Treating headaches During Pregnancy Without Drugs
By Dr. Brad Eli
Pregnant women are often relieved to learn about natural remedies that can be used for their headaches.
Headaches and hormones have an intricate relationship. This article will explain how jaw pain is related to pregnancy. Because pregnancy is a hormone rollercoaster, it’s not surprising headaches during pregnancy show a dynamic pattern, being worse at some points and better during others. The well-being of both the mother and the developing baby requires careful consideration regarding headache treatment options.
For this reason, many doctors and expectant mothers are interested in ways to treat headaches during pregnancy without drugs. First, let’s outline the clinical relationship between headaches and pregnancy. Next, we explore various effective ways to alleviate headaches during pregnancy without resorting to medication. We’ll explore safe and natural approaches that can provide relief and peace of mind to mothers-to-be.
Table of Contents
- Treating headaches During Pregnancy Without Drugs
- Do Pregnancy Headaches Differ from Regular Headache Types?
- How do Hormonal Changes During Pregnancy Affect Headaches?
- How do Female Hormones Change During Pregnancy?
- Can Jaw Pain be Related to Pregnancy?
- List of “Red Flags” for Headaches in Pregnancy
- What are Some Natural Treatments for Pregnancy Headaches?
- SUMMARY: Natural Therapies Are First Line Treatments for Pregnancy Headaches
Do Pregnancy Headaches Differ from Regular Headache Types?
Pregnancy headaches’ frequency and pattern can differ from those you experience when not pregnant. Before we begin our exploration of pregnancy, it’s crucial to have a foundational understanding of headaches.
In basic terms, headaches are divided into two categories:
- Primary headaches, such as tension-type headaches, migraines, and cluster headaches, are conditions in and of themselves, not linked to any underlying medical condition. They typically result from factors like stress, hormonal changes, or genetics.
- Secondary headaches, in contrast, are symptoms of an underlying issue, such as a sinus infection, head injury, or, in this case, pregnancy.
Distinguishing between primary and secondary headaches is crucial for healthcare professionals as it guides diagnosis and treatment, ensuring that the underlying cause of a secondary headache is addressed, while primary headaches are managed directly for symptom relief.
The September 22, 2015, Acute Headache Diagnosis in Pregnant Women: A Hospital-Based Study article states “Migraine is by far the most frequent type, accounting for about 90 percent of primary headaches in pregnant women.” Author Matthew S Robbins goes further to suggest that extra diagnostic vigilance should be heightened if the pregnant woman doesn’t have a previous headache history.
Types of Headaches During Pregnancy
|Causes of Primary Headaches Migraines||Migraines
|Causes of Secondary Headaches||Homeostatic disturbances and
How do Hormonal Changes During Pregnancy Affect Headaches?
Female hormones, particularly estrogen and progesterone, play a significant role in influencing headaches. Further, the relationship between hormones and headaches is complex and can vary from person to person. Since pregnancy triggers additional hormonal changes, it’s important to take facial and headache pain during pregnancy seriously.
Examples of the connection between female hormones and headaches:
Menstrual Migraines: Many women experience migraines that are closely linked to their menstrual cycle. These are often called “menstrual migraines” and typically occur in the days before, during, or after menstruation. Fluctuations in estrogen levels seem to trigger these migraines. When estrogen levels drop, it can dilate blood vessels in the brain, which can trigger a migraine.
Hormonal Contraceptives: Some women may experience changes in headache patterns when using hormonal contraceptives like birth control pills. These contraceptives can stabilize hormone levels, potentially reducing the frequency and severity of hormonal migraines. However, for some women, they may worsen headaches.
Perimenopause and Menopause: The hormonal fluctuations that occur during perimenopause (the transition period before menopause) and menopause can also influence headaches. Some women find that their migraines become less frequent or severe after menopause when estrogen levels decrease.
Hormone Replacement Therapy (HRT): People undergoing hormone replacement therapy as part of menopausal treatment may experience changes in headache patterns. The effects can vary, with some women finding relief and others experiencing an increase in headaches.
Not all women will be affected by hormonal changes in the same way. Some may have a strong connection between their menstrual cycle and migraines, while others may not notice a significant impact. Other factors, such as genetics, lifestyle, and stress, can also influence headache patterns.
How do Female Hormones Change During Pregnancy?
During pregnancy, female hormones undergo significant changes to support fetal development and prepare the mother’s body for childbirth and breastfeeding. Estrogen levels rise considerably, aiding in maintaining the uterine lining, supporting fetal growth, and causing physical changes.
