Women and Stroke: Understanding the Risk

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May is Stroke Awareness Month, so it’s a good time to remind women of the risk factors for stroke and how they may be different than those for men. Women are at a particularly higher risk than men due to hormones, pregnancy and childbirth. As many as 50,000 more women than men will have a stroke each year, and it will have a greater negative impact on their lives due to a longer life expectancy.

Risk Factors for Stroke

Understanding the basic risk factors for stroke is the best way to empower yourself and take control of your health. These major risk factors for women include: smoking, high blood pressure and high cholesterol.

It’s important to monitor your blood pressure regularly starting at age 18 and screen your cholesterol levels every four to six years starting at age 20. Knowing your numbers can help you make changes to mitigate your risk.

Other risk factors to watch for include:

Birth Control Medication

While hormonal birth control pills used to increase the risk of stroke at a greater rate in the past, women who are already at risk should be particularly careful. Be sure to get your blood pressure screened before taking the pill. Smoking while using birth control medication greatly increases your risk and you should speak with your doctor about help with quitting as soon as possible.


Pregnancy and childbirth are a lengthy stress test for your system. Pregnant women have a 21 in 100,000 chance of having a stroke, with the highest risks occurring during the third trimester and the post-partum period. If you have high blood pressure, it should be treated with medication and monitored closely throughout your pregnancy.


This dangerous condition develops during pregnancy when your blood pressure becomes too high and creates swelling, which can affect internal organs as well as the baby's development.

Pre-eclampsia doubles the risk of stroke later in life and, if you have any history of hypertension, you should speak with your health care provider about starting a low-dose aspirin regimen in the second trimester. Smoking, high cholesterol and obesity dramatically increase your risk as well.

It should be noted that you don't need to have a history of high blood pressure to develop pre-eclampsia. Having regular blood pressure checks during prenatal visits is key to identifying your risk as soon as possible.

Hormone Replacement Therapy (HRT)

Many post-menopausal women use HRT to help manage the symptoms of menopause. However, this therapeutic medication heightens the risk of stroke due to an increased chance of blood clots forming and higher blood pressure.

Migraines with Auras

A migraine with an aura (visual symptoms like flashing lights or blind spots) has been associated with ischemic stroke in younger women, particularly for those who smoke or use birth control medication. Smokers with migraines accompanied by auras should speak with their doctor about a cessation plan that helps them quit immediately.

Atrial fibrillation

Atrial fibrillation (AFib) is an irregular and often rapid heart rate where the upper two chambers of your heart, or atria, beat at irregular intervals. It increases your risk for stroke as well as heart failure and other heart-related complications. Symptoms can include shortness of breath, heart palpitations and weakness.

The Risk of Stroke in African American Women

Studies have shown African American women in their 50s have more than three times the risk of stroke compared to Caucasian women of the same age. They are more likely to have strokes at younger ages and to have more severe strokes. However, a healthy lifestyle could help reduce much of that risk; 80% of strokes can be prevented- Its even more important for African American women to know their numbers. High blood pressure often starts at a younger age and is more severe than in Caucasian women. And sickle cell anemia, the most common genetic disorder in African Americans, can lead to stroke when those cells block blood vessels to the brain.

Stroke Warning Signs

It’s critical to learn the warning signs of when stroke is happening, so you’ll know when to call an ambulance and get help F.A.S.T. Symptoms such as trouble speaking, facial drooping and arm weakness can all be signs that you may be having a stroke and they should be taken seriously. Call 911 immediately if you or a loved one are showing signs of a stroke.

Your medical providers also play a large role in your preventative care. Your primary care doctor will talk to you about your personal risk for strokes and work together with you to find the best treatment plan to your lower risk. They will also refer you to specialists, like cardiologists for your heart or endocrinologists for diabetes, to help manage specifics of your health care plan.

Because the risk of stroke is so high in women, it’s important to monitor your numbers and stay aware of any changes in your body. Be sure to get proper amounts of sleep, eat a nutritious diet, exercise regularly and quit smoking.

Expert Neurological Support is Here

Taking a proactive, preventative approach to your health and identifying your individual risk factors for stroke is very important, regardless of age. Should you ever find yourself or a loved one facing this condition and its journey to recovery, your experienced care team will carefully consider your unique needs to help you make the best decisions for your long-term health.

Learn more about AdventHealth’s comprehensive neurological care by visiting our website.

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