials are placed in a separate folder on Google Drive with free access.

You have the opportunity to familiarize yourself with the original source; the documents contain:

Full texts in the original, downloaded from sci-hub (with footnote numbers assigned in the article (1-11) and links to them).
Machine translation of every original article and review I link to (but without tables, they are very difficult to translate and format).

IN original materials contains mass useful information O different types headaches in pregnant women, not everything can be covered in one article. I always recommend turning to the original source, even if you trust the author of the Russian-language text. You may find this guide helpful in finding medical information.

I hope the work done will be useful to someone.

Maria Sokolova

Reading time: 8 minutes

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Unfortunately, scientists still know nothing about the exact causes of migraines, except that the main “culprits” are the blood vessels of the brain. During pregnancy, taking into account hormonal changes, there are even more reasons for migraines. And, although a migraine attack in itself does not harm the unborn baby, young mothers have a very hard time, because they are not suitable and can be dangerous during pregnancy.

How to treat migraine for expectant mothers?

Main causes of migraine during pregnancy

Most common cause migraine is emotional factor – stress, depression . Therefore, sometimes, in order to minimize the risk of migraines, It makes sense to contact a specialist .

Among other known reasons, we highlight the most common:

Food. The main ones (those that increase the risk of an attack) are chocolate and nuts, smoked and spicy foods, cheeses and tomatoes, citrus fruits, eggs. Also, the “trigger” can be
Too big food breaks, irregular nutrition.
Physical overexertion(long exhausting road, long queues, etc.).
Noise and light factors– prolonged viewing of TV programs, harsh light, loud music, etc.
Unpleasant odors.
Sudden changes in the weather. Including climate change.
Cold. Not only water, but even ice cream can trigger an attack.
Sleep disturbance– excess sleep, lack of sleep.
Hormonal changes in connection with pregnancy.

Elimination of harmful factors that provoke migraine attacks in pregnant women

First of all, to minimize the risk of an attack, you should get into the habit of: conduct exclusively healthy image life : refuse bad habits(if you haven’t already given up), develop an individual “health” strategy and stick to it. We also remember the following:

Optimal sleep time - about 8 hours.
Be sure to strengthen your immune system by all available means.
Avoiding hypothermia, and ice cream and juices - only in small parts, warming up on the way to the throat.
Regularly - . For example, walking.
Relaxing massage– if possible.
Balanced– “a little bit” and often.
Adequate fluid intake.
Avoid – noisy public places, harsh light in entertainment venues, meeting with people who can cause mood swings or stress.
Avoid traveling to countries with hot climates. During pregnancy, it is better to stay in your usual climate zone.

Drugs and treatment regimen for migraine during pregnancy

As for the medicinal solution to the problem of migraine, there are practically no such options during pregnancy. Therefore, the main emphasis should be on prevention and exclusion of provoking factors . Medications have an extremely negative effect on the formation of the fetus and, in general, on pregnancy. And most of them are contraindicated during this period.
As a rule, for migraines the following is prescribed:

Magnesium preparations.
Paracetamol.
Acetaminophen in a minimal dose.
Panadol, Efferalgan.

Treatment of migraine in pregnant women with folk remedies

Considering that you have to refuse medications during pregnancy, you can contact traditional methods, many of which really help relieve or alleviate an attack.

Peace and quiet.
At the very beginning of the attack, you should go to a well-ventilated room, take a horizontal position in silence and darkness, and try to fall asleep by placing a cool, damp towel on your forehead.
Tea with a lot of sugar.
Coffee is not suitable as a caffeinated drink - it increases blood pressure.
Breathing exercises.
Cold on the forehead(for example, ice in a towel) or, on the contrary, dry heat(down shawl, dog hair, felt bath cap) - depending on what exactly helps.
Under a shawl/scarf bandage, you can apply it to the pain localization points halves of raw chopped onion(cut to the skin) - a very effective method. Even a severe attack will go away in 15-20 minutes. After this, of course, throw away the onion.
Washing with cool water.
Relaxation techniques – meditation, auto-training, yoga for pregnant women, Bradley method, biofeedback method.
Head massage, acupressure.
Lubricating the pulse areas on the wrists Espol ointment. In summer - rubbing the same areas with nettle, ground to a paste.
Ointment Zvezdochka– on the temples and forehead.
Ginger root– from nausea during migraine. She will help acupuncture bracelets.

