Although the levels get a lot higher and lower, the
actual fluctuation of the hormones is not as pronounced as it can be when a
woman is not pregnant. This could be one reason why migraine can sometimes
improve during pregnancy.
Another reason for improvement could be that levels of
endorphins (pain-killing hormones naturally released in the body) are several
times higher than normal during pregnancy.
Does pregnancy always improve migraines?
Sadly, no. This is especially true for the early weeks. If
you get morning sickness and eat and rink less, low blood sugar and dehydration
can trigger a migraine. Some women’s migraines improve. If their usual migraine
is menstrual and/or without aura, 60 – 70% of women find an improvement. Some
stay unchanged. If your usual migraine is with aura, they are likely to
continue. Some (rarely) become worse and some have their first ever migraine
during pregnancy. This is likely to be with aura. If you get a bad headache, see
your doctor as this can be a sign of pre-eclampsia which needs quick treatment.
Which drugs can I safely take during pregnancy?
If you are planning to become pregnant, now is the time to
see your doctor to sort out medication for your migraines before, during and
after the baby is born when you may be breast-feeding. Because drugs can’t be
tested on pregnant women or those who are breast-feeding, the preference is to
stop all medications.
If you do need a painkiller, paracetamol is thought to be
safe during both pregnancy and breast-feeding. It’s best to take soluble ones as
soon as you feel an attack starting. Take them with food to avoid irritating the
stomach. You should avoid aspirin when the birth draws near as it can exacerbate
bleeding. You should not take more than 600mg of ibuprofen a day. Triptans are
not recommended during pregnancy
Many anti-sickness drugs are fine to use in pregnancy. These
are:
-
Buclizine
-
Chlorpromazine
-
Prochlorperazine
-
Domperidone
-
Metaclopramide
It’s probably best not to take the last two in the first
three months of your pregnancy.
What about drugs when I’m breastfeeding?
If you have to take aspirin or Metaclopramide while you are
breast-feeding, don’t breast-feed again for 24 hours after you have taken it. A
low dose of propranolol is safe during both pregnancy and breastfeeding.
Amitryptiline and pizotifen are also safe during both.
The following Triptans are safe during breastfeeding so long
as you don’t breastfeed your baby within 24 hours of taking it:
-
Almotriptan
-
Eletriptan
-
Frovatriptan
-
Rizatriptan
-
Sumatriptan
Am I better trying alternative and complementary medicine?
Many women do. Just be aware that some of these treatments
can affect your pregnancy just as conventional medications do. For example, some
women love aromatherapy but may not know that some oils (ie rosemary) can’t be
used during pregnancy. Feverfew and reflexology should also be avoided. Make
certain your therapist knows that you are pregnant.
Migraine returning
Some women have a migraine a few days after giving birth.
This could be due to the sudden drop in levels of estrogen. Tiredness,
dehydration and a low blood sugar can all play their part too. Do not hesitate
to contact your doctor.
