AHS Issues Position Statement Calling for Routine Migraine Screening in Women

The American Headache Society (AHS) has issued a new position statement recommending annual diagnostic screening for migraine among girls and women, particularly from adolescence to menopause, as part of routine preventative health care. The statement, published in Headache, the statement argues that migraine fulfills established criteria for population-level screening due to its high prevalence, significant morbidity, and considerable social and economic burden.

In the statement, the authors noted that migraine incidence and prevalence are exceptionally high among girls and women during adolescence and through menopause. They also emphasized that validated screening tools, such as ID Migraine screeners, are available and that effective treatments can reduce migraine symptoms and overall disease burden.

Todd Schwedt, MD,MSCI, FAHS, president of the American Headache Society, told NeurologyLive that the recommendation aims to improve identification of migraine in girls and women.

“This Position Statement from the American Headache Society (AHS) calls for diagnostic screening for migraine in girls and women from adolescence through menopause,” he said. “The AHS recommends that screening be conducted annually as part of preventative healthcare services for women.”

Schwedt, who also serves as the co-director of the Neuroimaging of Headache Disorders Laboratory at Mayo Clinic’s Arizona campus, added that, “Migraine is extremely common, especially among women for whom there is a lifetime cumulative incidence of 43%. It is a leading cause of disability among women under the age of 50. Despite its substantial impact, migraine is frequently underdiagnosed and undertreated. Validated and easy-to-use screening tools, such as ID Migraine, could be readily integrated into clinical practice to improve identification and care.”

Migraine is one of the most common neurologic conditions worldwide, affecting about 1.16 billion people globally and roughly 40 million individuals in the United States. The condition disproportionately affects women, with a lifetime incidence of 43% compared with 18% among men. Migraine often begins in childhood and becomes more common during puberty and adolescence, with the highest prevalence occurring between ages 25 and 54. It can significantly disrupt daily life, contributing to missed work or school, reduced productivity, and limitations in social and family activities.

Given this burden, the AHS now recommends routine annual screening for migraine in girls and women beginning at puberty and continuing through menopause. The goal is to identify migraine earlier and improve access to appropriate treatment, particularly during the years when the condition is most likely to develop or worsen. By incorporating screening into routine preventive care, clinicians may be able to reduce delays in diagnosis and better address the long-term impact migraine has on women’s health and quality of life.

In terms of screening, the AHS recommends use of the ID Migraine screener as the preferred screening tool because it has been validated among adults and adolescents in primary care settings. The instrument is a self-administered, three-question, survey designed to help clinicians quickly identify patients who may be experiencing migraines and who may benefit from further evaluation. The tool is also available in Spanish.

Globally, migraine accounts for about 1 in every 20 years lived with disability and represents 9.8% of all years lived with disability among girls and women aged 15 to 49 years. It is the leading cause of years lived with disability among women younger than 50 and is associated with missed work and school days, reduced productivity, and decreased participation in social and family activities.

Read more: Rimegepant Displays Safety and Efficacy in Study of Adolescents With Migraine

The ID Migraine Screener has previously been evaluated for diagnostic accuracy. In a systematic review and meta-analysis published in Headache, investigators reported that the use of the tool may improve appropriate diagnosis and management of patients with migraine. The analysis also suggested that the screener is particularly useful for ruling out migraine, reflecting its high sensitivity in identifying individuals to have the condition.

Across 13 studies including 5866 patients, the weighted prior probability of migraine was 59%. In pooled analyses, the ID Migraine screener showed a sensitivity of 0.84 (95% CI, 0.75–0.90) and a specificity of 0.76 (95% CI, 0.69–0.83). A negative result reduced the probability of migraine from 59% to 23%, with sensitivity analyses confirming similar findings.

According to the American Headache Society, integrating brief screening tools into routine preventive care may help clinicians identify migraine earlier and address a condition that remains widely underdiagnosed. The authors of the position statement noted that earlier recognition of migraine among girls and women could facilitate timely treatment, reduce disability, and lessen the broader social and economic burden associated with the disorder.

REFERENRCES
1. Schwedt TJ, Starling AJ, Ailani J, et al. Routine migraine screening as a standard of care for Women's health: A position statement from the American Headache Society. Headache. 2026; 66: 511-516. doi:10.1111/head.70023
2. Cousins, G., Hijazze, S., Van de Laar, F.A. and Fahey, T. (2011), Diagnostic Accuracy of the ID Migraine: A Systematic Review and Meta-Analysis. Headache: The Journal of Head and Face Pain, 51: 1140-1148. https://doi.org/10.1111/j.1526-4610.2011.01916.x