Treatment methods future mom chooses herself. Of course, if the pain becomes too frequent and unbearable, then You can’t do without consulting a doctor . To avoid resorting to pills, take steps in advance to eliminate all sources of migraines. The best option– leave for the duration of pregnancy a quiet, peaceful place in its own climate zone (for example, to the dacha, to the village to visit relatives), establish a sleep/diet schedule and eliminate all contacts with unpleasant people.

The website warns: self-medication can harm your health! The recipes given here do not replace a trip to the doctor!

Migraine during pregnancy is a condition caused by changes in a woman’s body that occur throughout the entire gestation period. This condition is very difficult to tolerate, since the use of most drugs is contraindicated.

Etiology

Migraine is considered a genetically determined disease. This means that most patients suffering from this disease have blood relatives who have a history of migraine attacks. According to statistics, migraines are more common in women, especially those of reproductive age.

There are a number of factors that can trigger a headache attack. They are also called trigger ones.

The most common include:

Hormonal "shocks". During pregnancy, a woman’s body undergoes complete hormonal changes, which affects the functioning of all organs and systems. If adaptation processes fail, a woman may experience severe headaches;
Increase or decrease in systemic pressure. Pregnancy is accompanied by an increase in the volume of circulating blood and its redistribution, which explains the increase in blood pressure mainly in the third trimester. Sometimes another mechanism may be triggered: progesterone, which is produced in large quantities during pregnancy, reduces vascular tone, which can lead to a drop in blood pressure. Both can cause migraines during pregnancy;
The condition of preeclampsia is a severe complication of pregnancy, in which there is generalized vasospasm and impaired renal function. One of the symptoms will be severe headaches;
Dietary disorders: overeating, hunger, abuse of certain foods (chocolate, cheese, coffee, strong tea, nuts, chicken liver, citrus fruits and others);
Stress factors, which include fatigue, nervous tension, lack or excess of sleep, anxiety;
Others: noise, light stimuli, changes in weather or time zones, physical activity.

In the pathogenesis of migraine, three mechanisms are distinguished: changes in the lumen of intracranial arteries, the occurrence of pathological impulses in the midbrain and excitation of the nuclei of the trigeminal nerve and spasm of the vessels innervated by it. At the present time, the combination of these phenomena and their role in the formation of a migraine attack has not been fully studied.

Symptoms

Clinically, migraine during pregnancy is not much different from headaches outside this condition. There are two large groups: simple migraine and migraine with aura.

A simple migraine is accompanied by a severe, often unilateral, throbbing and pressing headache. It is very strong and reduces a woman’s performance and changes her behavior. The pain is localized in the temporal or frontal region; sometimes it begins in the back of the head and “crawls” forward, involving the paraorbital region. Attacks recur 3-4 times a month. In this case, neurological and autonomic disorders and gastrointestinal disorders occur.

During an attack, women often complain of nausea and vomiting, which does not bring relief. They are irritated by bright lights, loud sounds and intrusive smells. The well-being of a pregnant woman can be complicated by toxicosis in the first or third trimester. For any physical activity the pain only gets worse.

Migraine with aura is characterized by the appearance of various neurological symptoms before an attack, which may partially remain after it. These symptoms are reversible and transient.

As the disease progresses, attacks may appear more frequently and last longer. However, the symptoms are repeated time after time with minimal differences.

The hormonal changes in the body that occur during pregnancy significantly reduce the severity of migraine symptoms. In most cases, attacks bother a woman only in the first trimester, and then they disappear.

However, sometimes pregnancy is a provoking factor and the first migraine attack occurs precisely against the background of ongoing pregnancy.

