Migraine During Pregnancy
Studies show that for most women with migraine, headaches typically improve during pregnancy. This is thought to be due to high levels of estrogen that remain stable throughout a pregnancy.
With all that being said, this is unfortunately not the case for everyone. There are some women who have new onset of migraine during pregnancy or feel acute worsening of their migraine headaches while pregnant.
While the options are significantly more limited, that does not mean there is nothing that can be done if you find yourself with more breakthrough headaches during a pregnancy. Some examples of treatment options include things such as certain nutraceuticals, certain external devices for migraine, occipital nerve blocks, etc. Occipital nerve blocks with lidocaine can be an excellent option either to break a persistent migraine or as a preventative option on a scheduled basis during a pregnancy. These typically offer immediate relief and can have lasting benefit for 3-4 weeks on average. Likewise, there are many neuromodulation devices on the market approved for both acute and preventative treatment of migraine. Many of these devices are felt to be safe for pregnant women and can offer relief. Lidocaine can also be compounded into a nasal spray formulation and be used acutely for breakthrough headache. This is typically very well tolerated and can be used more regularly if you find yourself with frequent breakthrough migraine.
The take home message is that you should not have to suffer without any treatment options if you are struggling with migraine during pregnancy. For this reason, it is important to have a headache specialist on your care team should you need any assistance in managing migraine headache during pregnancy.
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