Pregnancy and Migraine
Pregnancy for many women with migraine seems to bring some relief from migraine. Approximately 60% of them see an improvement of symptoms, especially in the second and third trimesters. The theory is that the higher and more stable levels of hormones are just about right to help keep migraines at bay, unfortunately, the migraine generally returns to its normal pattern when the baby is born.
Of those migraineurs who become pregnant, 15% actually experience worsening or new-onset migraine. This may be a result of morning (or anytime) sickness. When vomiting, you’re losing food, fluid and lowering blood sugar levels, you’re also in danger of dehydration. Many women who experience their first migraine during pregnancy will more than likely go on to suffer from the disorder for life afterwards.
Migraine itself doesn’t have any damaging effects on the baby or on the pregnancy, but any medication or treatment MUST be carefully monitored by your doctor. It’s recommended that all medication is discontinued during pregnancy as particularly the Triptans and all preventative medications are contraindicated. To date, paracetamol is the only medication considered ‘safe’ for use during pregnancy, but again must be monitored closely by a doctor. Sometimes the paracetamol can be given with an anti-emetic like Motilium which is also considered ‘safe’, but again, due to individual tolerances of different drugs, should never be taken without discussing it beforehand with a doctor. On rare occasions, a specialist MAY prescribe something a bit stronger, but only under strict supervision.
So how do you treat migraine during pregnancy if you can’t take drugs? I hear you cry in despair!
Okay, if drugs are ruled out, there are a few things which may offer relief during pregnancy including:
- Sleep/rest/retreat – Rest, sleep, retreating from the mayhem can all help you. Have some alone time (well alone with the baby bump time). Another option is to find a relaxation technique, such as yoga, mindfulness, or even sitting in a dark room listening to soft music. Whatever relaxes you and reduces stress is good. Beaumont Hospital has a mindfulness and relaxation centre, with some exercises on their website here. Again before trying anything new, speak to your doctor or gynaecologist.
- Biofeedback – This non-invasive, drug-free technique can help you to take control over some of your reactions to stress. You can learn to recognise levels of tension in certain parts of your body and then teach yourself to reduce the reaction. See www.biofeedbackireland.ie for more information
- Cold Therapy – Try using something like the Migra-Cap which you can find in some pharmacies (particularly McCabe’s) around the country. Migra-Cap combines cold therapy and complete darkness to relieve pain. It’s medication-free and very easy to use. Between uses, you leave it in your fridge or freezer.
- Light exercise – Exercise helps to balance your blood sugar levels, improves breathing and releases the feel-good endorphins, leaving you feeling much happier and healthier. Discuss with your doctor which exercise would suit you the best.
- Massage/relaxation therapy – Again, massage can help to relax you so this is good, BUT, make sure your doctor is happy that this is safe for you. Some massage therapists may refuse to treat a pregnant woman until after the first trimester. If the massage includes reflexology or aromatherapy, do double check that these will be safe as some oils may not be suitable and can be harmful to the baby. Certain conditions experienced during pregnancy can make reflexology unsuitable e.g. Continuous vomiting, Pre-Ecclampsia, DVT (Deep Vein Thrombosis). Make sure that the different therapists are trained in treating pregnant women. See Reflexology Ireland and the Irish Massage Therapists websites to find a local therapist
- Sniff green apples! – Yes, sniff green apples… Scientists at the Smell and Taste Treatment Center in Chicago found that the smell of green apples may help to lower pain
- Trigger avoidance – Again, use your migraine diary to identify and avoid your known triggers. Be aware that during pregnancy you may find additional triggers and keep an eye on them too.
- Increase in water, and snacking more frequently, especially if vomiting – As already stated above, if you suffer from a lot of sickness, this can result in low blood sugar levels and dehydration; two major triggers… try eating small, frequent meals and drinking plenty of water. If you experience nausea drink ginger ale or ginger tea
Homeopathic or herbal remedies (Feverfew) have side effects which may be harmful to the baby and so should be avoided as much as possible when pregnant, especially during the first three months, but discuss everything with your doctor.