Diagnostics

The clinical diagnosis of migraine is made primarily on the basis of the woman’s complaints and medical history, since laboratory instrumental research methods in this case are not informative. Therefore, there are diagnostic criteria that are compiled by the International Pain Association.

First of all, it is necessary to find out the etiology of the headache. If a woman had attacks before pregnancy, then migraine in this case is an independent disease. But pregnancy itself can become a provoking factor, which significantly affects the woman’s condition during pregnancy.

Collecting a family history is also important: since migraine is a genetically determined disease, close relatives may experience similar attacks.

Migraine in pregnant women should be differentiated from tension headache. The latter differs symptomatically: the pain is less intense, “helmet” type and is not accompanied by typical migraine manifestations.

Therapy methods

Treating migraine during pregnancy is quite difficult, since taking most medications is prohibited, especially during early stages.

If before pregnancy a woman complained of migraine attacks, then in this case prevention plays the main role. A woman should minimize the influence of factors that can provoke headaches.

If the first migraine attacks appeared during pregnancy, then you need to determine the trigger factors and try to exclude them from your life. It is worth thinking about normalizing your sleep and rest patterns and adjusting your diet. Many women during pregnancy allow themselves certain excesses in food consumption. It is necessary to reduce the amount of chocolate, cocoa, citrus fruits, peanuts, coffee, and some types of cheese. It is better to replace them with yogurt, fruits, nuts and walks in the fresh air.

At the very beginning of an attack, you can use cold. It is known to have a positive effect on the vascular system and help prevent or reduce an attack.
To do this, you can apply cold compresses to the forehead, ice cubes, washing with cool water or a cold shower. You should be careful not to apply ice directly to unprotected skin, as this can lead to frostbite.

Preventive measures include protection from stress factors and psycho-emotional balance. You should avoid obviously stressful situations or try not to focus your attention on them. Relaxation methods include meditation, yoga practices for pregnant women, and massage.

There are very few drug treatments for migraine in pregnant women. This is due to the high fetotoxicity of most drugs and their negative effect on fetal development. Therefore, only a doctor can prescribe and discontinue any medications.

To relieve pain, you can take paracetamol in a therapeutic dose. It does not pass through the placental barrier and does not have a teratogenic effect on the child. But monotherapy with paracetamol does not always bring the expected results. In the most severe cases, acetaminophen may be used in a minimal dose.

Carrying a fetus (unborn child) is a joyful event for many, but it can be spoiled by migraines that arise during pregnancy.

This is a serious test for any woman, since, in addition to other signs of pregnancy, pain occurs in the head in the early stages of carrying a baby.

Migraines during pregnancy can appear in the form of severe and moderate headaches, which greatly undermines the nervous system and health of the expectant mother.

How to relieve pain and how to treat this pathology? This question is often asked by women who are pregnant.

We will try to lift the veil of secrecy, which can, in some cases, alleviate the condition of the future woman in labor.

Causes

In order to understand how to treat migraine during pregnancy, it is necessary to find out the cause of the pain condition.

When pain appears on a constant basis, this may indicate several factors that provoked it.

Some of the causes of pain in pregnant women:

