What You Should Know About Stroke Risk and Stroke Symptoms in Women

You probably know that stroke is one of the top causes of death worldwide. But did you know that it disproportionately affects women?

Women make up 60% of all stroke deaths, according to the American Heart Association. So, if you’re a woman, it’s important to understand your unique risk factors and be aware of the early signs of stroke in women.

Stroke symptoms in women

The most common stroke symptoms are the same in both sexes, including:

• Face drooping.
• Arm weakness.
• Speech difficulty.
• Vision troubles.
• Balance or coordination problems.
• Severe headache without a cause.

But some women experience other, more subtle early signs of stroke that may be easy to brush off. This includes fatigue, confusion, general weakness and nausea or vomiting.

Any sudden, unexplainable loss in function should prompt a call to a healthcare provider. If it is a stroke, getting treatment immediately can make all the difference.

Stroke risk factors

Women and men share the major stroke risk factors: smoking, high blood pressure and elevated cholesterol.

But there are other risk factors that are unique to women, says neurologist Dolora Wisco, MD. These include certain hormones, childbirth, pregnancy, birth control pills and migraine headaches with aura. This is why women have their own set of stroke prevention guidelines with strategies to help reduce their risk.

“It’s necessary to have guidelines specifically for women,” Dr. Wisco says. “If you have high blood pressure, diabetes or cholesterol, or if you’re taking oral contraceptive pills­ and smoking, those are major risk factors that you need to pay attention to if you are female.”

The good news is that some of these factors can be changed or addressed­.

Science-based recommendations

The guidelines from the American Heart Association and the American Stroke Association provide science-based recommendations, including:

• Women with a history of high blood pressure before pregnancy should be considered for low-dose aspirin and/or a calcium supplement to lower risks of preeclampsia, a serious high blood pressure pregnancy disorder.
• Preeclampsia should be recognized as a risk factor well after pregnancy, because women who have preeclampsia have twice the risk of stroke and a four-fold risk of high blood pressure later in life.
• Other risk factors such as smoking, high cholesterol and obesity in women with preeclampsia should be treated early.
• Pregnant people who have moderately high blood pressure (150 to 159 /100 to 109 mmHg) may be considered for blood pressure medication. Expectant mothers with severe high blood pressure (160/110 mmHg or above) should be treated.
• Women should be screened for high blood pressure before taking birth control pills, because the combination raises stroke risks.
• Women who have migraine headaches with aura should stop smoking to avoid higher stroke risks.
• Women older than 75 should be screened for atrial fibrillation risk, because it’s linked to higher stroke risk.

Sticking to healthy lifestyle behaviors — like maintaining a healthy body mass index, eating a diet rich in fruits and vegetables, exercising regularly and not smoking — has been shown to reduce stroke incidence in women and improve stroke outcomes in both men and women.