Signs of a stroke can be different among women and men, due to several risk factors you may not know of which make stroke a leading killer of women. Here are 15 symptoms all women should keep an eye on.
If you believe you are at risk for a stroke, there is a helpful acronym to raise awareness of a stroke and save your life: FAST. Developed by the American Stroke Association (ASA), the acronym stands for face drooping, arm weakness, speech difficulty, and time to call 911. Unfortunately, these aren’t the only, or even the most evident, stroke symptoms in women, according to Cheryl Bushnell, MD, professor of neurology at Wake Forest Baptist Medical Center. “We have no idea why the stroke symptoms might be different for women. We need research on this topic,” says Bushnell. Women also have distinctive risk factors that make stroke the third leading cause of death for women.
15. Fainting or Seizures
You may want to think twice about a fainting spell and look deeper into the underlying issues, as it may be a stroke. Women are more likely to suffer from strokes in the back of the brain than men, says Diana Greene-Chandos MD, FNCS, assistant professor of neurosurgery and neurology at The Ohio State University Wexner Medical Center. Known as posterior circulation strokes, they cut off “blood flow to the occipital lobes, brain stem, cerebellum, and part of the temporal lobe. The top of the brain stem is where the consciousness center lies,” says Dr. Greene-Chandos, which can lead to fainting if blood flow to the brain is cut off. Dr. Greene-Chandos also states that fainting “could also be related to a hyperventilation response to any type of stroke, as a fear response” and seizures, a different type of stroke symptom in women, can also be confused with a loss of consciousness.
14. Difficulty Breathing
Women often confuse chest pains and shortness of breath with signs of a heart attack, but instead, they may be signs of a stroke. “This is consistent again with posterior circulation problems from the bottom of the brain stem where the respiratory drive centers lie,” says Dr. Greene-Chandos. Recognizing the early signs of stroke is crucial, says Kathryn Rexrode, MD chief of the Division of Women’s Health, Brigham and Women’s Hospital. “It is important to get prompt emergency care if you are experiencing stroke symptoms since some strokes can be stopped by use of thrombolytic, or clot-busting, drugs,” Rexrode added.
According to a survey conducted by Dr. Greene-Chandos and her colleagues at The Ohio State University Wexner Medical Center, the findings stated that only 10 percent of women surveyed knew that hiccups, combined with atypical chest pains, are early stroke symptoms in women. “Hiccups are consistent with posterior circulation problems from the brain stem,” said Dr. Greene-Chandos. The ability to swallow and the drive to breathe derive from the brain stem, along with other functions.
12. Sudden Behavioral Changes or Agitation
According to a report by the University of Michigan, women are twice as likely to report non-traditional symptoms. The most commonly reported, compared to men, was a shift in mental state. Such a shift could be consistent with a posterior circulation stroke, says Dr. Greene-Chandos, which can also target the areas responsible for memory and personality. The frontal lobe is also tied to personality, thus behavior change “could be due to a frontal lobe stroke as well,” said Dr. Greene-Chandos.
11. Nausea or Vomiting
Vomiting, dizziness, and nausea are known symptoms of a stroke in the cerebellum, says Dr. Greene-Chandos. “This is consistent with posterior circulations problems from either the brain stem or the cerebellum,” she says. It may also be present with intracranial hemorrhage strokes, in which an aneurysm (a bulging blood vessel burst) causes bleeding into the brain.Related: Clear Your Arteries Naturally by Following These 7 Steps
Although changes in your vision are considered a common sign of stroke, according to the National Stroke Association, women’s visual symptoms also include hallucinations. Occipital lobes, “the powerhouse of interpretation of visual input,” according to Dr. Greene-Chandos, can become damaged by posterior circulation issues.
9. Taking Birth Control Pills or HRT
Dr. Greene-Chandos’ study also found that only 11 percent of women who were surveyed were aware of the risks related to hormone intake, such as birth control pills or hormone replacement therapy (HRT), that can lead to a stroke. According to the American Stroke Association, the pill could double your chances of having a stoke. “Oral estrogens tend to increase clotting factors made by the liver, leading to a higher risk of blood clots,” Dr. Rexrode said. While on oral contraceptives, some women tend to see their blood pressure increase. If you are considering contraceptives or HRT, be sure to ask your doctor to monitor your blood pressure and watch for changes.