Hormonal imbalance. Migraine during early pregnancy involves a certain amount of hormones released. All this leads to a strong impact on the nervous system of the expectant mother. Most often this happens at the beginning of the first trimester of pregnancy, because the body becomes accustomed and adapts to this position. For this pain, therapy is not prescribed. If, however, the pain occurs with severe attacks, then the doctor can prescribe the necessary medications to relieve symptoms and pain. If this condition continues throughout pregnancy, it can greatly worsen the condition of the mother and her baby.
Development of hypertension. An increase in blood pressure often occurs in the last months of pregnancy (third trimester). All this is due to an increase in blood flow and blood volume itself. If the expectant mother had this condition before pregnancy, then she should constantly carry out prevention of this pathology from the beginning of her interesting situation.
It often happens that this condition provokes kidney disease, so a specialist is obliged to prescribe treatment with drugs that cannot harm the fetus. Also helps a lot proper nutrition, outdoor recreation. At this moment, it is necessary to completely eliminate nervous experiences and stressful situations.
Development of hypotension. When blood pressure drops significantly, this means that the body is oversaturated with the hormone progesterone. Since the properties of this hormone are tonic, it dilates blood vessels and lowers blood pressure. Head pain occurs due to lack of oxygen to the brain. Whether therapy is necessary or not in a given situation is determined by the doctor observing the pathology. The main drugs that are prescribed contain caffeine. You can drink a cup of hot coffee, but only if there are no contraindications for use.
Developing other diseases. Such diseases include: meningitis, sinusitis, eye diseases, kidney disease, encephalitis. When they are diagnosed, the doctor prescribes complete therapy that does not harm the pregnancy. Often, when migraine occurs in pregnant women, gestosis appears. This disease is characterized by vasospasm, which leads to increased blood pressure. In this case, the woman may lose consciousness or experience a severe headache.
Often the cause of pain may be the progression of chronic diseases. Migraines during pregnancy throughout pregnancy are due to problems with the spinal column. This exacerbation is associated with an increased load on the spine. Osteochondrosis and vegetative-vascular dystonia are also accompanied by headache.
Dietary violations. With severe overeating while carrying a child, weight gain leads to an increase in blood pressure. When malnourished, the body experiences a lack of essential substances, which also causes headaches. Therefore, it is necessary to fully comply with the food intake and avoid eating foods that contain toxins and harmful substances. Eating small, frequent meals helps a lot.
Experienced stressful situations. Constant nervous tension, fear of something, domestic quarrels - all this can cause a migraine and pregnancy can fail. Therefore, it is necessary to lead a more measured lifestyle, not to overload and think more about the unborn baby.

Therapy without drugs

During pregnancy, the use of many medications is prohibited, so you need to follow some recommendations:

severe overwork and constant lack of sleep;
excessive consumption of chocolate, citrus fruits, cheese products and spices;
lack of fluid in the body, which occurs in the first and second trimester of pregnancy;
allergic reactions;
weather changes and changes in climate zones.

All this can manifest this painful condition, so it is necessary to more carefully follow the recommendations of doctors. For pain, many women and girls turn to traditional medicine for help.

Traditional medicine methods for migraines

Often, fear of harming the child pushes a woman to use folk remedies medicine at home.

But it is worth paying attention to the fact that if a painful condition occurs frequently, then you cannot do without consulting a specialist.

There are the most popular methods to relieve migraine pain, which were used by our great-grandmothers:

Ice in bags. This remedy can be applied to a sore head, which will dilate the blood vessels. This method relieves headaches. This compress cannot be kept on a sore spot for a long time, as it can cause a cold in the head or provoke colds. It is also advisable to wrap the package with a towel so that there is no direct contact with the scalp and forehead.
You can use fresh cabbage leaves, after dousing them with boiling water. All this needs to be wrapped in a woolen scarf. This is the most effective and simplest remedy for relieving pain.
Sweet tea. Brew strong tea in a steamer, add sugar and drink slowly. This remedy and method has its contraindications. It is especially dangerous to drink it at the beginning of the first trimester of pregnancy.
Various herbal decoctions. If there are no contraindications, then take the herb lemon balm, chamomile, mint in equal parts and steam it in a jar or thermos. Before using this decoction, you should consult with your pregnancy doctor.

All these methods of pain relief have been tested over the years and centuries, so it is necessary to have a consultative conversation with a doctor. In addition to these methods, relaxation activities are widely used.

Relaxation techniques for migraines

In some cases, acupuncture is prescribed - the safest and most effective method pain relief.

There is the most pleasant way to relieve pain - aromatherapy. It is used in the absence of allergic reactions to additional essential oils.

Inhaling and exhaling evaporating oils relieves internal tension from the muscles, central nervous system, improves blood flow through the vessels, relaxes the human body. The following oils are suitable for use:

rose oil;
basil;
essential eucalyptus;
lemon;
rosemary;
peppermint oil based on essential components.

