Headache during pregnancy in 1st, 2nd and 3rd trimesters: causes and treatment

Headache (cephalalgia) are experiencing up to 40% of expectant mothers. With the emergence of cephalgia face pregnant in the first trimester of pregnancy, and headache, which appeared later, may be a symptom of any serious pathology that requires careful examination and treatment.

The causes of cephalgia in pregnant women

Headache is not a symptom of any disease, called primary. Primary cephalalgia characteristic of small and late (before birth) gestational ages. On the secondary cephalgia say when its appearance is due to chronic pathology or complication of pregnancy.

The causes of primary headaches

After implantation of the fertilized ovum begins with hormonal changes the body, the aim of which is preparation for gestation and childbirth. The load on the internal organs of the female is doubled, which creates conditions for the development of cephalgia:

  • Changes in hormone levels. In the period of gestation, significantly increases the production of progesterone which decreases the tone of smooth muscles, which prevents uterine contractions and abortion. In parallel, progesterone affects vascular tone, accompanied by hypotonia and the appearance of weakness, fatigue, drowsiness, fatigue, and cephalgia.

Please note

Headache due to hormonal changes that occurs early in gestation and is often accompanied by phenomena of early toxicosis.

  • The increase of circulating blood volume. One of the adaptive mechanisms of pregnancy is the increase in BCC, this prevents extensive blood loss during childbirth. BCC begins to rise from an early pregnancy, which is accompanied by vasodilation, which is supported by progesterone. And for low blood pressure is characteristic of dizziness and headaches.
  • Increased sensitivity to irritating factors. Also due to hormonal changes and is manifested by cephalgia occurs in response to loud sounds, unpleasant odor, bright light. Progesterone also contributes to the development of emotional lability in pregnant, so the slightest stress and anxiety cause tears, irritation and headache.
  • Meteosensitivity. Pregnant thanks to progesterone, are sensitive to weather changes, especially if increased meteosensitivity took place even before gestation. Change of weather, climate or time zone manifests the appearance of cephalgia.
  • The microclimate. Most people experience a headache, being in a stuffy or smoky room. Particularly sensitive to microclimate expectant mothers.
  • A change of posture. Typical of the third trimester of gestation. Under the weight of the pregnant uterus in the spine are changing bends that leads to the breakdown of blood flow in the vertebral vessels, lack of oxygen to the brain (hypoxia) and cephalgia.
  • A change of diet. In the early stages of a sharp rejection of the consumption of coffee and strong tea can cause cephalgia against a backdrop of ongoing hypotension. Later pain in the head can cause products that contain caffeine, tyramine, sodium chloride in large quantities, Veniamin. Therefore, women who bears a child, it is advisable to limit the intake of chocolate, tea, coffee, cocoa, citrus fruits, pickles, nuts, cheese.

It is important

Pregnant women are recommended to abandon the use of canned, smoked, semi-finished products, sausage products. They contain many food additives (dyes, preservatives, flavor enhancers), which not only provoke disorder of the gastrointestinal tract, but also affect the brain, causing cephalalgia.

  • Dehydration and hunger. Hypoglycemia contributes to the development of cerebral hypoxia, which results in a cephalalgia. Lack of fluid in the body provokes hypoxia, leads to spasm of blood vessels and the appearance of cephalgia.
  • Sleep deprivation or prolonged sleep. An excess or a lack of nighttime rest as well as sleeplessness, affect the condition of the pregnant woman and lead to weakness, lethargy, headache.
  • Other factors. Intense intellectual activity, excessive physical exercise, prolonged work at the computer, receiving cold food cause cephalalgia.

Causes of secondary cephalgia

During the period of gestation is possible exacerbation of chronic diseases of women or the development of complications of pregnancy that is accompanied by headaches:

  • Migraine. The main symptoms of migraine serve intermittent headache, which captures one half of the head (eyes – forehead – temple). The pain is intense, throbbing character, enhanced by turning your head and combined with loss of appetite, sleep disturbance, irritability or depression, nausea/vomiting. The etiology of migraine is unclear, but does not exclude the heredity. Provoke an attack can all of the above factors (hunger, physical or mental fatigue, stress, climate change, etc.).

It is important

If the disease was not diagnosed before pregnancy and for the first time showed itself only in the period of gestation, will need to report the attack migrenepodobnaya pain doctor to exclude more serious pathology with similar symptoms (bleeding in the brain or thrombosis of cerebral vessels).

  • Preeclampsia. A serious complication of pregnancy that occurs in the second half and is characterized by a triad of symptoms: proteinuria, hypertension, edema. When the rise in blood pressure is vasospasm, the brain isn’t getting enough nutrients and oxygen, resulting in a headache. In severe preeclampsia – preeclampsia except cephalgia pregnant complains of blurred vision, flashing “flies” before the eyes, nasal congestion, fatigue, drowsiness. If untreated, preeclampsia rapidly into eclampsia (convulsions, loss of consciousness), which could result in the death of the fetus and woman.
  • Hypertension. The disease is diagnosed before pregnancy. Hormonal changes in gestation, especially in the first trimester and before birth, affect the course of disease. The frequency of hypertensive crises may increase the period of gestation, and the disease aggravated by the onset of the preeclampsia. Headache during a hypertensive crisis is of a pulsating nature and localized in the occipital region. A bad headache can be accompanied by nose bleeding, nausea and vomiting, diplopia.
  • Overweight. As obesity and pathological weight gain (hidden edema) in gestational period contribute to spasm of blood vessels, which causes a pressure rise, resulting in a headache.
  • Cervical osteochondrosis. Curvature of the spine in the cervical spine leads to compression of arteries, circulatory disorders in the brain, hypoxia, and cephalgia. Aggravation of cervical degenerative disc disease is typical pregnancy second or third trimester and due to increased load on the spine caused by the enlarged uterus.
  • Vegetative-vascular dystonia;
  • Meningitis;
  • SARS;
  • Bleeding in the brain (injury or stroke);
  • Anaemia in pregnant women (lack of haemoglobin causes hypoxia and cephalalgia);
  • Glaucoma;
  • Neoplasms of the brain;
  • Sinusitis;
  • Kidney disease;
  • Problems with the teeth.

