Unique Risk Factors for Stroke in Women
Women's Health
March 24, 2022
Unique Risk Factors for Stroke in Women
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You may have a sudden, severe headache, feel weak or numb on one side of your face or body, have trouble speaking or understanding, or experience confusion and/or difficulty with your vision or motor coordination. If any of these symptoms occur, you may be having a stroke, which is what occurs when blood flow to the brain is blocked, causing brain cells to die.

Stroke is increasingly becoming a problem for American females, as it causes twice as many deaths as breast cancer and kills more women (one in five) each year than men (one in six). It is also the third leading cause of death for women and annually affects 55,000 more women than men.

Shavonne Williams, stroke program coordinator at Texas Health Dallas says raising awareness about stroke risk factors and prevention is paramount to saving lives.

“Making women aware of potential risk factors is very important,” she says. “The primary goal is stroke prevention, so education is the first step. One main controllable risk factor for stroke is high blood pressure.  One out of three women does not know she has high blood pressure. High blood pressure in pregnancy and some types of birth control medicines increase risk for stroke. Women are more likely to experience stress than men, which also puts them at greater risk.”

Because women often live longer than men, a stroke can have significant negative impact, as women who suffer a stroke may be living alone, experience more difficulty with their recovery and have a higher likelihood of needing care in a long-term facility.

Women may also not request or receive care as rapidly as men after a stroke, due to symptoms that are atypical and not as recognizable. In addition to the more common symptoms listed above, a female having a stroke may also experience the following:

  • Loss of consciousness
  • Overall weakness
  • Shortness of breath or difficulty breathing
  • Sudden behavioral change and/or agitation
  • Hallucination
  • Nausea or vomiting
  • Pain
  • Seizures
  • Hiccups

If you or someone around you is having symptoms of a stroke, call 911 immediately, as immediate medical attention can prevent long-term effects and death. As many as 85 percent of strokes are ischemic, meaning they are caused by a blood clot. If a person arrives at a medical facility and receives medication to dissolve the clot within three hours, it could very well save his or her life.

Common modifiable risk factors for stroke include high blood pressure, high cholesterol, heart disease, diabetes, obesity, stress and depression, alcohol and drug use, a poor diet and smoking. Other risk factors include age and gender, race and ethnicity, or a personal or family history of stroke and/or brain aneurysms or arteriovenous malformations.

As researchers dive deeper into how strokes present differently and affect women differently, they have also discovered risk factors that are unique to the female population. The National Stroke Association notes that risk for stroke increases when women who use birth control pills also have other risk factors, including advanced age (35+), smoking, high blood pressure or diabetes. In addition, a woman’s risk for stroke goes up during pregnancy due to increased blood pressure and stress on the heart, as well as in women who use hormone replacement therapy (progestin and estrogen) during menopause.

A recent article published in the American Heart Association’s journal, Stroke, provides the following additional risk factors that are specific to women:

  • Low levels of the hormone dehydroepiandrosterone (DHEAS)
  • The onset of menstruation before age 10
  • The onset of menopause before age 45 (either natural or surgical)
  • Use of hormonal contraceptives (oral, transdermal or vaginal)
  • Pregnancy complications including pregnancy-induced hypertension, preeclampsia and gestational diabetes

Authors of the article also noted that the risk of stroke increases when women use combined oral contraceptives (including and progestogen) and have other cardiovascular risk factors such as smoking, age over 35 and migraine with aura. Women who struggle with migraines are twice as likely to have a stroke, and those who have migraines, use hormonal contraceptives and smoke are dramatically at a higher risk for stroke. As a result, women who have migraines are strongly encouraged to quit smoking and use alternative birth control methods.

Williams offers several tips for women to improve their overall health and reduce stroke risk.

“I encourage women to have routine doctor visits, choose healthier foods, control stress and find ways to include at least 30 minutes of activity on most days,” she advises. “For women who suffer with migraines, talk to your doctor because he or she may be able to prescribe medications or other treatments to reduce the frequency of migraines.

“Make sure other health issues such as heart disease and diabetes are controlled. If you are a smoker, talk to your healthcare provider about programs to assist with smoking cessation.”

If you have one or more of the above factors, it may be time to get proactive and see your primary care physician to discuss what you can do to lower your risk for stroke.

To learn more about stroke and to find the accredited stroke center nearest you, visit TexasHealth.org/Stroke.

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