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Doctor at the Desk

Different Strokes

Why stroke in women is different
By: Stef dela Cruz, MD article_20

The world is slowly but surely opening its eyes to what it means to be female. It was only a little more than a hundred years ago when for the first time, women were finally given the right to vote. We have been weighed and measured based on our capacity to bear children and keep our homes tidy.

When it comes to stroke, the story isn’t that different. Much of what you’ll read in textbooks emphasize risk factors experienced by men.

Let’s change that today, shall we?

Must-know stroke facts about women

There is a very valid reason we should be focusing a whole lot more on women when it comes to a stroke: Females tend to be more gravely ill than their male counterparts. More women die within a month of getting diagnosed with stroke, according to Peter Appelros and his colleagues in a 2009 study published in Stroke.

The above disparity can be observed anywhere around the world. It’s a discrepancy that the researchers admitted was even bigger than previously stated in the medical text.

Here are a few facts that, if taken to heart and shared, might help change the statistic.

Fact #1: Migraines alone increase stroke in women

Aside from head-splitting migraines, I also suffer from ocular migraines. These rather trippy visual hallucinations make me see colorful, undulating patterns of light where there are none. I’ve long realized that these are related to the oral contraceptives I’ve been taking for an ovarian tumor for more than 15 years.

Unfortunately, that means my chances of dying due to stroke are so much higher compared to the general population.

Fact #2: Oral contraceptive use alone puts women at higher risk for stroke

The risk of stroke in women who use oral contraceptives is increased threefold, according to a 2000 article by Leslie Allison Gillum and colleagues published in in the Journal of the American Medical Association.

Women like me might think of shifting to a pill preparation with lower estrogen content but according to the study, the risk remained even if we did. The good news is that the risk is small at about one stroke case occurring in every 24,000 women.

Fact #3: Diabetes is a more threatening risk factor for stroke in women

You might already know that diabetes increases the risk for stroke in both men and women. However, if you were born female, you might have drawn the proverbial shorter straw.

Males with diabetes have a twofold risk for stroke. Diabetic women, on the other hand, are in greater danger for stroke – by up to 6.5 times, according to the 2006 American Heart Association/ American Stroke Association Guideline for the Primary Prevention of Ischemic Stroke published in Circulation.

Fact #4: Getting pregnant comes at a price: a higher stroke risk

The gift of pregnancy and bearing children is unique to females. Unfortunately, a higher stroke risk is part of the package.

Pregnancy leads to many changes in a woman’s body, including a decrease in anticoagulants and an increase in clotting factors. A pregnant woman’s capacity to dissolve clots is also reduced, according to a 2004 article by Benjamin Brenner published in Thrombosis Research.

About three pregnant women out of every 10,000 suffer from stroke, compared to just 1 out of every 10,000 non-pregnant women of childbearing age. Different pregnancy-related conditions, such as postpartum infection and hemorrhage, further increase the risk.

How women can prevent stroke

Fellow females, regardless of whether you’re a mom or not, know this: You are amazing! You can be all the more amazing by spreading the word about stroke awareness in women.

Here are a few things we can do to prevent stroke, courtesy of the American Heart Association.

  • Get checked for hypertension before getting pregnant. If you have high blood pressure, your doctor may consider giving you low-dose aspirin or a calcium supplement to prevent preeclampsia.
  • Stop smoking, especially if you have migraines. Women who suffer from migraines with aura have a much higher risk for stroke if they smoke. But even if you didn’t have these awful migraines, stop smoking anyway.
  • Get screened for arrhythmias if you’re more than 75 years old. Women over 75 who suffer from a type of irregular heartbeat called atrial fibrillation should seek treatment early. Atrial fibrillation increases the risk of stroke in this age group.
  • If you’ve had a complicated pregnancy in the past, ask your doctor how you can prevent stroke in the future. You may think you’re out of danger now that your pregnancy is long over, but if you’ve had preeclampsia or eclampsia in the past, visit a neurologist and ask what measures you can take to lessen your risk for stroke. These measures may include smoking cessation, addressing high cholesterol levels, and weight management.
We may be at a disadvantage because of our stroke risk, but not if we can help it! Armed with the above knowledge, girls like you and me can do what we do best: Run the world
Read more:
Different Strokes, Different Folks
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Keywords: blood pressure, feminine hygiene, arrhythmias, estrogen, Oral contraceptive, Migraines, stroke   
  
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