Headaches during pregnancy: What can I do about them?

Question: I'm 11 weeks pregnant, and I'm having horrible migraines. Can pregnancy cause headaches? What can I do to treat headaches during pregnancy? I'm afraid to take any pain relievers for fear of hurting my baby.

Many women experience an increase in headaches during pregnancy. This is because hormonal changes during pregnancy — including fluctuations in estrogen — may trigger headaches. In fact, in women with no prior history of migraines, about 1 to 2 percent have their first migraine during pregnancy. Headaches due to hormonal changes often become less frequent in a woman's second and third trimester.

Headaches during pregnancy also may be due to:

• Poor posture or muscle tension, especially in the third trimester
• Stress
• Fatigue and lack of sleep
• Caffeine withdrawal, if you've suddenly stopped drinking soda or coffee because of your pregnancy
• Dehydration
• Sinus congestion and allergies
• Hunger or low blood sugar

You do need to be careful about how you treat your headache pain during pregnancy. Many headache medications may have harmful or unknown effects on a developing baby. Aspirin, ibuprofen (Advil, Motrin, others) and most prescription migraine drugs aren't safe for pregnant women. Also, some herbal remedies used to treat headaches, such as feverfew and butterbur, aren't recommended during pregnancy. However, most pregnant women can safely take acetaminophen (Tylenol, others). It's a good idea to check with your health care provider before taking any medications to treat your headaches.

To help relieve or prevent headaches during pregnancy without the use of drugs, consider these tips:

• Use a compress. Apply a warm compress (such as a hot towel) to your face, eyes and temples to relieve sinus headaches. To relieve tension headaches, apply a cold compress to the back of your neck.
• Avoid headache triggers. Learn to recognize the foods or stresses that trigger your headaches so that you can avoid them. Keeping a diary of your meals, activities and headaches for several days can help you pinpoint your triggers.
• Rest. Lie down in a dark, quiet room with your eyes closed.
• Exercise. Regular low-impact exercises in addition to relaxation exercises, such as deep breathing, yoga or visualization, can help keep headaches at bay.
• Eat a healthy diet. Smaller, more frequent meals can help keep your blood sugar from getting too low, which may help prevent headaches. Avoid going for long periods without eating.
• Keep a regular sleep schedule. Go to bed and wake up at about the same time every day, even on weekends.
• Maintain good posture. This is especially important at the end of your pregnancy when your back is straining under additional weight.
• Try massage. Have your partner or a friend massage your shoulders and neck to relieve tension and reduce headache pain. Massaging your temples also may help.