How to Deal With Headaches During Pregnancy
You were warned about the morning sickness, the back pain, the breast tenderness and other pregnancy problems, but a throbbing head might have caught you off guard. Turns out, headaches during pregnancy can unfortunately be pretty common—especially since there are over 200 different types, says Rebecca Erwin Wells, MD, MPH, associate professor of neurology at Wake Forest School of Medicine in North Carolina. “Some have no underlying cause aside from genetics. But there are definitely factors during pregnancy that can trigger headaches.” One of the biggest factors? Whether you were already prone to them. Keep reading to learn more about the different causes of headaches in pregnancy, ways to find pregnancy headache relief and—perhaps most importantly—how to prevent them from happening in the first place.
According to Rebekah Mustaleski, CPM, a certified professional midwife and compression director at Motif Medical, headaches can be an early sign of pregnancy. Early pregnancy headaches are usually caused by all the initial hormonal changes—specifically, the increase in estrogen levels may be to blame, says Stephanie Hack, MD, board certified ob-gyn and host of the Lady Parts Doctor Podcast.
If you were already susceptible to them before getting pregnant, you may also experience headaches in pregnancy—but it’s not a guarantee. While some people may get headaches more frequently while pregnant, others may experience them less often, Mustaleski says. Ultimately, how often (and intensely) you experience pregnancy headaches will depend on your individual circumstances.
As mentioned, frequent hormonal changes can cause headaches during pregnancy. But, for the most part, the causes of headaches in pregnancy remain similar to what they may have been before you were expecting. In general, headaches can be triggered by changes to one’s normal routine—and pregnancy can dramatically alter everything from your eating and sleeping to your exercise habits, says Matthew Robbins, MD, FAAN, FAHS, associate professor of neurology at Weill Cornell Medicine. Some of the most common causes of a headache during pregnancy include:
- Surging hormones
- Medical conditions related to hormonal changes (like morning sickness)
- Drops in blood sugar
- Increased blood volume and circulation
- Stress
- Lack of sleep
- Dehydration
- Caffeine withdrawal
- Changes in posture (particularly as your bump grows)
- Temporary vision changes (caused by fluid retention and changing hormones)
“Headaches are most commonly caused by either dehydration or hormonal changes,” Mustaleski emphasizes, adding they can occur at any time of the day—and even every day. “If they’re caused by dehydration, they’re more likely to show up in the morning. Stress or tension headaches are most common in the evening, and hormonal headaches often last all day.” Hormonal pregnancy headaches usually crop up in the first trimester and then again between 16 and 18 weeks, she adds, but some people may also experience them in the third trimester. It really varies from person to person.
As for how they’ll feel, a headache during pregnancy should feel similar to ones experienced before baby. You may feel them in your forehead, temples, back of the head or behind the eyes. They can range in severity from a short, dull ache to lasting for several days.
Factors in severity of pregnancy headaches
While pregnancy headaches are highly individualized, there are certain factors that can affect the severity of headaches during pregnancy, Hack says, such as:
- Diet
- Medications
- Withdrawal from caffeine or other substances
- Environmental factors
- Medical conditions (like hypertension, gestational diabetes and preeclampsia)
“Headaches are common when you’re pregnant, but they typically don’t last more than 24 hours,” Mustaleski says. If you have a severe headache that lasts longer than a day, call your ob-gyn, as headaches can be a sign of preeclampsia or gestational hypertension. (More on this below.)
According to Hack, any headache you might have experienced prior to pregnancy, you may also experience during pregnancy—and they’ll largely feel the same as they did prior. There are two types of headaches, Hack says:
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Primary headaches: These include tension headaches, cluster headaches and migraines. The triggers of these headaches won’t change due to pregnancy, but pregnancy may make it harder to avoid them (such as larger hormone fluctuations, caffeine withdrawal and changes in posture).
-
Secondary headaches: These headaches are caused by other medical conditions, such as sinusitis. Unfortunately, you may deal with more of these during pregnancy. “Sinus headaches are more common in pregnancy, in part because your body tends to make more mucus during pregnancy—and in part because there are a lot of cold medications you can’t take if you get sick,” Mustaleski says.
While these are the two most common types of headaches in pregnancy, you may also experience additional symptoms alongside them, depending on what’s causing your headache to begin with. For example, if you’re suffering from a pregnancy headache due to preeclampsia, you may also experience blurred vision, nausea, vomiting and abdominal pain, Hack says.
Most headaches during pregnancy aren’t a big deal, but, as mentioned, sometimes they can be a sign of other conditions, like preeclampsia, anemia, asthma, a cold, the flu, HELLP syndrome (hemolysis elevated liver enzymes and low platelet count), sinusitis, toxoplasmosis and varicella (chicken pox), among others.
While this can sound scary, don’t panic. The key is to flag any new, persistent or worrisome symptoms to your doctor. “When [headaches] are new, more intense or different than usual, [if you experience] additional symptoms, or they persist longer than usual, these are all reasons to call the doctor,” Hack says. In other words, if you’re someone who didn’t usually get headaches before, but have started to after pregnancy, it’s worth flagging to your doctor. Or, if you’re someone who was prone to headaches, but they’ve changed since pregnancy (gotten more severe, more frequent, accompanied by new symptoms, etc.), you’ll also want to flag that to your doctor.
