Dr. Kenley Neuman, OB/GYN at Virginia Physicians for Women, discusses the stroke risk factors that are unique to females, what symptoms to look for, and how to assess your own risk
Summary: Women face a higher stroke risk due to age, hormonal shifts, and unique health factors. Understanding the causes of stroke, recognizing symptoms, and taking preventive steps can help reduce risks.
- Women have a higher stroke risk than men, partly due to longer lifespans.
- Pregnancy, oral contraceptives, and menopause-related hormonal changes increase stroke risk.
- Common stroke symptoms include numbness, confusion, vision problems, headaches, and dizziness.
- Women may also experience unique stroke symptoms like hiccups, nausea, and extreme fatigue.
- Early detection and lifestyle changes can help prevent strokes—consult a VPFW physician for risk assessment.
Did you know that women have a higher risk of having a stroke than men?
In fact, according to Go Red for Women, each year, 55,000 more women than men will experience a life-changing stroke. Ultimately, about 1 in 5 women will have a stroke at some point in their lifetime, while only 1 in 6 men will experience a stroke, per the Framingham Study.
After heart disease and cancer, stroke is the third leading cause of death for women worldwide. In fact, stroke kills about twice as many women as breast cancer each year. It’s also a leading cause of severe long-term disability.
What causes strokes in women, and how can you reduce your risk?
In this guide, we’ll discuss the unique risk factors that make women more prone to stroke and what symptoms to look for. Continue reading to learn how to identify and prevent strokes in women at any age.
What is a stroke?
A stroke is a medical emergency that occurs when blood flow to the brain is interrupted or there is sudden bleeding in the brain, causing brain cells to become damaged or die. This can cause brain damage, long-term disability, or even death.
What are the Causes of a Stroke in a Woman?
It’s important to be aware of the common causes of stroke – including factors that are and aren’t unique to women. High blood pressure (also called hypertension), obesity, physical inactivity (regardless of weight status), diabetes, and smoking or tobacco use, are all common risk factors in both men and women. Heart disease, including abnormal heart rhythms like atrial fibrillation, is another common risk factor.
Some risk factors can be managed, but some, like age, are out of our control. According to the CDC, age is one of the highest risk factors for stroke. A person’s stroke risk will increase the older they get, regardless of their biological sex. However, on average, women live longer than men. As a result, a woman’s stroke risk is naturally higher.
However, age and lifespan aren’t the only reasons women are more prone to strokes. Women have additional unique, gender-specific risk factors for stroke due to hormonal shifts.
Women and Stroke: Gender-Specific Risk Factors
Pregnancy
Pregnant women are three times more likely to have a stoke as non-pregnant women of the same age. Hormone changes during pregnancy can increase the risk of blood clots, which are a primary cause of most strokes. Pregnant women are most susceptible to stroke beginning in the third trimester of pregnancy. That risk persists until a woman is three months postpartum. According to the National Institute of Health, a stroke occurs 30 times out of every 100,000 pregnancies.
Pregnant individuals with high blood pressure should be treated and monitored closely by their obstetrician.
Preeclampsia
Having preeclampsia (persistent high blood pressure associated with elevated protein in the urine that develops during pregnancy or the postpartum period) doubles the risk of stroke later in life. Discuss low-dose aspirin guidelines with your healthcare provider to reduce your risk of preeclampsia.
Birth Control Pills
Likewise, taking certain oral contraceptives can increase a woman’s stroke risk, especially in women with high blood pressure. However, the stroke risk due to contraception is lower than the stroke risk associated with pregnancy. Women should be screened for high blood pressure before being prescribed birth control pills. You should never smoke while taking oral contraceptives.
Since men traditionally do not take oral birth control or become pregnant, these risks are unique to women.
Menopause
What about later in life? Hormone changes related to menopause can also increase a woman’s stroke risk. This is due to the decline in estrogen levels. In fact, during the 10 years after menopause, the risk of stroke roughly doubles in women.
Harvard Health has found that early menopause further increases a woman’s risk of experiencing a stroke. The link between stroke and an earlier menopause was highest among women who entered menopause early naturally, but risk was still elevated in women who entered menopause early due to having their ovaries surgically removed.
Hormone Therapy
Hormone therapy may provide some cardiovascular benefits when used in the initial years after menopause. However, using hormone therapy later in menopause does not appear to have a protective effect against coronary heart disease and stroke and may raise a woman’s cardiovascular risks. Talk with your provider about your personal risks and goals when deciding whether hormone therapy is right for you.
Stroke Symptoms in Women
Recognizing the symptoms of a stroke in women quickly is key to receiving effective treatment. Efficient treatment of a stroke is associated with more positive outcomes for stroke survivors. When symptoms are missed or brushed off, it can lead to delays in receiving life-saving treatment.
Common symptoms of stroke in women include:
- Sudden numbness or weakness in the face, arm, or leg
- Trouble speaking or understanding speech
- Vision problems
- Severe headache without a known cause
- Dizziness, loss of balance, or trouble walking
- Fainting or seizures
- Disorientation and confusion or memory problems
However, there are several rare stroke symptoms that are unique to women, such as:
- Hiccups
- Nausea or vomiting
- Shortness of breath
- Extreme fatigue
The acronym F.A.S.T. can help you remember some of the most common symptoms of stroke and what to do if you see them.
- Face: does one side of the face droop when smiling?
- Arm: Does one arm drift downwards when both arms are raised?
- Speech: Is speech slurred or strange when repeating a simple phrase?
- Time – Call 9-1-1 right away if you notice any of these signs.
If you or someone you know experiences sudden, unexplained symptoms, seek medical help immediately. Do not drive yourself or anyone experiencing stroke symptoms to the hospital. Call 911 for an ambulance so that medical personnel can begin lifesaving treatment on the way to the emergency room.
Acting quickly can save a life. The earlier someone with a stroke arrives at the hospital, the more likely they are to receive effective treatment.
Assess Your Stroke Risk and Learn Prevention Strategies at VPFW
In many cases, stroke in women is preventable. The first step is assessing your risk. Your VPFW provider can help. While things like age and family history can’t be controlled, your physician can work with you to optimize any key modifiable risk factors, including but not limited to those related to your reproductive health.
Your doctor may recommend prevention strategies such as medication or lifestyle changes. Monitoring your blood pressure and hormone changes can help prevent a stroke at any age. So can managing your weight and avoiding behaviors that increase your risk, such as:
- Eating a diet high in saturated fats, trans fat, cholesterol, or sodium
- Not getting enough physical activity
- Drinking too much alcohol
- Tobacco use
It’s time to take your health into your hands. Schedule your appointment to discuss your concerns today.
