Migraine affects nearly one in every five adult women, with the peak prevalence
during the mid-thirties. Since women are typically affected with migraine during
their reproductive years, it is not surprising that many women in their
childbearing years will seek medical care for migraine during pregnancy and
lactation. Clinicians are often apprehensive about treating migraines in fertile
and pregnant women because of concerns about treatment effects on their
unborn babies, often resulting in under-treatment of disabling pain and nausea.
Fortunately, a variety of relatively safe and effective drug and non-drug treatments
are available for migraine-related pain and nausea during conception,
pregnancy, and nursing. This book provides a comprehensive resource to
address diagnosis, testing, and treatment of headaches in reproductively fertile
women.
The term safe is used in this book to describe treatments that are considered
to be relatively safe for women to use during pregnancy or when nursing.
Clinicians using this information should remember that all drugs have certain
risks of adverse events and relative safety is often based on limited data,
particularly during pregnancy. Ideally, the treatment of headaches in pregnant
or lactating women would not need to include medications; however, this is not
always feasible. Relative safety needs to be balanced against the consequences
of untreated headache, which might include vomiting, dehydration, and disability.
Recommendations in this book are based on published evidence in the
literature and clinical experience, with full referencing for suggested therapies.