Why Are Women At Higher Risk For Stroke Than Men?

As someone who has suffered a TIA, I have more than a passing interest in stroke risk but I didn’t realise how much difference simply being a woman made.


Women and men are similar in many ways, but not when it comes to stroke risk and symptoms.

The good news for us is that we generally live longer than men. The less than great news is that the risk for stroke increases with age, which means that women typically have a higher stroke risk.

On average about 55,000 more women than men will have a stroke. More women than men die from stroke each year because older women outnumber older men.

Strokes are the leading cause of disability for women, and they kill twice as many women as breast cancer.

Stroke ranks No. 4 among all causes of death, behind heart disease, cancer, and chronic lower respiratory disease. However, it’s the third-leading cause of death among women, and women account for almost 60 percent of stroke deaths.

What are the reasons for the increased risk?

I have always believed that information about your health and potential risks is vital to protect you and there are specific reasons why the risk of stroke is higher in women than men, including:

Postmenopausal changes: The risk for vascular diseases increases as we age, and certain conditions that arise after menopause can increase that risk.

These include high blood pressure, high cholesterol, and diabetes.

Preeclampsia/eclampsia: This condition can double a woman’s risk of having a stroke for years after the pregnancy.

Cerebrovascular disorders: Women have a higher rate of aneurysms and subarachnoid hemorrhage, which is bleeding in the area between the brain and the thin tissues that cover it.

This is an additional risk factor for stroke.

Migraines with aura: This condition can more than double a woman’s risk of stroke.

Hypertension: High blood pressure is one of the most common – and most treatable – risk factors for stroke.

Atrial fibrillation: Women generally have a higher rate of atrial fibrillation or irregular heart rhythm then men. This is a major risk factor for large embolic strokes.

Having this condition puts a person at five times greater risk for stroke.

Women also should pay attention to other stroke risk factors, in particular those that are related to cardiovascular disease.

It’s important for everyone to keep their hearts healthy, and women should be particularly mindful of this to decrease their risk of stroke.

How symptoms of stroke in women differ from men

In general, men and women face the same stroke symptoms, including sudden onset of:

– Confusion

– Difficulty walking, balancing, or speaking

– Numbness or weakness

– Severe headache with no apparent cause

– Vision problems

However, women often report these additional stroke symptoms:

– Difficulty breathing

– Fainting or loss of consciousness

– Feeling weak all over

– Hallucinations

– Hiccups

– Seizures

– Sudden behaviour changes or agitation

– Vomiting or nausea

Women react differently to stroke symptoms

The way men and women tend to react to their symptoms also is notably different. Men are infamous for minimizing their symptoms. They don’t assign a high degree of urgency or importance to them and often shrug them off.

Women, on the other hand, acknowledge their symptoms but often try to find other reasons for not feeling well. For example, a woman is likely to say her blood pressure is high because she’s upset about something or recently started a new medication, or to say she’s in pain or feels weak because she didn’t sleep well.

Women also tend not to seek care for stroke symptoms because they don’t want their friends or family to worry. Or sometimes, they don’t want to deal with a serious medical diagnosis because too many people depend on them.

But when stroke symptoms occur and you don’t act quickly, severe and sometimes catastrophic consequences can ensue. You may not be able to do simple things like go shopping alone or pick up your kids or grandkids.

Women must ask themselves, is avoiding a visit with the doctor worth living that way?

6 things you can do to prevent a stroke

No surprise that’s it’s all about your overall lifestyle and health choices.If you want to dramatically decrease stroke risk then do the following:

1 Look to your diet first which means eating in moderation to have a healthy weight. That means more vegetables and fruit, less saturate fats and red meat and cutting down on salt.

2 Exercise is essential, and what is recommended is something moderate three to four times a week. Make it something enjoyable like walking, dancing, gardening, swimming but make sure it fits easily into your lifestyle.

3 Check your blood pressure as high BP is very common at menopause and often related to being overweight. Talk to your doctor about what is the ideal measurement for your age and weight and then check it regularly at home.

4 De-stress as stress will raise your BP faster than anything else so tackle it as best you can. Learn to relax whether that is listening to music, talking to a friend, meditation or just going for a walk.

5 Don’t ignore those requests from the doctor’s surgery for a routine health check. Take advantage and find out where your health might be at risk so you can start to deal with it.

6 Stop smoking as it increases high blood pressure, which is a major risk factor for stroke.

Women who are most at risk of stroke

Investigators at Brigham and Women’s Hospital in the USA are exploring the effects of potential risk factors that are unique to women, including hormone levels, hormone therapy, hormonal birth control, pregnancy and time of menstruation and menopause.

They analyzed the scientific literature and identified several factors that increase stroke risk in women. These include:

– Menstruation before age 10,

– Menopause before age 45,

– Low levels of the hormone dehydroepiandrosterone (DHEAS),

– Use of birth control pills.

– A history of pregnancy complications can also indicate higher stroke risk. These problems include gestational diabetes and high blood pressure during or immediately after pregnancy.

Some of these risk factors are common, and the researchers stressed that few women who have one or more will suffer a stroke. However, they said it’s important for women and their doctors to be aware of any heightened risk.

Helpful information:

If you know you are at risk, whether that is low or high, then it makes good sense to do all you can to minimise that and provide the best conditions to avoid either a TIA or stroke.

The symptoms of a transient ischaemic attack (TIA) are the same as those of a stroke, but they only last for a few minutes or hours. Like a stroke, the signs and symptoms of a TIA usually begin suddenly and a TIA is a warning that you’re at risk of having a full stroke in the near future.

Hormone balance is related to stroke risk as women suffering oestrogen dominance are more likely to be overweight so rebalancing with progesterone as well as taking all other lifestyle measures is the best place to start.

The best diet for heart health is the Mediterranean  diet – but if you are not sure what it is, then this article can help.