There’s still a huge treatment gap for the one in three women who experience migraine, researchers say.
One in three Australian women experience migraine but only 36% have sought medical help, new data shows.
The survey of more than 3600 Australian women found that migraine was most prevalent among young women: almost half (46%) of women aged 18 to 24 years said they experienced migraine, compared with 8% of women aged 65 years and over.
Among women aged 18 to 24 years, 34% sought help but only 18% had been diagnosed with migraine, according to data from the 2025 Jean Hailes National Women’s Health Survey and Migraine and Headache Australia.
The researchers said many women reported isolation and stigma and felt health professionals lacked awareness and understanding of migraine.
Researchers received comments from women such as describing migraine as “a terrible waste of my life because I wasn’t believed” and that it was “more acceptable to tell colleagues I had a hangover than migraine”.
To find out how many women were likely to experience migraine – even if they haven’t received a diagnosis – researchers asked women whether they had had headaches that impacted their daily activities, made them nauseous or caused sensitivity to light in the previous three months.
The researchers found that 46% of women had more than one migraine attack a week, 56% said their attacks were severe or very severe, and diagnosis took more than 10 years for 13% of women.
Neurologist and headache specialist at Alfred Hospital, Dr Emma Foster, said there were three major hurdles that stopped patients receiving the best treatment for migraine.
She said some patients didn’t realise their severe headaches were migraine attacks; and even if they did see a doctor, migraine wasn’t correctly diagnosed; and if migraine was diagnosed, patients weren’t given appropriate medication.
“We estimate one in five Australians live with migraine, and most of these are women of working age,” said Dr Foster, an early career researcher at Monash University.
For GPs, it would be reasonable to ask as part of routine wellness checks as to whether people experience headaches, she said.
“If yes, consider going through the ID-Migraine questions. If migraine is diagnosed and based on how frequent and severe their headaches are, consider discussing treatment options.”
Those three ID-Migraine questions are:
- Do you feel nauseated or sick to your stomach when you have a headache?
- Does light bother you a lot more than when you don’t have headaches?
- Did your headache limit you from working, studying, or doing what you needed to do for any day in the previous three months?
If a patient answered “yes” to all three questions, that meant a positive predictive value of 93% for identifying migraine, Dr Foster said.
Dr Foster said migraine needed to be treated in three phases, including lifestyle, acute therapy and preventive therapy (the latter is recommended if people have four migraine days a month).
Migraine is a life-long brain condition but could vary over an individual’s lifetime, she said.
“Often, women’s first experience of migraine occurs around the time of puberty. It may vary significantly during pregnancy and in the perimenopausal period, it may change again,” said Dr Foster.
“It’s important to check in regularly to see how treatment is going, and patients and clinicians should be ready to change treatment over if it’s becoming less effective.”
Dr Foster said there was a wide range of preventive medications that could be trialled in women who experienced four or more migraine days each month.
Some medications co-treat other conditions, such as candesartan which is an effective migraine preventer as well as being helpful for blood pressure, she said.
“If a woman has trialled and not tolerated or failed at least three of these oral medications, she may be eligible for advanced therapies such as botulinum toxin injections, or anti-CGRP monoclonal antibodies,” she said.
“It is always important to address lifestyle factors that may be exacerbating migraine – stress, caffeine, sleep deprivation. These can be major factors in perpetuating migraine.”
