There seem to be many different opinions about the effect of pregnancy on migraines.
The main rule is that the effect is individual.
According to practical experience, migraines can be more troublesome during the first trimester of pregnancy, when many changes occur in hormonal function.
For many, the latter part of pregnancy can be a migraine-friendly time.
Migraine with aura can even get worse.
As a completely unscientific observation, it can be stated that in some people between the first and last child, i.e. even outside of pregnancy, migraines can be very calm.
Many people say this.
Migraine treatment during pregnancy planning
The new generation of biologic migraine medications administered under the skin are long-acting.
Depending on the drug, complete elimination from the body takes 4–7.5 months.
Tablet-form medications (rimegepant and atogepant) are eliminated from the body within three days.
The difference is significant when considering stopping migraine medication and contraception.
With conventional contraceptives, adjustment is relatively simple – with the exception of valproate and topiramate, which should not be used in women of childbearing age.
It is advisable to stop candesartan at the same time as stopping contraception.
Before stopping contraception, discuss the medication you are taking with your doctor.
Migraine treatment during pregnancy
The most recommended migraine treatment during pregnancy is non-drug.
This includes eating regularly, getting enough sleep, and exercising.
Massage or other manipulations of the neck, shoulder and scalp do not harm the developing fetus.
Paracetamol has not been shown to have any adverse effects on the fetus.
A combination of paracetamol and codeine is used to some extent, but medications containing opiates are not ideal during pregnancy.
There is extensive experience with sumatriptan in the treatment of migraine attacks during pregnancy, and no problems have been observed during more than 30 years of use.
Ibuprofen is allowed after the first trimester, but should not be used close to delivery, as it may interfere with the development of pulmonary and arterial circulation.
Acetylsalicylic acid should not be used during pregnancy due to the risk of bleeding.
Contraceptives should not be used during the first trimester of pregnancy.
During the second and third trimesters, metoprolol and propranolol have been shown to be safe, with metoprolol being better tolerated.
Migraine treatment during breastfeeding
All non-drug treatments are permitted.
Sumatriptan is excreted in breast milk in only small amounts, so it can also be used during breastfeeding.
When it comes to preventive treatment, it is important to discuss suitable options with your doctor.
Summary
Reconciling difficult-to-treat migraines and pregnancy can seem challenging, but fortunately, for most people, pregnancy is tolerable in terms of migraines.
Markku Nissilä, neurology specialist
Frequently asked questions about migraines during pregnancy
Does pregnancy affect migraines?
For most people, migraines improve during pregnancy, but for some, symptoms may worsen, especially in early pregnancy.
Can migraines be treated during pregnancy?
Yes. Non-drug treatment is the first choice. Paracetamol and sumatriptan are proven safe options.
What medications should be avoided during pregnancy?
Ibuprofen is not recommended in late pregnancy, and acetylsalicylic acid should not be used due to the risk of bleeding.
Is migraine prevention possible during pregnancy?
Preventive medications are not recommended during the first trimester. In later stages, metoprolol is a safe option.
Can sumatriptan be used while breastfeeding?
Yes, it can. It is excreted in breast milk in very small amounts.
Read more and find natural help
Many factors contribute to migraines – including neck muscle tension and stress.
Discover the Atlas Care device , which relaxes the muscles at the base of the skull and relieves the symptoms of migraine and tension headaches.