If you’ve ever experienced a pounding headache that shows up right before your period, you’re not alone. Menstrual migraines affect up to 60% of women who get migraines, and for many, these headaches can be debilitating. But what happens when you get pregnant? Does the pain get better, or could it get worse? The answer is—it depends.

Pregnancy is a time of major hormonal changes, and these shifts can influence headache patterns. For some women, migraines improve or even disappear during pregnancy, especially after the first trimester. Others may find that their headaches worsen or persist, creating a new set of challenges during this important time. Understanding these changes can help you prepare and manage your symptoms effectively.

Why Do Menstrual Migraines Happen?

Menstrual migraines are linked to the natural drop in estrogen that happens just before your period starts. This sudden dip can trigger inflammation and changes in brain chemistry, leading to a migraine. For women who are sensitive to these fluctuations, the hormonal rollercoaster of pregnancy can either ease or exacerbate headaches.

How Pregnancy Affects Migraine Patterns

During pregnancy, estrogen levels rise significantly and remain high, particularly after the first trimester. This steady increase in estrogen can be a blessing for many migraine sufferers, reducing the frequency and intensity of headaches. Studies suggest that up to 70% of women who experience menstrual migraines notice an improvement in their symptoms by the second trimester.

However, not everyone gets relief. Some women, especially those with a history of migraines that aren’t linked solely to their menstrual cycle, may continue to experience headaches throughout pregnancy. Additionally, tension headaches or other types of pregnancy-related headaches may become more common, especially in the first trimester due to factors like:

• Increased blood volume: Your body is producing more blood to support your growing baby, which can put extra pressure on your blood vessels.
• Changes in sleep patterns: Fatigue and disrupted sleep can contribute to tension headaches.
• Dehydration: It’s easy to become dehydrated during pregnancy, especially if morning sickness makes it hard to keep fluids down. 

What to Do If You Experience Headaches During Pregnancy

If headaches are making pregnancy more difficult, there are ways to manage the discomfort safely. While some traditional migraine medications aren’t recommended during pregnancy, there are still plenty of strategies to help you feel better:

• Stay hydrated. Aim to drink at least 8-10 glasses of water a day to prevent dehydration-related headaches.
• Prioritize rest. Lack of sleep can be a migraine trigger, so try to establish a consistent sleep schedule and practice good sleep hygiene.
• Manage stress. Relaxation techniques like deep breathing, meditation, and prenatal yoga can reduce tension and prevent headaches.
• Consider magnesium. Magnesium supplementation has been shown to reduce migraine frequency in some cases, but always talk to your doctor before adding supplements during Cold or warm compresses. Applying a cool compress to your forehead or a warm one to your neck can offer soothing relief.

When to Call Your Doctor

While headaches can be a normal part of pregnancy, certain types should never be ignored. If you experience:

• Severe headaches that don’t go away or worsen over time
• Vision changes, such as blurring or seeing spots
• Sudden swelling in your hands, feet, or face
• High blood pressure

These could be signs of a more serious condition like preeclampsia, which requires immediate medical attention.

Postpartum Migraine Patterns

After delivery, estrogen levels drop rapidly, which can trigger postpartum migraines. If you’re prone to menstrual migraines, be aware that the early postpartum period can be a vulnerable time for migraine recurrence. Staying ahead of potential triggers with good hydration, rest, and self-care can help manage symptoms.

The Bottom Line

Pregnancy affects every woman differently, and headache patterns can be unpredictable. If you’ve struggled with menstrual migraines in the past, staying informed and working closely with your healthcare provider can help you navigate pregnancy with greater comfort and confidence. By understanding what’s happening in your body and taking steps to manage your symptoms, you can focus on what matters most—nurturing yourself and your growing baby.

Source:
 Parashar, R., & Ray, B. S. (2021). Migraine and pregnancy: A review of pathophysiology, management, and future directions. The Lancet Neurology, 20(3), 30482-8. https://doi.org/10.1016/S1474-4422(20)30482-8.