Migraine and Pregnancy

Migraine is especially common in women of reproductive age. There are many treatments available for migraine that are highly effective but common questions I get from patients who fall into this population include:
What am I going to do when I am trying to get pregnant, am pregnant, or breast feeding?
Will I have to stop my current treatment that has been working so well?
What are the fertility risks associated with migraine treatment during this time?

Don’t worry, we will find an individualized treatment plan for you! Another reason not to worry is the fact that for most women, pregnancy and breast feeding after pregnancy is protective against migraine. Approximately 47% of women have improvement in their migraines during their 1st trimester, 83% during their 2nd trimester and 87% during their 3rd trimester. Essentially for most women, the rate of remission from migraines increases as the pregnancy progresses.

Even if your migraines don’t improve during your pregnancy there are still options for you, such as:
Non-pharmacological behavioral changes and approaches can help decrease the frequency and severity of migraines. For example: rest and relaxation techniques, biofeedback, behavioral sleep modification, prenatal yoga.
Supplements and minerals are safe during pregnancy and are shown to improve migraine. Supplements include: Riboflavin, Vit B2, CoQ10, and Magnesium.
Acetaminophen (Tylenol) is safe to use in all trimesters as an abortive while pregnant
Metoclopramide (also known as Reglan) is an ant-nausea medication that is safe during all trimesters, can help with the nausea associated with migraines and the nausea associated with pregnancy (hyperemesis gravidarum)
Occipital and trigeminal peripheral nerve blocks (preferably done with just lidocaine) can be given when pregnant
Neuromodulation devices

By: Caroline Pruski, NP