Understanding Stroke Risk: A Lifesaving Conversation for Women

Did you know that stroke kills more women than men? In fact, one in five women will experience a stroke during their lifetime, making stroke the third leading cause of death in women nationwide. With May as both National Stroke Awareness Month and Women’s Health Month, it is an opportune time to talk about the unique factors that put women at higher risk for stroke and how these risks can be managed or prevented.

Conditions specific to women such as pregnancy, menopause, and endometriosis, as well as hormonal contraception use, are known contributors to increased stroke risk. Thankfully, making healthy lifestyle choices, such as eating a balanced diet rich in fruits, vegetables, and whole grains; smoking cessation; managing blood pressure and cholesterol levels; and addressing underlying medical conditions like atrial fibrillation, can go a long way towards reducing stroke risk in women.

When strokes do occur, survival rates increase and the disability rates decrease when emergency treatment begins quickly. Because familiarity with the warning signs may save your life or the life of someone you know, Mount Nittany Health encourages everyone to learn the acronym BE FAST:

• B- Balance: Loss of balance, headache or dizziness
• E- Eyes: Blurred vision
• F- Face: Does one side of the face droop or is it numb? Ask the person to smile.
• A- Arm: Is one arm weak or numb?
• S- Speech difficulty: Is speech slurred, are they unable to speak, or are they hard to understand? Ask the person to repeat a simple sentence.
• T- Time: If the person shows any symptoms, even if they go away, call 911 and take them to the hospital immediately.

“Traditional stroke symptoms are the same for women and men, but women are more likely to have additional symptoms, including nausea, loss of consciousness, or appearing confused,” said Jeffrey Elias, DO, FACEP, Emergency Medicine, Mount Nittany Health. “When any of these symptoms occur, restoring blood flow as quickly as possible – within the minutes to hours following the onset of symptoms – is crucial. Our team of stroke care professionals in the Emergency Department is ready to respond swiftly and effectively.”

Prevention of Pregnancy-Associated Stroke

Stroke is estimated to occur in about 30 out of every 100,000 pregnancies, with the highest risk occurring the first few days following childbirth.

Pregnancy encompasses an array of physiological changes, such as changes in blood volume, cardiovascular function, and coagulation that can contribute to stroke risk. Additionally, pregnancy-related complications like preeclampsia, gestational diabetes, and high blood pressure can further increase the risk of stroke.

Receiving routine prenatal care to monitor these risk factors is a vital part of maintaining a healthy pregnancy. Eating a balanced diet, engaging in regular exercise, avoiding harmful substances, and getting adequate rest are other equally important measures that not only reduce stroke risk, but promote the overall well-being of both the mother and developing baby.

Reducing Stroke Risks Associated with Menopause

The menopause transition, typically occurring for women between the ages of 45 and 55, is marked by a range of physical and emotional symptoms due to the natural decline of estrogen levels in the body.

This decline in estrogen can increase LDL and decrease HDL, negatively impacting overall cholesterol levels – a common stroke risk factor. Other symptoms of menopause may include weight gain and metabolic changes, like insulin resistance, which may contribute to diabetes and therefore increase stroke risk. Women should be sure to manage these risk factors in collaboration with their primary care provider in order to live their happiest, healthiest lives during this time of great personal change.

Endometriosis and the Risk of Future Stroke

Endometriosis is a condition where tissue similar to that found in the lining of the uterus grows outside of the uterus, often on the ovaries, fallopian tubes, and pelvic lining. This misplaced tissue acts like the uterus lining, which thickens and bleeds during menstruation, causing pain, inflammation, and scarring.

These side effects of endometriosis can contribute to several common risk factors of stroke, including high blood pressure, high cholesterol, and cardiovascular disease. In addition to speaking with their healthcare provider about how to treat and manage endometriosis, women should also discuss how to manage these underlying health conditions, including diabetes and obesity, and eat a balanced diet and exercise regularly.

Stroke Risk Associated with Hormonal Contraception Use

Estrogen containing hormonal contraceptives can increase clotting factors in the blood, raise blood pressure, and subsequently promote blood clot formation. These risks increase significantly when smoking, which is why all women are advised to quit smoking before beginning hormonal birth control. Other stroke risk factors associated with hormonal contraception use include diabetes, hypertension, atrial fibrillation, and increased age.

Women who have any concerns about their stroke risks while taking hormonal contraceptives should discuss them with their doctor.

“Stroke can be devastating for anyone, which is why it’s important for everyone to know how they can protect themselves from stroke,” said Nina Kephart, MSN, RN, Stroke & Sepsis Coordinator, Mount Nittany Health. “Educating women about their unique risks empowers them to care for themselves in the same way they so often care for others. I would encourage any woman who’s concerned about their stroke risk to start the conversation with their primary care provider today – don’t wait.”