How Do Strokes Affect Women?

Although men have more risk factors for strokes, they are particularly deadly for women and pose a greater threat to women's health than breast cancer.

Medically reviewed by Lindsey Marcellin, MD, MPH

Stroke statistics for women are surprising and distressing. Though you may think of stroke as a man’s disease, women are at a greater risk of suffering a major disability from stroke and, worse, are more likely to die from a stroke than men. The death rate for women from stroke is twice that of breast cancer. And for African-American women, the numbers are even more devastating — half will die of stroke or heart disease, says the National Stroke Association.
Stroke: A Look at Women's Risks
With the number of women suffering strokes now surpassing the number of men for the first time, women need to be concerned about minimizing stroke risk and optimizing overall health. In addition to stroke risk factors that men and women share, women also have the following risks:

Hormones. These include oral contraceptives ( birth control pills) and hormone replacement therapy during menopause.
Extra weight. The "spare tire" of extra belly fat can increase a woman's risk of stroke up to five times when combined with high levels of triglycerides, which are fats found in the blood.
Migraines. Women are already more likely to suffer migraines than men, and those who do are three to six times more likely to suffer a stroke than women who don't have migraines.
Being pregnant. Pregnancy can tax the heart and boost blood pressure, both of which may lead to an increased risk of stroke.

Stroke and Aging: What’s the Connection?
"Right now, more women in the U.S. have strokes than men. More women die of strokes each year, and one of the biggest differences is age," says Ralph L. Sacco, MD, neurologist-in-chief at Jackson Memorial Hospital in Miami, Fla., and spokesperson for the American Stroke Association. "Women tend to live longer, and age is such an important factor in increasing the risk of stroke. There are more elderly women out there, so there are going to be more stroke patients in women than men," says Dr. Sacco. "In the oldest age group, the actual risk of stroke seems to be a little greater in women than in men in their 70s and 80s."
The reasons are still not clear. “For a long time there was the [idea] that estrogens protected women in their younger years, and when they became post-menopausal that protection was lost and an increased risk of stroke could occur," says Sacco. A number of large studies have now "found that the risk of stroke is greater because of treatment with post-menopausal estrogen. We don't actually know why," notes Sacco.
Stroke: Symptoms in Women
Complicating the situation is that women's stroke symptoms are often quite different than the typical symptoms that men experience.
"Sometimes women with stroke can present with more atypical symptoms — that's been found for heart disease as well as stroke. Studies have shown that, for example, certain pain syndromes and change of consciousness, which we don't always think about as typical stroke symptoms, may be seen more frequently in women than men," says Sacco. In addition to pain, women may also experience nausea, chest pain, heart palpitations, or difficulty catching their breath.
According to Sacco, medical professionals are now aware of the differences in stroke symptoms between the sexes. "By and large, healthcare professionals now know how to recognize symptoms of stroke. It's more the patient not recognizing what the signs and symptoms of stroke are and not getting medical attention quick enough," Sacco notes.
It's important for women to understand their risk of stroke and be aware that they might have a different set of warning signs than men. Above all, don’t brush off stroke symptoms because you think it's a disease that strikes men — it can sneak up on women who aren't aware that they are every bit at risk.

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