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Headache in pregnancy: what it can be and clarified doubts

Pregnancy provides numerous changes in the general health of women and also in their routine, which can generate some discomfort. Headache in pregnancy, especially in the first trimester, can be a consequence of hormonal changes or even changes in diet, for example. However, it may be related to more serious problems and, therefore, should always be investigated.

What can cause a headache in pregnancy?

Headache in pregnancy, especially in the first trimester, can be related to hormonal changes, tiredness, nasal congestion, changes in diet, among other points. And in some cases, the pain lessens or disappears as the hormones stabilize.

It is essential, however, that the doctor accompanying the pregnant woman knows about all the episodes of headache so that he/she can investigate the case, especially when the pains are frequent, intense and/or accompanied by other symptoms.

Roger Taussig Soares (CRM 69239), a neurologist at the Hospital Alemão Oswaldo Cruz, comments that a very important change in the pattern of pain during pregnancy requires a neurological assessment.

“Women with a history of migraine are at greater risk of developing cerebrovascular complications during pregnancy. In addition, other causes of headache may arise, such as cerebral venous thrombosis, cerebral hemorrhage, pituitary tumor, reversible cerebral vasoconstriction syndrome, hypertensive disease of pregnancy (eclampsia or preeclampsia), idiopathic intracranial hypertension, among others. The neurologist will know how to investigate the possible causes”, explains Soares.

Doctor answers questions about headache in pregnancy

In such a special phase as pregnancy, it is normal for doubts and fears to arise. Check below the clarification for the main doubts about headache during pregnancy.

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1. Is it normal to have a headache at some stage of pregnancy? “A woman who presents with a headache during pregnancy can fit into one of three scenarios: she already had a primary headache type, such as a migraine or tension headache, and then she is having her normal headache during pregnancy. gestation; she never had and started with a new severe headache during pregnancy; she had a primary headache and this headache got a lot worse during pregnancy. These last two scenarios may be signs of a more serious problem that needs to be investigated by the neurologist”, Soares highlights.

2. Is it possible to have migraine during pregnancy? It is possible and relatively common for the migraine pattern to change during pregnancy, according to Soares. “A headache that was migraine without aura can turn into a migraine with aura; and a migraine with aura can become a migraine without aura, for example”, explains the neurologist.

3. Will the woman who already suffered from migraine before becoming pregnant continue to have attacks during pregnancy? “Among women who have migraine before pregnancy, 50 to 75% feel an improvement in the frequency and intensity of attacks, and the headache may disappear completely during pregnancy. These statistics are especially valid for the first pregnancy”, says Soares. On the other hand, women who have had several children, says Soares, may have a worsening of the crises in half of the cases. “Headaches after childbirth happen in 30 to 40% of women, regardless of a history of migraine. In general, the headache pattern returns to pre-pregnancy quickly after delivery. After a month, more than half of the women have their ‘normal’ crises again”, explains the neurologist. In selected cases, highlights Soares, the neurologist may consider preventive treatment for migraine during pregnancy. “Prophylactic drugs are indicated when the impact of crises is important and non-drug treatments associated with analgesics are not enough. Depending on the pregnancy, the choice of prophylaxis follows an appropriate logic for the situation”, explains the doctor.

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4. Can the pregnant woman take medicine for a headache? The pregnant woman should never take a medication on her own, always having to talk to the neurologist and/or the gynecologist who follows the pregnancy about this intention. “It is recommended to avoid all types of analgesic drugs during pregnancy and to use them only when non-drug resources do not work”, Soares highlights.

5. What should a pregnant woman do during a headache episode? “Some possible interventions are massage, acupuncture, relaxation, do-in, mindfulness techniques and regular physical activities. In addition, there are pregnancy-safe electrical stimulation devices such as Cefaly. The doctor must guide the best conduct in each case”, explains Soares.

Some simple measures that can help in times of pain are: lying down in a quiet environment without light and noise; apply cold water compress to forehead; wash your face with cold water or shower with warm or cold water; eat every three hours (or as instructed by the doctor).

In any case, the doctor accompanying the pregnancy should always be informed about the occurrence of headaches during pregnancy. Learn more about what happens at each stage of pregnancy.

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