Statins: How the drug prevents heart attacks and strokes
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Some aspects of women’s lives increase the risk of stroke, making women more likely to have a stroke than men. This is not only because of their increased longevity and the fact that stroke event rates increase in the oldest age groups, women are directly more likely to have a stroke for a number of reasons from conditions common to women to hormonal treatments women take. Express.co.uk reveals the six reasons why stroke is more common in women, according to the Stroke Association.
Stroke impacts women more than men because women have more events and are less likely to recover.
More women than men die from stroke, and it’s twice as common for women between 20 and 39 to have a stroke than men of the same age.
On top of that, more women have strokes in later life and more women than men have another stroke within five years of the first stroke.
However, the Stroke Association points out that despite being a woman, taking care of your health and managing your risk factors will help you avoid a stroke.
The site reads: “For example, if you are a younger woman who doesn’t smoke and is physically active, your risk of stroke will probably be very low.
“The aim is to spot in advance if you are more likely to have a blood clot or stroke, and avoid it happening if possible.”
The symptoms of stroke are no different in men and women, but women may experience additional general weakness, disorientation and confusion, memory problems, fatigue, nausea or vomiting.
The contraceptive pill and patch
The combined oral contraceptive pill and the contraceptive patch contain both oestrogen and progestogen.
Treatments including oestrogen can slightly increase your risk of serious problems such as stroke, heart attacks, and blood clots.
The Stroke Association pointed out: “If you have any of the risk factors for stroke such as high blood pressure, smoking or being overweight, you may not be able to use these types of contraceptive.
“This also applies if you have had a stroke or blood clot before, or have migraine with aura.”
Oestrogen is the hormone in the combined pill that can raise stroke risk, and luckily the progestogen-only contraceptive pill, the contraceptive injection and implant do not and so are unlikely to raise your risk of stroke.
The intrauterine system (IUS) releases a small amount of progestogen into the uterus, but it may not be suitable if you have a history of serious heart disease or stroke.
Pregnancy
Although the overall risk of stroke in a younger woman is very low, pregnancy and childbirth do slightly increase your risk of a stroke.
Stroke is still very rare among pregnant women, but you can help to have a healthy pregnancy by attending all pre and post-birth appointments.
According to The Stroke Association, one reason for the higher risk is that pregnancy makes your blood become more ‘sticky’ and likely to form clots.
The site explains: “This may be the body’s way of protecting you from bleeding during birth.
“Your blood pressure may rise, and you should have your blood pressure measured at ante-natal appointments to spot the signs of preeclampsia.
“Because of your age, your overall risk of a stroke is likely to be very low, but you can help to have a safe pregnancy by staying active and keeping your circulation healthy.
“Having a good diet, staying a healthy weight and stopping smoking will all cut your risk of a blood clot or stroke.”
If you have any existing health problems like diabetes or high blood pressure, make sure your GP and midwife know.
You may need to change medications or get extra monitoring.
The chance of a stroke or blood clot is higher all through pregnancy, but the riskiest time is the first few weeks after birth.
Hormone replacement therapy
Hormone replacement therapy (HRT) tops up your levels of hormones to control menopausal symptoms such as hot flushes, vaginal dryness and mood swings and it has proven very successful at doing so, but it doesn’t come without its risk.
There are different types of HRT that use oestrogen and progestogen in different combinations or alone.
HRT tablets containing oestrogen cause a small increase in your risk of stroke.
However, if you use a patch or a gel form of HRT with oestrogen, this does not increase your risk of clots or stroke.
The Stroke Association said: “If you have a family history of blood clots, you may need some extra checks before receiving HRT.
“Like the combined contraceptive pill, the increase in risk from taking HRT tablets is very small, particularly if you are under 60.
“So provided you are in a low-risk group, or your risk factors are well managed, your overall risk is still very small.”
Fertility drugs and IVF treatment
The hormones used to increase fertility or to prepare for in-vitro fertilization (IVF) can have rare complications that may increase the risk of blood clots and stroke.
Ovarian hyperstimulation syndrome (OHSS), when the ovaries swell, happens in around a third of IVF cycles, the Stroke Association pointed out.
While most cases are mild, a very small percentage may lead to serious complications such as pain, breathing difficulties and blood clots in the veins.
The Stroke Association warns: “If you are having IVF it’s important to get help with any symptoms of OHSS as soon as possible.
“If you are having or considering having IVF treatment, you can ask your doctor about the effect on your risk of stroke, and what you can do to manage any risk factors you may have.”
Migraines
Migraine affects more women than men, and if you experience migraine with an aura you are more likely to have a stroke.
The aura usually happens at the start of a migraine attack, before a headache begins and it often includes visual changes such as seeing flashing lights or dark patches.
People with migraines, particularly with aura, have roughly twice the risk of an ischaemic stroke (a stroke caused by a clot).
The Stroke Association said: “Because of this link, women who have migraines with aura are advised not to take the combined contraceptive pill.
“It is important to remember that your individual risk is still small, particularly if you don’t have many other risk factors for stroke.”
Lupus
Lupus is an autoimmune condition that mainly affects women, and lupus makes stroke more likely.
The condition mainly affects the skin, but some forms can also cause fatigue and joint pain with irregular flare-ups.
The severe form of lupus is called systemic lupus erythematosus (SLE), and this can cause kidney damage leading to high blood pressure, which makes a stroke more likely.
The Stroke Association said: “There is no cure for lupus itself, but you can treat the symptoms such as pain and high blood pressure.
“If you have SLE, your kidneys should be monitored, and kidney problems can be treated with immunosuppressants.
“You can also take steps to reduce your risk of a stroke by making healthy lifestyle choices like eating healthily, not smoking and taking plenty of exercise.”
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