Progesterone, produced by the placenta, also increases to maintain the uterine lining, and prevent contractions. Human chorionic gonadotropin (hCG) surges in early pregnancy, while prolactin remains relatively low to prevent lactation until after childbirth. These hormonal shifts are vital for a healthy pregnancy but can influence other underlying health conditions, such as headaches.
Can Jaw Pain be Related to Pregnancy?
Yes. Both face and jaw pain can be triggered by added neuromuscular tension. Your jaw pain may range from mild discomfort to severe pain that interferes with daily activities.
When the muscles in the face and jaw become tense due to factors like stress, anxiety, or habits like teeth clenching and grinding (bruxism), it can lead to sustained muscle contraction. This prolonged muscle tension can trigger discomfort and pain that often radiates to the head and neck. Such tension can result in tension-type headaches or act as a trigger for migraines, activating pain pathways connected to the trigeminal nerve, a key nerve in migraine physiology.
The good news is that managing neuromuscular tension can be achieved entirely without medications. Relaxation techniques, massage therapy, stress management, and oral appliances can all contribute to headache prevention and relief.
As discussed above, the hormone rollercoaster during pregnancy is thought to be responsible for the unique pattern of primary headaches during this time. Another factor may be attributed to an increase in blood volume during pregnancy. As far as secondary headaches, any number of the complex physiologic changes during pregnancy can lead to the conditions that precipitate a secondary headache condition.
When during pregnancy are headaches the worst?
Primary headaches during pregnancy appear to be at their worst during the first trimester. However, as pregnancy goes on, levels of estrogen steadily increase. With increased estrogen levels and the lack of hormonal swings during menstruation, many women experience a welcome relief from headaches. Secondary headaches are much less common but tend to occur in the second and third trimesters.
What are the red flags for headaches in pregnancy?
While headaches during pregnancy are common, certain “red flags” warrant immediate medical attention. These include severe, sudden-onset headaches, particularly if accompanied by visual disturbances, high blood pressure, swelling in the hands and face, or persistent vomiting. Headaches associated with neurological symptoms like numbness, weakness, or difficulty speaking should also be taken seriously. Any headache that doesn’t respond to typical treatments should be evaluated by a healthcare provider as soon as possible.
List of “Red Flags” for Headaches in Pregnancy
- Headaches that peak in severity in less than five minutes.
- New headache type.
- Change in previously stable headache pattern.
- Headache that changes with posture (e.g., Standing up).
- Headache that wakes you up.
- Headache caused by physical activity or coughing, laughing, or straining.
- Blood clotting disorders.
- Neurological symptoms or signs.
- History of malignancy.
- History of HIV or active infections.
- History of pituitary disorders.
- Elevated blood pressure.
- Recent travel at risk of infective disease.
Should I go to the ER for an extreme headache during pregnancy?
Absolutely yes! Any extreme headache during pregnancy is considered a “red flag” headache. Because there are so many types of secondary headaches during pregnancy, and because many of these can be severe, it’s always advisable to seek immediate care from a healthcare professional.
When is the risk of taking headache medicines the highest during pregnancy?
The risk of taking headache medicines during pregnancy is the highest in the first trimester.
Teratogens are substances that can harm a baby’s development in the womb, causing birth defects. Medications are perfect examples of teratogens. They have the most significant impact on pregnancy during the first trimester, which is the first three months. This is when the baby’s vital organs are forming, and they are most vulnerable to teratogenic effects.
This means that the risk of taking drugs and the incidence of primary headaches peak during the same time, the first trimester. This is why looking for ways to treat headaches during pregnancy without drugs is so important.
Which headache drugs are safe to take during pregnancy?
Any treatment that avoids taking medication is preferred during pregnancy. There are some drugs that are thought to be “safe”, but the fact is that even the safest headache medicines carry risks.
For instance, Tylenol (acetaminophen) is the safest drug for headaches during pregnancy. However, even with Tylenol, there are researchers who are arguing that more caution should be taken given increasing evidence of possible risk to the fetus. This warning comes from an international consensus statement of over 90 scientists, clinicians, and other health professionals. 
Can you get a headache when labor starts?
Yes. A headache attack can add to a woman’s pain management during labor pain. Few studies exist on headaches and migraines, particularly the onset of tension-type headaches (TTH) during labor and the postpartum period.
