What Every Woman Needs to Know About Stroke

Stroke is a leading cause of death and disability in both men and women, but more women than men will have a stroke over their lifetime.

“Generally, stroke is more common as we get older,” says UNC Health vascular surgeon Liliana Nanez, MD. “Because women tend to live to be older than men, more women than men die of stroke.”

Stroke was the third-leading cause of death of women in 2018, just after heart disease and cancer. It was the fifth most common killer of men.

One in five women between ages 55 and 75 will have a stroke. Stroke kills twice as many women as breast cancer.

Fortunately, many strokes can be prevented. For those that can’t be, fast treatment is essential for survival and functioning.

Stroke Symptoms in Women

A stroke, sometimes called a “brain attack,” happens when blood flow to the brain is disrupted, either by a clot or blockage in the brain or by a burst blood vessel. The result can be brain damage, disability or death. It depends on which part of the brain is affected.

For women and men, the best way to spot a stroke is to remember FAST from the Centers for Disease Control and Prevention:

  • Face: Does one side of the person’s face droop, especially when trying to smile?
  • Arms: If the person raises both arms, does one drift down?
  • Speech: Is their speech slurred or off?
  • Time: If you see any of these symptoms, call 911 without delay. Minutes can make the difference for recovery.

“Generally, the symptoms of stroke are similar in men and women,” Dr. Nanez says. “But women can have a few different symptoms, too.”

Women having a stroke may be more likely to experience:

  • Difficulty breathing
  • Fainting
  • Loss of consciousness
  • Feeling weak all over
  • Nausea and vomiting
  • Agitation

Stroke Risks for Women

There are two types of stroke: ischemic and hemorrhagic.

An ischemic stroke occurs when a blockage forms, preventing enough blood from getting to the brain.

A hemorrhagic stroke may occur when blood vessels are weakened by constant high pressure, and an aneurysm—or bulge—forms in the brain, which may rupture and cause bleeding.

High blood pressure is a major stroke risk for both men and women, because the increased pressure can damage and narrow blood vessels over time.

Women may have additional risks for stroke, Dr. Nanez says. These include:

Other stroke risk factors include both medical and lifestyle issues, she says.

In addition to uncontrolled high blood pressure, medical risks include high cholesterol levels, atrial fibrillation (Afib, or irregular heartbeat), diabetes and sleep apnea.

Lifestyle issues include being overweight or obese, living a sedentary lifestyle, drinking alcohol, using recreational drugs and smoking.

The good news, though, is that four out of five strokes are preventable, Dr. Nanez says.

Reducing the Risks of Stroke

“There are a number of things both men and women can do to reduce their risk of having a stroke,” she says.

These include:

  • Control your blood pressure and talk to your doctor about how to lower it if it’s too high.
  • Lower high cholesterol through diet or medication.
  • Stop using tobacco products.
  • Manage your diabetes with your doctor’s help.
  • Maintain a healthy weight.
  • Eat fruits and vegetables as part of a healthy diet.
  • Exercise at moderate intensity for at least 150 minutes a week.
  • Drink alcohol in moderation, if at all.
  • Avoid using recreational drugs.

Knowing the signs of stroke is critical, she says, as lives and brain function can be saved by getting emergency care as quickly as possible.

Doctors who treat stroke say that “time is brain.” Once brain cells die, they cannot be recovered. If you are having an ischemic (clot) stroke, you may be given a thrombolytic (clot-busting) drug. If you are having a hemorrhagic stroke, you may undergo a procedure to strengthen a weak or broken blood vessel, or you may need surgery to stop blood loss.

“Remember the CDC’s FAST reminder for stroke survival,” Dr. Nanez says. “See if the face is drooping on one side; find out if one arm drifts down when both arms are raised; notice if their speech is slurred. And if these things are present, time is critical. Call 911 immediately.”

If you have questions about your stroke risk, talk to your doctor. If you need a doctor, find one near you.