What should doctors do?

Other than prescribing something for my ocular migraines but really feel as a woman who has struggles since early 20s left alone. IUD was my only offered help

Migraine can be complex. I am sorry to hear that you feel unsupported in your experience. Often migraine can worsen around the time of peri-menopause and menopause, due to the hormone shifts occurring in the body at this point in life. There are a range of hormonal and non hormonal options which are safe and effective to manage ocular migraine, including newer agents which have only been around for a few years. Migraine medicine has moved on a lot, so it would be worth a conversation with your family doctor or a neurologist regarding what your options might be.