Headaches during pregnancy: Causes and treatment

Experiencing headaches during pregnancy, especially in the first few weeks is normal. They can be attributed to a variety of factors related to the physical and hormonal changes that occur during this time. If hormonal changes can lead to mood swings in pregnant women, an increase in levels of estrogen and progesterone, can also trigger headaches. These hormonal changes can cause the blood vessels in the brain to dilate, leading to headaches. While other factors cause headaches during pregnancy, there are also ways to get relief from the pain.

Types of headaches during pregnancy you may experience

Here are the common types of headaches that pregnant women experience and should be on the look out for:

1. Tension headache

Tension headaches represent 26 percent of headaches during pregnancy, as per research published in the Journal Of Headache And Pain in 2017. It is often described as a feeling of tightness or pressure around the forehead or the back of the head and neck. It can cause mild to moderate pain, and is usually not accompanied by other symptoms.

2. Migraine headache

“It is typically characterised by throbbing pain, which usually happens on one side of the head,” says obstetrician and gynaecologist Dr Madhu Juneja. It may also be accompanied by nausea, and sensitivity to light.

3. Cluster headache

Cluster headaches during pregnancy are rare, but can be severe. It can occur in cyclical patterns or clusters, causing intense pain typically around one eye or on one side of the face.

“Headaches during pregnancy can range from mild discomfort to severe pain that can affect daily routine, and can last from a few hours to several days,” says the expert.

What are the causes of a headaches during pregnancy?

Here’s a breakdown of the potential causes of headaches during each trimester –

1. First trimester (weeks 1 to 12)

• Hormonal changes: The rapid increase in hormones, particularly estrogen and progesterone, can trigger headaches in early pregnancy. These hormonal shifts affect blood circulation and may lead to headaches.
• Increased blood volume: During first few weeks of pregnancy, blood volume increases significantly, which can lead to changes in blood pressure and contribute to headache.
• Dehydration: Nausea and vomiting (common in early pregnancy) can lead to dehydration, a known trigger for headaches.
• Stress: Early pregnancy can be a time of emotional stress and anxiety, contributing to tension headaches.
• Changes in sleep patterns: Many women experience sleep disturbances or increased fatigue, which can lead to tension headaches.

2. Second trimester (weeks 13 to 26)

• Continued hormonal changes: Hormonal fluctuations continue, which can still trigger headaches, especially as the body adapts to these changes.
• Physical changes: As the uterus grows, changes in posture and weight distribution can lead to tension headaches, especially in the neck and shoulder areas.
• Increased stress: The psychological stress of pregnancy can persist, leading to more frequent tension headaches.
• Dietary changes: Changes in diet, skipping meals, or caffeine withdrawal can trigger headaches.

3. Third trimester (weeks 27 to 40)

• Preeclampsia: Headache may be a symptom of preeclampsia, according to the UK’s National Health Service. It is a serious condition characterised by high blood pressure and signs of damage to another organ system. If headaches are severe or accompanied by other symptoms like visual changes, swelling, or abdominal pain, immediate medical attention is required.
• Physical discomfort: As pregnancy progresses, physical discomfort, including back pain and tension in the neck and shoulders, can contribute to tension headaches.
• Sleep disruptions: Discomfort and anxiety about labor can lead to sleep disturbances, resulting in fatigue-related headaches.

How to treat headaches during pregnancy?

Here are some safe methods for treating headaches during pregnancy:

1. Hydration

Have a good amount of fluids to avoid dehydration, especially if you have morning sickness. It is basically nausea and vomiting during pregnancy that many women experience while they are expecting.

2. Rest

It is common to feel tired during pregnancy, especially in the first few weeks. “So, take breaks and ensure adequate sleep to combat fatigue, which can cause headaches,” says the expert.

3. Cold compress

Applying a cold pack to the forehead or neck can provide some relief. Ice has a numbing effect, which may be useful to manage headaches, as it can dull the sensation of pain.

4. Massage

Gentle massage around the temples and neck area may help reduce tension. Use your fingertips to gently massage your temples and neck in circles to do away with headaches.

5. Relax

Consider doing yoga, meditation, or deep-breathing exercises to manage stress, which is a common cause of headache. You can also talk to a friend or find time to do something you enjoy, and do away with headaches during pregnancy.

6. Over-the-counter pain relief

To cope with headaches during pregnancy, paracetamol should be the first choice of painkiller if you are pregnant, as per the UK’s NHS. But for your own safety, take paracetamol for the shortest possible time during pregnancy. “Acetaminophen (Tylenol) is also considered safe during pregnancy, but consult your doctor before taking any medication,” says Dr Juneja.

Frequently asked questions (FAQs)

1. When should I be worried about headaches during pregnancy?

While headaches can be a normal part of pregnancy, it’s essential to monitor their frequency and severity. If headaches are severe, persistent, or accompanied by other concerning symptoms (such as visual disturbances, swelling, high blood pressure, or severe abdominal pain), it’s important to consult a doctor. These could be signs of more serious conditions, such as pre-eclampsia.

2. Do miscarriages cause headaches?

Headaches are not typically considered a direct sign of miscarriage. But if they are accompanied by spotting or bleeding, back pain, and cramping, you should check with your doctor.

3. Can a headache affect the baby?

Headaches during pregnancy are usually normal. They do not harm your baby, but sometimes, they can be a sign of preeclampsia, which may lead to an unplanned preterm birth.