Massage method for relieving migraine pain

This method helps well with migraines, if only it is performed correctly and by a specialist.

Massage activities on the neck and head are a proven method, but in this situation this method cannot be done without a specialist.

You can try to master the basics of this method, and then you need to do it yourself.

There are three most common ways to massage yourself. These measures need to be done to yourself and massaged for 10-13 seconds, 10 approaches:

The starting point of influence is located between the eyebrows in the middle of the frontal bone.
The second point that can relieve pain from a migraine is located between the fused bones on the foot of the big and second toe.
The third place is in the place of deepening of the bone growth behind the edges of the eyeball.

What is the rule for performing these procedures:

Pressing on the points should be done with the pads of your fingers.
The pressure is strong, but not painful.
Pressure on the points must be done with in a circular motion, as if rubbing the cream into the bone.

If massage activities are carried out correctly, then you can notice good relaxation of muscle tissue and how tension and pain go away.

The massage session ends with slow circular movements with gradual deceleration until a complete stop. It happens that you still have to use drug intervention.

Drug intervention for migraine

If the above methods do not bring a positive result, drug treatment is used.

However, before this you need to consult with your doctor so as not to harm the pregnancy.

The most dangerous is the use of drugs during the first and second trimester, since the fetus is not protected and the drugs can harm the development of the baby.

If the pain is incredible, a pregnant woman can take paracetamol or similar products containing it.

This drug, although it is a way to relieve heat from the human body, is also a good analgesic.

What is positive about this use is that this drug is the safest among other drugs. This remedy is even prescribed to infants.

If you have problems with blood flow, you can sometimes see Actovigin in doctor’s prescriptions. This remedy relieves migraine headaches well and eliminates the cause of its occurrence.

Before using this product, you must make sure that there is no allergic reaction to the composition of the star.

If these migraine attacks are caused by periodic surges in pressure, then the doctor, taking this into account, must carefully prescribe the appropriate medications. For severe pain, you can take a No-Shpa tablet.

It is completely prohibited to take medications containing acetylsalicylic acid.

These prohibited medications also include Analgin and its derivatives. All of them are highly toxic to the baby developing in the womb and can cause serious problems for the child.

With the development of modern technologies, special drugs for migraines, but they are prescribed only by a specialist doctor. Some of them are recommended even during pregnancy.

When to see a doctor for migraines

Seizures during pregnancy are common and widespread. Migraine is not particularly dangerous for humans.

True, quite often, this pathology and condition requires urgent advice or treatment from a specialist.

In what cases should a pregnant woman consult a doctor:

pain due to migraine occurs very often;
constantly increasing migraine pain;
pain constantly in one part of the head without a long tendency to subside;
the painful condition is accompanied by surges in blood pressure;
in addition to the pain in the head, there is a deterioration in speech ability, a strong reaction to light and bright objects, vomiting and nausea.;
sensitive numbness of legs, arms;
the auditory reflex disappears and vision is lost.

All of the above can become serious signs of illness in a pregnant woman, so after contacting a doctor, he will issue a referral for a full diagnosis of the body.

Migraine during early pregnancy requires immediate consultation with a doctor and subsequent treatment.

During pregnancy, it is necessary to completely protect not only the woman, but also the fetus itself. Since improper self-medication will lead to the child’s disability or loss.

Useful video

This disease is one of the most poorly studied phenomena by specialists. Doctors are still trying to figure out the cause of its occurrence, but so far they have only come to the conclusion that the disease is caused by a genetic factor and women suffer most from it.

So, migraine is a chronic disease characterized by recurring, severe headaches and a number of other symptoms, including increased sensitivity to light, sounds and smells.

Watch a video about what migraine is:

Features of migraine in pregnant women

Every pregnant girl experiences migraines differently. Some people experience pain that is barely noticeable, while others are not susceptible to the disease at all, but mainly due to hormonal changes in the body, headaches plague expectant mothers.

