Know how to recognize subtle signs of stroke in women

Key takeaways:

  • Women have unique stroke risk factors and symptoms.
  • Stroke is the fourth leading cause of death in women.
  • Some of the subtle signs of stroke may be easy to brush off or ignore.
  • Having high blood pressure during pregnancy is the leading cause of stroke in pregnant women.
  • Find out ways to reduce your risk of stroke.

[5 MIN READ]

Nearly every 40 seconds someone in the United States suffers a stroke, and every four minutes someone dies from stroke. This staggering data from the Centers for Disease Control and Prevention also reveals that stroke is a leading cause of long-term disability, especially for stroke survivors over age 65.

But did you know that stroke disproportionally affects women? According to the American Heart Association, women make up 60% of all stroke-related deaths in the U.S., making it the fourth leading cause of death in women. 

Although women tend to have strokes later in life than men, a recent study conducted by the University of Colorado School of Medicine, found that more women ages 25-44 had strokes than men in the same age category. The researchers gleaned the data over a three-year span from health insurance records of men and women. Similar research in Europe showed similar results.

80% of strokes are preventable - so the key in stroke care is prevention. Your doctor will identify your risk factors and help you manage them to reduce your chances of having a stroke.

"80% of strokes are preventable - so the key in stroke care is prevention. Your doctor will identify your risk factors and help you manage them to reduce your chances of having a stroke," says Yince Loh, M.D., a neurointerventional surgeon and neurology specialist at Swedish Neuroscience Institute.

Stroke interrupts blood supply to brain

A stroke happens when a blood vessel that carries oxygen and nutrients to the brain becomes blocked. Usually, this happens when a piece of plaque breaks off from an artery wall and lodges in the pathway to the brain. The sudden interruption of the blood supply to the brain is called an ischemic stroke.

A hemorrhagic stroke is caused by a burst blood vessel that bleeds into brain tissue. A transient ischemic attack (TIA) also known as a “mini-stroke,” is a sudden, short-term loss of blood flow to the brain that disrupts oxygen supply. Although it’s not classified as a stroke, a TIA produces symptoms of a stroke, except the symptoms disappear within minutes to an hour.

No matter what type of stroke, minutes matter. It’s important to seek help at the first sign of stroke.

No matter what type of stroke, minutes matter. Delaying treatment can increase the risk of death or permanent brain damage, which is why it’s important to seek help at the first sign of stroke.

Signs of stroke shared by men and women

Men and women share many of the same signs of stroke. The three most common signs are:

  • Face drooping
  • Arm weakness or numbness
  • Speech difficulty

Other signs may include numbness or weakness in the face or leg, vision problems, trouble walking and lack of coordination.

Time is brain: Use BEFAST

Remember, during a stroke “time is brain.” In other words, every second the brain is not receiving oxygen increases your risk of death or a debilitating condition. Use this acronym as a way to determine when to call for help.

Balance – Sudden loss of balance or coordination

Eyes – Change in vision or having trouble seeing

Face is drooping

Arms (or arm) are weak or numb

Speech is slurred

Time to call 9-1-1

Subtle signs of stroke in women

In addition to the above, women experience a number of other subtle signs of stroke that they may be inclined to brush off or explain away, including:

  • Bad headache
  • Brain fog
  • Exhaustion
  • Vomiting or nausea

All of these subtle signs can be confused with other conditions, which is why it’s important to pay attention to anything that comes on suddenly, or you experience the loss of bodily functions you can’t explain. 

Women often present with symptoms that are not as easily identified as stroke. With any of the subtle signs mentioned above, you should call 9-1-1 immediately.

"Women often present with symptoms that are not as easily identified as stroke. With any of the subtle signs mentioned above, you should call 9-1-1 immediately," says Dr. Loh.

This infographic developed by the AHA explains how signs of stroke differ between men and women.