Some symptoms that can indicate a red flag (and may warrant hospital evaluation) when combined with headaches during pregnancy are:
- Fever
- Swelling in the legs, hands, face or somewhere else
- Sudden weight gain
- High blood pressure
- Abdominal pain
- A persistent pregnancy headache that’s not going away
- Weakness
- Numbness
- Consistent visual or speech disturbances
Your doctor may refer you to a specialist for additional evaluation or ask you to go to the hospital in severe cases. As Wells says, when it comes to pregnancy, it’s always best to be safe.
For headaches during pregnancy that are run-of-the-mill and not accompanied by red flags, there are safe and effective ways to find relief. “First and foremost, talk to your doctor about your pregnancy headaches and treatment options,” Wells says. “That should include non-drug treatment options.” Most doctors will recommend non-medicinal, natural remedies for headaches during pregnancy first. These at-home remedies for pregnancy headache relief include:
- Applying a warm compress to your face and eyes (especially for sinus headaches)
- Using a cold compress on the back of your neck (especially for tension headaches)
- Eating small, frequent meals to make sure your blood sugar levels don’t drop
- Drinking half your body weight in ounces of water or adding electrolytes to water
- Massaging the shoulders and neck
- Using peppermint essential oils on your temple
- Resting in a dark and quiet room
- Taking a warm shower or an Epsom salt bath
- Sleeping it off
Other non-medical approaches to treating headaches during pregnancy might work too. Cognitive behavioral therapies, relaxation strategies and biofeedback (which helps you control your body through techniques like muscle relaxation and electronic monitoring) are all possible treatments for pregnancy headaches, Robbins says. “Things like acupuncture and yoga can largely be done safely during pregnancy too," he adds. "These forms of headache relief are a great place to start before going straight to medication.”
Mustaleski also cites magnesium—specifically magnesium glycinate supplements—as a potential solution for patients struggling with headaches in pregnancy. Just remember, if you’re thinking of taking any herbal remedies, talk to your doctor to make sure they’re pregnancy-safe first. “Anything that a pregnant woman consumes will affect baby,” Wells says, and sometimes “it’s not worth the risks.”
Pregnancy headache relief using medicine
If natural methods don’t relieve the pain, what can pregnant women take for headaches? Over the counter doses of acetaminophen (Tylenol) are usually okay to use, but it’s generally recommended that pregnant women steer clear of painkillers like aspirin and ibuprofen (Advil and Motrin). Hack also says calcium channel blockers, antihistamines and certain antidepressants can improve symptoms. However, never take any pills or supplements without your doctor’s approval. “Talk to your doctor about headaches and the risks of the medication,” Wells says, and ensure it’s safe for you and baby. “Sometimes, dealing with chronic pain is more of an issue than small risks associated with the medication,” she adds.
Of course, the best cure for pregnancy headaches is prevention. “One of the most important pieces of advice I give to women who are planning to become pregnant or have become pregnant is to be mindful of keeping their routines regular,” Robbins says. Here, the experts’ top tips for how to prevent headaches during pregnancy:
- Stay hydrated
- Eat regular, healthy meals to avoid blood sugar spikes or low blood sugar
- Keep your sleep schedule consistent
- Exercise regularly
- Find ways to de-stress from everyday life
- Practice good posture (particularly in the third trimester)
“Especially during pregnancy, when the medical treatment options for headaches become much more limited, those preventative measures become much more important," Robbins says. "These triggers can be very individualized, so it’s best to know your triggers and avoid them.”
Wells agrees. “Regular sleep. Regular hydration. Regular, consistent meals. Consistency is key,” she says. “Maintaining a healthy lifestyle during pregnancy is so important. Prevention is priceless when it comes to headaches during pregnancy. It’s a simple solution, but it can have a profound effect.”
Please note: The Bump and the materials and information it contains are not intended to, and do not constitute, medical or other health advice or diagnosis and should not be used as such. You should always consult with a qualified physician or health professional about your specific circumstances.
Plus, more from The Bump:
Rebekah Mustaleski, CPM-TN, IBCLC, is a certified professional midwife specializing in evidence-based maternity care. She co-founded Roots & Wings Midwifery in Knoxville, Tennessee. Mustaleski received her bachelor’s degree in psychology from Centre College and worked as a doula and birth photographer prior to establishing Roots & Wings.
Stephanie Hack, MD, MPH, is board certified ob-gyn and host of the Lady Parts Doctor Podcast. She obtained her medical degree from Lewis Katz School of Medicine at Temple University, as well as a masters degree in public health. She completed her residency at Georgetown University Hospital and Washington Hospital Center.
Matthew Robbins, MD, FAAN, FAHS, is the program director for the neurology residency and an associate professor of neurology at Weill Cornell Medicine. He has previously served as the chief of neurology at the Jack D. Weiler Hospital and director of inpatient services for the Montefiore Headache Center. He earned his bachelor’s degree from Yale University; his medical degree from SUNY-Downstate College of Medicine; and completed his neurology residency at the Albert Einstein College of Medicine/Montefiore Medical Center in New York.
Rebecca Erwin Wells, MD, MPH, is an associate professor of neurology at Wake Forest School of Medicine in North Carolina. She received her bachelor’s degree from University of North Carolina at Chapel Hill; medical degree from East Carolina University Brody School of Medicine; and master’s degree in public health from Harvard University. She completed her residency at the University of Virginia Health System, as well as fellowships at Osher-Harvard Medical School and the John R. Graham Headache Center in Massachusetts.
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