Migraine is a common neurological disorder, especially among women. But only about half of sufferers seek medical attention for these intense headaches, and most wait before seeking help from a doctor. Fewer of them leave the doctor’s office with the correct diagnosis and a treatment plan that works well.

While lack of access to care is a major barrier to managing migraine and most often affects people of color and other underserved groups, some experts believe gender bias plays a large role in why Migraine is often misdiagnosed, underdiagnosed, and undertreated.

“Unfortunately, it’s another example of old misogyny,” says Christopher Gottschalk, MD, a neurologist and director of the Yale Medicine Head and Facial Pain Center. “It must be that women who complain of pain in the head and cannot function must be lazy, neurotic or trying to get their way. It is not possible that they have this (medical) problem.”

No matter your race, ethnicity, or gender identity, it is key that a medical professional take your headache seriously. This is because you may need a prescription for specific migraine treatments.

How to talk to your doctor about migraine

Headaches are never a walk in the park. But the disabling nature of migraine distinguishes these attacks from other types of headache. Experts agree that you should stress this life-changing aspect to your doctor.

“Don’t even use the word headache,” says Gottschalk. “Let’s talk about: ‘These episodes I have keep me from functioning for a few hours or days on a regular basis. And I can’t live like this.’”

Below are some ways migraine episodes can affect your life beyond the headache:

• You may feel sick to your stomach or vomit.
• Light and sound may bother you.
• You may feel fatigued or have trouble thinking clearly.
• Your skin may hurt.

If left untreated, these symptoms can last several hours or even a few days. Experiences of brain fog, skin pain, or sensitivity to light may persist between attacks, especially if you have a lot of headaches.

During a migraine episode, you may not feel well enough to do everyday things. And you’ll want to share with your doctor all the ways this affects your life.

Advocate for Yourself and Educate Your Doctor

Most medical providers are familiar with migraine, but not all doctors specialize in headache medications. The good news is that there are many online resources that will help you focus on your headache and get you closer to the right treatment.

“There’s something called ID Migraine, which is a three-question screen that’s been validated millions of times,” Gottschalk says. “That’s the kind of thing where you can find that screen, answer it, and show it to your doctor.”

According to ID Migraine, there is a strong chance that you have a migraine if you answer yes to at least two of the following three questions:

• Has a headache prevented you from doing everyday things for at least one day in the last 3 months?
• Do you get nauseous when you have a headache?
• Do light or sound bother you when you have a headache?

You can also review the POUND mnemonic, or memory aid, with your doctor. Tell them if you have at least four of the following during an attack:

• Pburning headache
• ohDuration of headache in one day (4 to 72 hours if untreated or treatment does not work)
• Younilateral (unilateral) headache
• northnausea or vomiting
• dsoothing headache

Visit trusted websites to learn more about how to identify migraine symptoms. Some examples are:

• American Headache Society
• National Headache Foundation
• American Migraine Foundation

You’ll also find headache questionnaires and information on how to talk to your doctor through groups like Miles for Migraine, Migraine Again, or the Coalition for Headache and Migraine Patients (CHAMP).

Ask to try new treatments

There are several medications that target and treat the acute migraine process. These treatments come in pills, injections, nasal sprays, or through a vein in the arm (an intravenous line). You may also benefit from non-drug therapies.

It is difficult to predict which migraine treatment will work best for you. But there are many ways to stop a headache once it starts or decrease your chances of having an attack in the future.

Along with triptans, some newer acute and preventative migraine treatments you can ask your doctor about are:

• Gepants (CGRP blockers)
• Ditanes
• Dihydroergotamine (DHE)
• CGRP Antagonists
• Neuromodulation devices

You can also benefit from:

• Biofeedback
• Cognitive behavioral therapy
• Changes in lifestyle

The goal of acute migraine treatment is to get you back to normal life. With effective acute migraine treatments, that means being headache-free (or close to it) in a couple of hours. Preventive therapy should decrease the number of future attacks. And the ones you have should be less intense and shorter.

Get a second opinion

Let’s say you’ve already talked to your primary care doctor about your migraine. And for some reason, you are not receiving the level of treatment you want. The next person you’ll want to see is probably a neurologist.

A neurologist is a doctor who specializes in the diagnosis and treatment of disorders of the brain and nervous system. And they should be more familiar with the latest migraine medications and therapies.

Dawn Buse, PhD, is a migraine researcher and clinical professor of neurology at Albert Einstein College of Medicine in New York City. She says most people are well cared for by their regular doctors. “But there are some people with migraine whose illness may be more complex or severe who would benefit from seeing a neurologist,” she says.

Here are some questions that can help you determine if a neurologist is right for you:

• Have you already spoken to a primary care doctor or OB/GYN about your headaches?
• Has your primary care doctor prescribed migraine medications that don’t work well or cause side effects?
• Are you pregnant or want to be pregnant and are you getting a lot of serious headaches?
• Do you have 15 or more headache days a month?
• Have you had the “worst headache of your life” or a change in your headache pattern?

What if you are already seeing a neurologist but still need more comprehensive or advanced care?

“If you want to learn more about the latest therapies or next-generation therapy combinations, there are healthcare professionals and headache centers who are experts in headaches throughout the country,” says Buse. “But there aren’t many and they are mainly located in big cities.”

Consider coming in for a consultation once or twice if you want to see a headache expert and your insurance doesn’t cover it or is too far away. Buse says they may be able to create a treatment plan for you that your local neurologist or primary care doctor can follow.

Visit the National Headache Foundation or the American Migraine Foundation to find a doctor or headache specialist near you.