According to doctors, migraine is not dangerous for a child, but it causes inconvenience to a woman who, due to her position, is contraindicated for any medications. Moreover, depending on the course of the painful sensations, headaches may be accompanied by darkening of the eyes, nausea, and sudden jumps in blood pressure.

Main symptoms

Severe throbbing pain in one part of the head (most often in the temporal lobe or in the forehead area, above the eyebrows). But it is also possible that during an attack the pain can “move” all the way to the back of the head.
Any physical activity results in extreme pain.
Increases sensitivity to any sounds, light, smells.
Nausea and vomiting.
Before an attack, vision may be impaired (dots begin to jump before the eyes, a sensation of 3D effect occurs, fog and even hallucinations in the form of flickering appear), hearing (the perception of sound changes) This phenomenon is detected both 5 minutes before the onset of a headache and a whole hour . The symptom has the scientific name aura.
A migraine can last for several hours or several days (usually no more than 3).
Blood pressure increases.

You can learn more about the signs and symptoms of migraine in women and how to treat the disease at home.

Is treatment with pills acceptable?

How to treat migraine during pregnancy? When preparing to become a mother, a girl first studies what will be allowed to her in a future new state. And, of course, everyone is aware that the use of the main layer of medicinal chemicals forbidden. But what to do if a woman is pregnant, and the headache is so overwhelming that she can’t cope without pills?

Experts have long conducted a series of experiments and identified a list of medications that, at a certain minimum dose, will not cause any particular harm to the baby, but will help the mother. Such tablets that relieve headaches include paracetamol and drugs based on it: efferalgan, panadol, acetaminophen. These medications can be taken at all stages of pregnancy.

ATTENTION: The daily dose of paracetamol should not exceed 2 grams (4 tablets of 500 mg)!

As for other medications, their use should be approached very carefully, after consulting with your doctor in advance! So, popular for headaches Aspirin, ibuprofen, naproxen tablets can only be used in the second trimester! Failure to heed this warning may put the fetus at risk of developing a number of defects (if these medications are taken in the first trimester) or even premature birth(in the third trimester).

Analgin, baralgin, spasmalgon, citramon, tempalgin - taking by a pregnant woman is strictly prohibited!

Sumatriptan, a direct anti-migraine drug, is allowed to be taken only on the recommendation of the attending physician, and then only if the benefit of its use for the mother exceeds the possible risk to the fetus. It is possible that the doctor, looking at the patient's condition, will prescribe beta blockers. You have to be very careful here. From this category of drugs For pregnant women, only metoprolol and atenolol are allowed for treatment.

Based on this, it is clear that you need to be extremely careful when using medications during pregnancy. once again It's not worth the risk.

You can learn more about how and how to treat a migraine head in this material.

How to get rid of an illness using folk remedies?

Folk remedies are especially good in the early stages of pregnancy. An excellent alternative to pills is acupuncture. A safe and, importantly, really helpful remedy for migraines. All this is thanks to needles that block the passage of nerve impulses along painful pathways. Several sessions will help restore the impaired functioning of the vascular system and relieve headaches for a long time. Allowed in the first trimester.

If needles scare the expectant mother, then good old “grandmother’s” recipes will come in handy.

This is how you can treat migraines in the early stages.

You can find out more about whether you can do without taking pills in this material.

Prevention

Migraines can be prevented. To do this, you need to remove provoking factors and make your daily routine healthier:

no stress, unpleasant communication and unloved activities;
walks in the open air;
good sleep of at least 7 hours;
yoga;
proper nutrition excluding foods that cause headaches (citrus fruits, chocolate).

Women who suffer from migraines are concerned about the question: will this disease go away with childbirth? Doctors reassure: the closer the hour of birth of the baby, the less frequent the attacks. This is explained by the restructuring of the body, which by the second half of the term gets used to the changes that began in it with the birth of a tiny life in the girl, and now it itself is learning to cope with the problem. So the main thing is to get through the first trimester, then it will be easier.

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