The risk of headache during pregnancy

Pregnant should seek medical assistance if the following signs:

  • the nature of the headache has changed (first was bothered by a dull, aching pain, then began pulsating);
  • cephalalgia occurs immediately after waking up;
  • the pain is localized to a particular area of the head;
  • appearance of other neurological symptoms (deterioration of vision, hearing, disorder of sense of smell, cutaneous sensation, paresthesia, numbness of extremities);
  • cephalalgia accompanied by an increase in blood pressure, and edema or a sharp decline;
  • the intensity of the pain increases.

Treatment of headache in pregnant women

Due to the fact that headache is observed in almost half of pregnant women are recommended to conduct a series of measures that either prevent the occurrence of cephalgia:

  • The revision of the supply. The expectant mother should give up or limit sugary carbonated drinks, semi-finished products, sausages and fast food (high content of food additives and preservatives). It is also necessary to reduce the consumption of seasoning, greasy, spicy food, pickles, pickles, strong tea and coffee. Served at optimal temperature (15 – 60 degree), to avoid drinking too cold or hot food. Meal to make fractional, up to 5 – 6 times a day, and the portions are small. If you experience hunger, you need to make small snacks (biscuits, fruit).
  • Maintaining a healthy lifestyle. If the woman still did not refuse from bad habits, particularly Smoking, should do so as quickly as possible. Smoking causes fetal hypoxia and slows down its development, and also aggravates the headache. Useful daily walks in the forest areas, therapeutic gymnastics for pregnant women, swimming pool.
  • Climate control. The room where a woman spends most of the day, as well as the bedroom, should be regularly aired. It is recommended to avoid stays, even short, in a smoky, stuffy room.
  • Elimination of noise and loud sounds. Pregnant and want to limit the viewing of television programs, films, avoid staying in a noisy company, to give up listening to loud, rhythmic music. In the rooms it is desirable to create ambient lighting, Central lighting to replace the local (lamps, sconces).
  • NAPs. If my work schedule allows, in the mode of the day, the future mom should include the NAP (60 – 90 minutes).
  • The exclusion of physical and emotional exhaustion. To avoid stress, conflict situations, excessive fun or joy. Night sleep pregnant should last at least 8 hours at work, requiring a prolonged stay in one position (sitting at a computer, Pullman), every 30 – 40 minutes conduct a short physical warm-up (to take a few steps, stretch, dilute/to reduce hand).

First aid

On their own, without medication, to get rid of a headache will help the following activities:

  • Short-term stay. Pregnant it is advisable to lie down and take a NAP for 15 minutes – 20. The area should be quiet, ventilated and dim.
  • The head massage. Performing light circular movements in the temporal areas, combing hair in different directions, a slight massaging of the neck will ease an attack of cephalgia.
  • Shampooing. If possible, it is desirable to wash the head with warm water, in parallel, by performing light massage movements to the scalp.
  • Aromatherapy. Fill and light the aroma lamp oils of aromatic plants, depending on the blood pressure. With reduced AD recommended orange, grapefruit or verbena oil, at elevated – lemon, lavender, peppermint or ylang-ylang. Allowed the use of aromatic oils in the form of cold compresses (dilute a few drops of oil 250 ml of cold water wet her towel that attach to the location of the pain).
  • Warm tea, decoctions of herbs. In the case of low blood pressure or hunger, drink a glass of sweet strong tea. Reception of herbal teas (rosehip, lemon balm, mint) also get rid of the pain.
  • The compresses. Of heaviness and pain in the head (temple, neck, forehead) applying warm or cold compress (depending on pressure). You can apply a poultice of crushed cabbage leaves (must exude juice).
  • Water treatment. Reception a warm shower or bath with essential oils or bath salts ease the pain.

It is important

Take a bath only after consultation with the obstetrician-gynecologist.

  • Compression of the head. Slight contraction of the head with a shawl/scarf will reduce the cephalalgia.


Non-pharmacological measures are often ineffective and pain attack have medication.

It is important

Every pregnant need to bear in mind that most medicines are contraindicated to take in the gestational period. Medical treatment is prescribed by a physician and performed under his control.

Cure for cephalgia, resolved pregnant:

  • The paracetamol. The main effect of the drug is to reduce the temperature. Additional – reduces or relieves headaches. Paracetamol has no negative impact on the fetus and newborn is allowed to receive in the gestational and lactational periods. Children’s Panadol, the active active substance of which is paracetamol allowed to take during pregnancy. Panadol Extra is allowed only with cephalgia due to low blood pressure (caffeine).
  • No-Spa. The main action of the antispasmodic drug. The drug causes relaxation of blood vessels, lowers blood pressure, thereby pain is reduced.
  • Nurofen. The active substance is ibuprofen. Assigned with caution. The drug has analgesic and antipyretic effects, but the effect on the clotting system of the blood (inhibits platelet aggregation), meaning that the reception of Nurofen is contraindicated in the last weeks of pregnancy (risk of bleeding in childbirth).

It is strictly forbidden to take the following medications (to provoke the formation of congenital abnormalities, bleeding before birth, during birth or after):

Read more about the medications recommended for cephalgia in pregnant women, see the article: “What to take for headache pregnant”.

Sozinova Anna Vladimirovna obstetrician-gynecologist