What causes headaches in pregnancy?

The exact cause of a headache isn’t always clear. In the first trimester, changing hormone levels and blood volume may play a role. A dull, overall headache can come with stress, severe tiredness (fatigue), and eyestrain. Sinus headaches may be more likely because of the nasal congestion and runny nose that are common in early pregnancy. Hunger and low levels of blood sugar can trigger headaches, too. Women who suddenly stop their morning coffee and sodas may experience caffeine withdrawal headaches. Those who also suffer with nausea and vomiting in early pregnancy can become dehydrated. This can also bring on a headache.

Migraine headaches are a common type of headache in pregnancy. These painful, throbbing headaches are often felt on one side of the head and result from expansion of the blood vessels in the brain. The misery is sometimes accompanied by nausea, vomiting, and sensitivity to light. A small percentage of women with migraines also have an aura with the migraine. They see flashes of light or feel tingling in their arms and legs.

When should I be concerned?

When a headache is severe, or just doesn’t go away, or when you have dizziness, blurred vision, or changes in your field of vision, you should contact your healthcare provider. Headaches can sometimes be related to blood pressure problems in pregnancy. If they are persistent or severe and happen after 20 weeks of pregnancy, let your healthcare provider know. Although strokes during pregnancy are rare, migraines can increase a pregnant woman’s risk for them. If you have migraines, report them to your provider.

What can I do about headaches?

Steps to manage headaches include the following:

• Stay away from any known headache triggers, including allergens and certain foods, like monosodium glutamate, cured meats, and strong cheeses.

• Smoking is never a good idea in pregnancy. You should also stay away from secondhand smoke.

• Try to eat well and drink plenty of fluids, especially if you are prone to morning sickness.

• Reduce your stress level. Try a massage or cold pack to help with tension headaches. 

• If your headache is a migraine, rest in a cool, dark room with no noise, and try using warm or cold compresses or an ice pack.

There is good news, however. Most women have fewer headaches during pregnancy, especially after the first trimester. And those with a history of migraines often find there is improvement during pregnancy.