What is the biggest trigger for migraines?

There isn’t one single trigger for everyone. Hormonal changes, stress, poor sleep and dehydration are among the most commonly reported.

Can stress alone cause a migraine?

Stress is a major trigger, but migraines often occur after the stressful period has ended. This “let-down” effect highlights the importance of recovery as well as stress management.

Does drinking more water help prevent migraines?

For people whose migraines are triggered by dehydration, good hydration can reduce the risk of attacks. Water is unlikely to stop an established migraine, but may help prevent one in susceptible individuals.

Should I avoid chocolate if I get migraines?

Not necessarily. Chocolate is commonly blamed, but research suggests cravings before a migraine may explain the association. It’s best to identify your own patterns before excluding foods.

Can weather changes really trigger migraines?

Yes. Some people are sensitive to changes in barometric pressure, humidity or temperature. Recognising the pattern lets you focus on modifiable factors such as hydration, sleep and stress.

Can hormones make migraines worse?

Yes. Falling oestrogen around menstruation, ovulation and perimenopause is among the most common triggers in women. If your migraines follow a hormonal pattern, tailored treatment may help reduce their frequency.

Migraine & pregnancy

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Home/Migraines/Migraine & pregnancy

If you are pregnant and experiencing migraines, you are not alone. Around 1 in 5 women experience migraine, and because it is most common during the reproductive years, many women have questions about managing it in pregnancy.

The reassuring news is that many women find their migraines improve during pregnancy, particularly after the first trimester. Managing migraine safely is about balancing effective relief with the wellbeing of your developing baby, and there are several evidence-based options.

The short answer

Can pregnancy make migraines better?

Quick answer

Yes. Around 60–70% of women with migraine without aura notice a significant improvement during pregnancy, particularly in the second and third trimesters as hormone levels become more stable. Migraine with aura is less likely to improve and may continue.

Across the trimesters

How pregnancy affects migraine

Unlike the hormonal fluctuations that trigger migraine around menstruation, pregnancy brings a steady rise in oestrogen that stays relatively stable after the first trimester. For many women, attacks ease as the pregnancy progresses.

Typical migraine frequency

Before
pregnancy

1st
trimester

2nd
trimester

3rd
trimester

A common pattern: attacks may persist through the first trimester — when nausea, dehydration and fatigue peak — then ease markedly once oestrogen stabilises. Individual experiences vary.

Often improves

Stable hormones and fewer menstrual cycles mean migraine without aura frequently settles, especially after the first trimester.

May be unchanged

Women with aura are less likely to see improvement, and some experience migraine for the very first time during pregnancy.

Can worsen early on

First-trimester hormone shifts, nausea, dehydration and disrupted sleep can temporarily increase attacks.

Safety first

When to seek urgent medical attention

Pregnancy changes how headaches are assessed. Some symptoms may point to conditions such as pre-eclampsia, and need immediate attention.

Seek urgent advice immediately if you have…

!A sudden, severe “thunderclap” headache

!Headache with blurred vision or visual loss

!Persistent headache after 20 weeks, or with high blood pressure

!Swelling of the face or hands

!Confusion, weakness, difficulty speaking or seizures

!Fever with neck stiffness, or a headache unlike your usual migraine

Treatment

Safe migraine treatment in pregnancy

Treatment is always individualised. The goal is the safest, most effective plan for both you and your baby, poorly controlled migraine affects your wellbeing too, so leaving severe attacks untreated is not the aim.

Usually considered safe

✓Paracetamol — first-line pain relief, at the lowest effective dose for the shortest time.

✓Sumatriptan — the best-studied triptan; current evidence has not shown an increased risk of major birth defects when clinically indicated. Only used where the benefit outweighs the possible risk, and always discussed with your doctor first.

Usually avoided

×CGRP medicines (erenumab, fremanezumab, galcanezumab, eptinezumab) and gepants (atogepant, rimegepant) — insufficient safety data.

×Some require a washout period before conception — speak to your clinician if you are planning a pregnancy.

Without medication

Reducing attacks naturally

Lifestyle measures matter more than ever in pregnancy.

Stay hydrated

Regular fluid through the day; dehydration is a common trigger.

Eat regularly

Small, frequent meals steady blood sugar and help avoid attacks.

Prioritise sleep

Keep a consistent bedtime routine where possible.

Manage stress

Gentle exercise, breathing, mindfulness or prenatal yoga.

Keep a diary

Tracking symptoms helps identify triggers and guide treatment.

Before & after

Planning, birth and breastfeeding

Planning pregnancy

A pre-pregnancy medication review can stop medicines that are not safe, discuss safer alternatives, optimise migraine control and ensure you are taking folic acid where appropriate.

After birth

Migraine often returns within weeks or months, driven by falling hormones, sleep deprivation, stress and missed meals. A postpartum plan helps reduce the impact.

Breastfeeding

Paracetamol and ibuprofen are compatible. Sumatriptan passes into milk in only very small amounts; exposure can be minimised by avoiding breastfeeding for 12 hours after a dose and discarding milk expressed in that time. Always check with your clinician or pharmacist.

If you experience aura, treatment and contraception choices change — see migraine with aura and migraine & contraception.

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Common questions

Migraine & pregnancy FAQs

Can pregnancy cure migraines?

Not permanently. Many women have fewer migraines during pregnancy, particularly after the first trimester, but attacks often return after childbirth when hormone levels change again.

Is it safe to take sumatriptan during pregnancy?

Current evidence suggests sumatriptan, when clinically indicated, is not associated with an increased risk of major birth defects, and it is the preferred triptan if one is needed. Treatment decisions should always be made with your healthcare professional.

Can migraine harm my unborn baby?

Migraine itself does not usually harm the baby. However, severe or unusual headaches during pregnancy should always be assessed to rule out conditions such as pre-eclampsia.

Can I breastfeed if I take migraine medication?

Some medicines are compatible with breastfeeding, including paracetamol, ibuprofen and sumatriptan. Infant exposure can be minimised by avoiding breastfeeding for 12 hours after treatment and discarding any milk expressed in that time. Always seek individual advice, especially if your baby was born prematurely or has medical problems.

Should I stop my prevention medicine if I'm trying to conceive?

Not without medical advice. A medication review before trying for a baby is recommended, as some preventers need to be stopped or switched, and a few require a washout period before conception.

The bottom line

Migraine is common in pregnancy, but for many women it becomes less frequent as hormones stabilise. Safe, effective options are available, and careful planning before conception together with the right medication choices and healthy habits can help you manage attacks while protecting both you and your baby.

If you have a new, severe or unusual headache during pregnancy, seek assessment promptly, not all headaches in pregnancy are migraine.

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