Risk factors unique to women

Just as men and women share many of the same symptoms of stroke, the two genders share risk factors, as well, including:

  • Age
  • Family history
  • Smoking
  • High blood pressure
  • High cholesterol
  • Lack of exercise
  • Diabetes

Women also have stroke risk factors unique to their gender, including pregnancy and preeclampsia. According to the AHA, the risk of stroke in pregnant women is 21 to 100,000. Having high blood pressure during pregnancy is the leading cause of stroke in pregnant women or women who have recently given birth.

Women who had preeclampsia during pregnancy need to be aware that they may be at higher risk of stroke later in life.

Preeclampsia is a pregnancy complication with symptoms that include swelling and high blood pressure. Women who had preeclampsia during pregnancy need to be aware that they may be at higher risk of stroke later in life than women who didn’t have high blood pressure during pregnancy.

Other risk factors that women of all ages should be aware of include:

  • Birth control pills – If you’re at high risk for stroke, take extra precaution before using oral contraceptives. Get screened for high blood pressure, and never smoke while taking the pill.
  • Hormone replacement therapy - Post-menopausal hormone therapy does not reduce the risk of a recurrent stroke. In fact, according to research, hormone replacement therapy may increase the risk of fatal stroke.
  • Migraines with auraResearch shows that women under age 50 who experience migraine with aura are at higher risk of stroke, especially if they smoke and take birth control pills.
  • Atrial fibrillation – If you have atrial fibrillation (AFib), described as a quivering or irregular heartbeat, you are at higher risk of stroke. In a study of more than 100,000 people with AF, women were 47% more likely to have an ischemic stroke than men.
  • Race - Black women in their 50s may have more than triple the risk of stroke compared with white women of the same age, according to a 2019 study published by the AHA journal, Stroke.

Women need to be even more attuned to their unique risk factors.

According to Dr. Loh, "As prevention is key in stroke management, women need to be even more attuned to their unique risk factors. The above gender-unique risk factors all contribute to the disparity of stroke between men and women."

Need to know: Reducing your risk of stroke

Assess your lifestyle and medical conditions to determine your risk for stroke:

  • Do you have high blood pressure and/or high cholesterol?
  • Do you have diabetes?
  • Have you been diagnosed with atrial fibrillation?
  • Do you smoke?
  • Are you overweight?
  • Do you avoid exercise?
  • Has a close relative had a stroke?

If you answered yes to any of those questions, you may be at greater risk for having a stroke. 

By making changes to your lifestyle, you can greatly reduce your risk of stroke, and heart disease as well. Start small, perhaps adjusting your diet.

By making changes to your lifestyle, you can greatly reduce your risk of stroke, and heart disease as well. Start small, perhaps adjusting your diet to include more plant-based foods to your meals. Skip takeout when possible, and limit alcohol consumption.

If you smoke, it’s time to quit. There are a lot of resources available to support your effort.  If you’ve never enjoyed exercise, consider adding extra steps to your day by walking around the block at lunch. Regular exercise is an important component to preventing stroke and other diseases.

Other changes or habits that can help prevent stroke include:

  • Losing weight if you are overweight
  • Managing your blood sugar if you have diabetes
  • Taking your medications are directed

Learn the symptoms of stroke, and have your family members learn them, too. If you think you are having symptoms of stroke, call 9-1-1 immediately. If you have risk factors for stroke, see your health care provider for a screening.

The Swedish Neuroscience Institute at Cherry Hill has been awarded the Comprehensive Stroke Center Certification from DNV GL- Healthcare. Learn more.

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Find a doctor

If you feel you are having a stroke call 9-1-1 immediately.

If you would like to connect with a primary care provider who can assess your risk of stroke, you can either use Swedish Virtual Care or our provider directory.

Learn more about the Swedish Stroke Center.

Find out the latest updates on how we’re handling COVID-19.

Related resources

Is COVID-19 causing strokes in younger people?

Heart disease and stroke prevention: It starts with knowing the risks

Time is brain, so BEFAST to recognize stroke

Signs of a stroke and actions you should take

This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.

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