Stroke in Women: Why It’s Different + What You Need to Know

Stroke is the third-leading cause of death in women.

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Stroke is a big problem for all Americans, but statistics suggest it may especially affect American women: Stroke is the third-leading cause among women, but it’s the fifth-leading cause of death for men, according to the National Stroke Association.

“Approximately 55,000 more strokes occur in women [than in men] each year,” says Carolyn Brockington, MD, a neurologist at Mount Sinai Hospital in New York City. “So the question is, why are women having more strokes?”

Risk Factors for Stroke in Women

Women experience many of the same stroke risk factors as men do:

  • High blood pressure

  • Diabetes

  • High cholesterol

In fact, the biggest risk factor for both ischemic and hemorrhagic strokes is high blood pressure (or hypertension). About 77 percent of people having a stroke for the first time have a BP higher than 140/90 mm Hg, according to the American Heart Association (AHA). Find out what your blood pressure numbers mean here.

Although men and women have similar rates of hypertension from ages 45 to 64, a higher percentage of women than men have elevated BP after age 65. Among those 75 and older, 80 percent of women have high blood pressure, compared to 72 percent of men, according to the AHA.

But there are other stroke risk factors that are unique to women. Two prime examples: migraines and hormones.

Women comprise about 75 percent of people who get migraines. And stroke is three times more common in women who suffer from frequent migraines than in women who do not, according to the American Migraine Association. In particular, having migraines with aura—seeing sparks or dots, or feeling tingling sensations—are linked to a higher risk of stroke.

Women also experience more hormonal changes throughout the life cycle, such as during pregnancy and menopause or while taking birth control or hormone replacement therapy. “It produces what we call a relative hypercoagulable state,” says Dr. Brockington.

When your body is in a hypercoagulable state, you have an elevated tendency to form blood clots. If the fluctuating hormones cause more blood clots, one could potentially travel to the brain and cause blood clots. This is one possible reason women’s risk of stroke increases after menopause.

Symptoms of Stroke in Women

During a stroke, women may have similar symptoms as men do. These are the common symptoms of stroke, according to Dr. Brockington.

  • Weakness on one side, such as a drooping arm

  • Numbness on one side, such as lack of facial expression

  • Problems with speech, such as slurring or not understanding what people are saying

  • Problems with vision

  • Problems with walking and coordination

Find out how to recognize symptoms of stroke quickly using F-A-S-T.

However, women’s symptoms of stroke may stray from these classic signs. “The presentation can be a little bit different,” says Dr. Brockington. “Sometimes the symptoms are a little bit subtle.”

In other words, the stroke symptoms may not be debilitating, and they may not catch the attention of others. That poses a problem, since women are more likely to prioritize others and downplay their own needs and concerns. Even worse, women’s pain is also less likely to be taken seriously by others.

“If suddenly something happens to you, you really need to go to the emergency room,” says Dr. Brockington. “If you’re not being taken seriously, you know your body. You know something’s wrong.”