However, the National Institute of Health (NIH) reports the following statistics:
Data analysis showed that 145/474 women had a history of headache: 65/145 (44.82%) reported a diagnosis of migraine. Eight reported experiencing a probable migraine attack (4 with aura) and one reported probable tension-type headache during labor or postpartum.” – New Onset Headache During Delivery and Postpartum: Clinical Characteristics of a Case Series
All women in the study reporting migraine/headache attacks during labor had no previous history of either headaches or neurological illness. Birth preparedness and complication readiness can help avoid headaches and jaw-clenching issues during labor and delivery.
What are Some Natural Treatments for Pregnancy Headaches?
A long list of medication alternatives can be used to treat headaches during pregnancy.
Non-Drug treatment options for pregnancy headaches:
- Hydration: Drinking plenty of water generally helps with headaches.
- Rest: Optimizing sleep can alleviate tension headaches and migraines.
- Cold Therapy: Applying a cold compress to your forehead or the back of your neck can relieve inflammation and constrict blood vessels.
- Heat Therapy: A warm compress or shower can help relax tense muscles in your neck and shoulders.
- Acupressure: Gentle pressure on specific points on your hands, feet, or forehead may alleviate headache pain.
- Yoga and Stretching: Gentle yoga or stretching exercises can help relax tense muscles and reduce headache discomfort.
- Dietary Changes: Identifying and avoiding trigger foods like processed meats, aged cheeses, and artificial sweeteners may reduce the frequency of migraines.
- Neuromuscular relaxation: Reducing muscle tension in the face and jaw is a powerful way to treat headaches. This can be achieved through oral appliances and jaw physical therapy exercises. For example, a dental deprogrammer reduces muscle tension.
- Behavioral Pain Reduction: Behavioral techniques like deep breathing, meditation, and progressive muscle relaxation can help reduce headaches.
How can oral appliances help with headaches during pregnancy?
Specialized oral appliances called “anterior deprogrammers” are designed to reduce facial and jaw neuromuscular tension. This, in turn, reduces the forces that cause and perpetuate headaches. When people use these oral appliances, they typically note an immediate relaxation of their jaw and face muscles. This relaxation contributes to symptomatic relief from headaches and helps prevent headaches from recurring.
This non-drug intervention is a powerful addition for pregnant individuals suffering from headaches, primarily when used in conjunction with the other natural treatment modalities described above.
NIH strongly encourages non-pharmacological techniques and clinical treatments for migraines during pregnancy.
Migraine during pregnancy is associated with adverse outcomes in the mother and newborn, including pregnancy-induced hypertensive disorders, low birth weight, and preterm birth. As was reported in a study conducted in Denmark, low birth weight, preterm birth, and cesarean delivery rates were higher in pregnant women suffering migraine, and in babies born to women with migraine, the duration of hospitalization was longer and respiratory problems were more common. Therefore, controlling migraine attacks during pregnancy is of great importance.
Non-pharmacological techniques and treatments are the first-line treatment for women with mild migraines during pregnancy.” – Determination of the Frequency of Migraine Attacks in Pregnant Women and the Ways They Cope with Headaches: A Cross-Sectional Study 
SUMMARY: Natural Therapies Are First Line Treatments for Pregnancy Headaches
Pregnancy always comes with its share of challenges, which unfortunately include headaches. The problem is that the typical treatment for headaches involves medications, which can harm the developing fetus. This creates an immediate need for natural therapies that pregnant individuals can use as an alternative to medicines.
Of the natural remedies that can be used for headaches, the use of an oral appliance stands out because of its powerful effect on neuromuscular tension in the face and jaw. When combined with other natural treatments, this approach offers a compelling medication-free option for pregnant individuals seeking relief from headache pain.
Feel free to share your experiences treating headaches during pregnancy by emailing email@example.com
Dr. Brad Eli, DMD, MS is a graduate of UCLA’s post-doctoral Orofacial Pain program. He specializes in the field of orofacial pain, temporomandibular disorders, and headache treatment. Dr. Eli has also been on the educational staff at university hospitals, pain centers, and the clinical staff of Southern California hospitals.
 Sandoe CH, Lay C. “Secondary Headaches During Pregnancy: When to Worry,” April 2019, https://link.springer.com/article/10.1007/s11910-019-0944-9
 Dr. Andrea Negro, et al, “Headache and pregnancy: a systematic review”, Oct 2017, https://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/s10194-017-0816-0
 Bauer AZ, et al, “Paracetamol use during pregnancy – a call for precautionary action”, Dec 2021, https://www.nature.com/articles/s41574-021-00553-7
 Guzin Kardes, et al, “Determination of the Frequency of Migraine Attacks in Pregnant Women and the Ways They Cope with Headaches: A Cross-Sectional Study,” July 2023, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10379615/