Headache is one of the most common complaints during pregnancy. The reason is estrogen. Because of it, women in general are 3-4 times more likely to suffer from headaches, especially from migraines. And during gestation, the level of this hormone changes. And although more often pregnancy reduces the risk of migraine attacks, they do not completely disappear (and may appear for the first time). MedAboutMe explains how to deal with migraines during these sensitive periods - pregnancy and lactation.
Pregnancy and migraines: what to expect?
In general, migraine in women is considered a hormone-dependent pathology: the less estrogen, the higher the likelihood of an attack. Associated with this, for example, "menstrual migraine", which develops 2-3 days before menstruation and in the first days. This condition is corrected quite simply: in the absence of contraindications, a woman is prescribed hormonal contraceptives. But it is clear that this is not an option during pregnancy.
There are also forms of migraine in which an attack develops not due to a reduced amount of estrogen, but when it rises - for example, due to the same contraceptives. And finally, there is migraine, which does not correlate with hormonal status - in both women and men.
How likely is it that the migraine will not subside during pregnancy?
In about 7 out of 10 expectant mothers, seizures become less frequent, weaker, or do not occur at all during gestation. However, for the remaining three out of 10, they continue. Pregnancy can also provoke the onset of migraine - according to various studies, from 1.3% to 16.5% of women with migraine first met with migraine during gestation.
In addition, during gestation, many previously familiar with seizures first develop an aura.
Migraine aura indicates specific neurological disorders. They can occur before the attack (most often), during it, and even immediately after.
Most often, the visual aura - flashes, "lightning", blind or white spots.
There may be an auditory aura - with sounds, as well as an aura in sensations - tingling, numbness, most often capturing the head, face, shoulder and arm.
Although the aura itself is not an indicator of a particular danger of migraine, but if such sensations with numbness appear for the first time (especially in a pregnant woman), it is necessary to urgently consult a doctor in order to exclude other causes of the condition.
Migraine after childbirth
After the baby is born, natural hormone levels are restored. For this reason, quite often migraines, which did not manifest themselves during pregnancy, return - including during breastfeeding. The longer the period of lactational amenorrhea (absence of menstruation due to hepatitis B), the lower the risk of seizures.
However, hormones are not the only provocateurs of migraine attacks after childbirth. Lack of sleep with a small child, difficulty with feeding the mother on time, fatigue and anxiety can increase the frequency of attacks and worsen pain.
What to do with migraines during pregnancy and hepatitis B?
Cure migraine is still impossible, despite all the advances in science. Most often, the predisposition to this pathology is hereditary, and it can manifest itself as migraine attacks in children even at an early age (and they do not always coincide with the classical description).
But it is possible to prevent this headache, to influence its frequency and strength even at home, independently and without medication. It is important to identify your migraine provocateurs (according to studies, 15% of patients do not know them) and avoid additional ones. Which ones?
This is the most common provocateur of migraine attacks, which works in almost all patients. That is, for a warning, you need to monitor how much you drink.
Irregular eating can trigger an attack. It is important for expectant mothers to avoid violations of the regimen in any case, including to avoid headaches during pregnancy.
Lack of sleep and overwork
Lack of sleep or poor quality sleep badly affects the entire body, and also often causes a migraine attack. For obvious reasons, sleep can be disturbed during pregnancy - but then you need to compensate for it with rest.
In a stuffy room, even the healthiest person can get a headache from a lack of oxygen, what can we say about a future mother with a tendency to migraine. Vascular spasms, insufficient blood supply to the brain cause bouts of nausea, fainting - and migraines.
Exercise does help prevent migraine pains. And this has been proven even for pregnant women: Russian scientists compared the frequency of attacks in two groups of expectant mothers with severe migraines. The first fulfilled all the doctor's prescriptions, and the second walked for an additional 4 hours and used relaxation techniques. As a result, in the second group, the frequency of attacks dropped sharply to less than one in three months. Walk more!
Both physical and emotional - both of these types are closely related, and both can provoke migraines. To relieve stress, advise yoga for pregnant women, breathing techniques, relaxation techniques - whatever suits you personally.
The emotional state can reach the stage of depressive-anxiety disorder, and this is another trigger for migraines. It especially affects mothers after childbirth in the form of perinatal depression.
If anxiety grows, fatigue absorbs and there is little that pleases, you do not need to endure - it is better to go to a psychotherapist in a timely manner. Antidepressants for pregnant and lactating women have a much wider range of options than migraine medications, and psychotherapy can effectively combat both pathologies.
What about migraine medications for pregnant and lactating women?
Alas, there are no completely safe migraine drugs for pregnant and lactating women. There are effective drugs - for example, opiates, triptans, valproates - which, in general, are highly discouraged even by women who are not pregnant, but capable of conceiving a child, the danger to the fetus is so great.
According to the latest data, another consequence of the valproate group was found out - taking such medications during pregnancy reduces the child's intelligence (IQ) by 6-11 points.
The molecules of many migraine medicines reach the baby through the placental barrier or in breast milk. Therefore, most drugs for the treatment and control of seizures are not prescribed during gestation. They are especially dangerous in the first trimester - when the frequency of attacks sharply increases.
The biggest limitation of any medication during pregnancy is in the first trimester and 2 weeks before PDD.
So how to treat migraines during pregnancy and breastfeeding?
On the advice of a doctor, you can use paracetamol once, from the second trimester - ibuprofen. An independent decision to take is dangerous: even these familiar drugs can harm without considering all aspects of health. So, for example, the usual acetylsalicylic acid is not prescribed to pregnant women at all.
In severe migraine attacks, drug therapy is carried out under the supervision of a physician, taking into account the risk to the mother and child.
From non-drug, but medical means for helping with migraines, the effectiveness of psychotherapy, biofeedback and hardware effects on the trigeminal nerve has been proven. It is he who is "guilty" at the beginning of the attack. And since the branches of this nerve are close to the skin (in the forehead), it is possible to influence it with the help of an electromagnetic field, for example, with a Cefaly electrode. Important: all types of therapy are selected and prescribed only by doctors!