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Women's unique risk factors for stroke

Bryn Mawr Hospital May 6, 2015 General Wellness

women's stroke riskIf you looked strictly at statistics, it might appear that stroke is a greater risk for men than it is for women. After all, more men are affected by stroke every year than women. But look more closely and you’ll find that, although more men are having strokes, more women are dying from them.

“Stroke is a very serious health risk for women. It’s the third-leading cause of death for women, behind heart disease and cancer,” explains Arie Hallowell, nurse manager of the Neuro-Cardiac ICU (NCICU) at Bryn Mawr Hospital. “Although stroke is still very serious and a major cause of disability, it’s only the fifth-leading cause of death among men.”

Though men and women share a number of similar stroke risk factors, Hallowell explores some stroke risk factors that are unique to women below.

Migraine with aura

Migraines, which occur more commonly in women, have long been suspected to be a risk factor for stroke. But in a 2013 study, researchers found that migraines with aura—defined as migraines that are accompanied by visual symptoms like seeing zigzag patterns, flashing lights, or blind spots—are considered as significant a risk factor as high blood pressure, obesity, and smoking.

If you notice visual symptoms like these during your migraines, alert your physician at your next appointment.

Use of oral contraceptives

The use of oral contraceptives can be common in young women who aren’t planning to become pregnant, and some of whom might brush off its role in increasing their stroke risk.

“When women are young, they assume stroke can’t or isn’t going to happen to them,” says Hallowell. “The reality is that even the health care decisions you make at a young age can impact your health later on.”

Women who take a low-dose estrogen birth control pill, especially for an extended period of time, may be twice as likely to suffer a stroke than women who don’t.

Talk to your OB/GYN about other birth control options if you’re concerned about your stroke risk.

History of pre-eclampsia/eclampsia

In 2014, for the first time ever, the American Heart Association and American Stroke Association issued official guidelines for the prevention of stroke in women that declared pre-eclampsia a significant risk factor for stroke and heart disease. In fact, women who experience pre-eclampsia during pregnancy may have a 60 percent greater chance for stroke later in life.

If you’re pregnant and experiencing symptoms like headaches, nausea, aches and pains, and changes in vision, alert your OB/GYN.

If you have a history of pre-eclampsia, ensure your OB/GYN and primary care physician are aware, and discuss how it might impact your stroke risk.

Menopause & Hormone replacement therapy

Hormone replacement therapy (HRT) is a common treatment option for women who are dealing with unpleasant symptoms of menopause like hot flashes, night sweats, and mood swings. However, it can also come with an increased stroke risk. Before pursuing HRT, talk to your OB/GYN or primary care physician about your health history and other stroke risk factors like blood pressure, history of smoking, and obesity. Learn more about whether hormone replacement therapy is right for you.

Atrial fibrillation

Atrial fibrillation, more commonly understood as a rapid heartbeat that contributes to poor blood flow, has been linked to stroke risk in both men and women. However, women have a significantly higher risk of atrial fibrillation-related stroke than their male counterparts.

“If you have atrial fibrillation, talk to your cardiologist about the use of blood thinners and your stroke risk,” says Hallowell.

The most important way to prevent stroke is understanding your risk factors and symptoms. If you have questions about your stroke risk, talk to your physician.

The Main Line Health Stroke Program provides a comprehensive continuum of high-quality stroke care that includes community education, assessment and stroke-prevention efforts, early identification and acute-treatment strategies, rehabilitation and secondary-stroke prevention efforts.