8. Early Menopause or Early Menstruation
Dr. Rexrode’s research also found that the early onset of menstrual changes can significantly alter a woman’s risk for stroke. Starting menstruation before the age of 10 or menopause before the age of 45 can put a woman at a higher risk of a stroke. “During the years that a woman is menstruating, she produces higher levels of estrogen and other hormones,” Dr. Rexrode says, and the shortened exposure to these hormones might make the risk higher, though researchers are looking for deeper confirmation.Related: 7 Natural Ways to Lower Blood Pressure
7. Pregnancy Complications
During pregnancy, women who are diagnosed with preeclampsia (dangerously high blood pressure) are prone to a high risk of stroke later in life. Gestational diabetes is also a high-risk indicator. Preeclampsia is a sign of stress on the circulatory system, and can also predict the risk of developing high blood pressure later in life, says Dr. Bushnell. “Also, gestational diabetes is associated with an increased risk of diabetes– both hypertension and diabetes are very important stroke risk factors.” ASA’s new stroke guidelines for women, written by Dr. Bushnell, recommend doctors pay close attention to a patient’s health during pregnancy. Dr. Rexrode also notes that pregnancy itself increases stroke risk.
6. Multiple Miscarriages
Miscarriages may also be a predictor of stroke risk if the miscarriage was due to a clotting disorder, according to the American Stroke Association. “The clotting factors increase the risk of developing clots in the heart or in the blood vessels of the brain, both of which can lead to a stroke,” Dr. Bushnell says. A history of clots in the legs, or deep vein thrombosis (DVT), is also another sign of a clotting disorder.
5. Low Levels of Key Hormone
Dr. Rexrode’s research also identified another stroke risk in women: low levels of DHEA (dehydroepiandrosterone). “DHEA, a hormone made by the adrenal glands, is used in the manufacture of other hormones, including estrogens and androgens (male hormones),” says Dr. Rexrode. “It is not entirely clear whether low DHEA levels reflect some other underlying problem, or whether the effect on risk of stroke is through their influence on other hormone levels.”Related: 19 Things to Consider for Good Heart Health
4. Migraines with Aura
Migraines are more common in women. According to the American College of Cardiology, migraines with visual disruptions, known as auras, are a risk factor for stroke. Migraines are known to constrict brain blood vessels, and could contribute to cutting off blood supply to the brain, says Dr. Greene-Chandos. “This increases the risk of stroke,” she says.Related: 5 Signs you’re Hooked on Caffeine and How to Cut Back
3. Autoimmune Diseases
Women are more susceptible to autoimmune conditions like lupus than men, Dr. Greene-Chandos says. Autoimmune diseases can raise the risk of stroke and cardiovascular disease, as shown in recent research from Spain. The link may be caused by inflammation, says Dr. Greene-Chandos. “Autoimmune inflammatory conditions put women at risk for inflammation of the cerebral vasculature (blood vessels).”
2. Mental Health Problems
Although mental health may not be 100 percent connected to stroke, it is, however, evident that stress is a risk factor for high blood pressure and cardiovascular problems, and women may be uniquely disposed to stress, says Dr. Bushnell. According to a preliminary study from Harvard, the report found that increased activity in the amygdala, the area of the brain that responds to stress, was found to be greatly associated with the risk of stroke.
1. Irregular Heartbeat
Atrial fibrillation (AFib) is a symptom that is specifically of concern as women age. According to the American Heart Association, women who have untreated AFib are five times more likely to have a stroke. “Atrial fibrillation leads to blood clot formation in the heart, which can then break off and lodge in a blood vessel in the brain,” Dr. Bushnell says. Unfortunately, there is no known reason why AFib is a bigger issue for women than men. The American Heart Association, along with the American Stroke Association, guidelines advise that women over the age of 75 should be screened for AFib.Related: 7 Health Problems Your Hands Can Help Predict