What are the Warning Signs of a Stroke in Women?

At the age of 22, the notion of having a stroke wasn’t even on Tyana DeJesus’ mental radar. Even when she felt herself close to passing out at work. Even when her hearing became muffled, her vision doubled, and she couldn’t move the left side of her body. Even when she vomited in her mask as she entered the Baystate Emergency Department where her mother had rushed her.

In fact, the idea of a stroke never crossed Tyana’s mind until she heard the word from Baystate neurologist Dr. Ennis J. Duffis.

“Tyana had what we call a basilar artery occlusion, which is one of the most severe kind of strokes a person can have,” says Dr. Duffis. Left untreated, it can leave a patient paralyzed, cause them to slip into a coma or even result in death.

Tyana recalls, “When they told me I was having a stroke, I looked at my mom and we were both crying. I asked my doctors to please not let me die. I haven't lived my life. I haven't achieved any of my goals.”

Fortunately, her mother’s prompt action and the care she received at Baystate prevented the stroke from doing any permanent damage. But for many women, the outcome isn’t always so positive.

Alarming facts about strokes and women

According to Baystate neurologist Dr. Heydi Flores Podadera, the incidence of strokes in women is much higher than most people realize.

“The lifetime risk of stroke for women between the ages of 55 and 75 in the United States is 1 in 5,” she says. “Each year 55,000 more women than men have a stroke and more women die as a result of a stroke than men. In fact, stroke kills twice as many women as breast cancer and is the fourth leading cause of death for women. Even so, many women are not aware of their risks or the fact that many strokes can be prevented.”

Understanding strokes and why women are at risk

In the simplest of terms, a stroke occurs when a blood vessel that carries oxygen or nutrients to the brain is blocked by a clot or ruptures. Within minutes, brain cells in the impacted area of the brain start to die. While both men and women can and do have strokes, there are times in a woman’s life when she is at an increased risk of stroke – during pregnancy, menopause and her older years. 

Some well-recognized risk factors unique to women include:

• High blood pressure is the leading cause of stroke. High blood pressure strains blood vessels, which can make them rupture. Nearly 50% of adult women have high blood pressure, and nearly three-quarters of those with high blood pressure don't have it under control.
• Smoking damages cells that line the blood vessels and makes blood more likely to clot
• Use of oral contraception and hormone replacement therapy can increase a woman’s risk of stroke
• Pregnancy can increase blood pressure. Women are at highest risk of stroke at the end of pregnancy and after delivery. Women with high blood pressure should be treated with medication and monitored throughout their pregnancy.
• Pre-eclampsia, a pregnancy-induced high blood pressure, should be treated by your doctor
• Developing atrial fibrillation (Afib), an irregular or rapid heartbeat, as you age. Strokes caused by Afib are often more severe in women than men and more women than men die from Afib-related stroke or have more deficits and poorer quality of life after a stroke.
• Migraines with aura are associated with stroke in younger women, especially if they smoke or use birth control pills.

Know and control your stroke risks

While not all the risk factors for stroke are under your control, there are several you can reduce through lifestyle changes and help from your doctor. These include:

• High blood pressure is the #1 preventable cause of stroke. Work with your doctor to learn what’s a healthy blood pressure for you, and how to keep it in a healthy range.
• Smoking nearly doubles your risk of having a stroke and is particularly dangerous for people who have high blood pressure. It’s not easy, but quitting smoking is possible.
• Diabetes increases your risk of having a stroke by 200% over people who don’t have diabetes and increases your risk of having a stroke at an earlier age. Work with your doctor to manage your diabetes
• Diets high in saturated fat, trans fat and cholesterol, salt and calories can lead to obesity and boost your risk of a stroke. Visit The American Heart Association Diet and Lifestyle Recommendations  for information and tips on how you can ward off a stroke and other health problems with simple dietary changes.
• Obesity and excess body weight are linked to high blood pressure and increased risk of stroke. Even losing as little as 5 to 10 pounds can significantly reduce your risk.
• Physical inactivity can lead to weight gain, high blood pressure, high cholesterol, and a greater risk of stroke at any age. Simply adding a short walk to your daily routine (150 minutes total per week) can improve your overall health. If you have a chronic condition or disability, talk with your doctor about what types and amounts of physical activity are right for you.
• High cholesterol can lead to blood clots which can cause a stroke. Your doctor can help you find ways to manage your cholesterol through diet and/or medication.

If you suspect a stroke, BE FAST!

The key to surviving a stroke is seeking help immediately.

To help you recognize the signs of a stroke and to encourage you to take action if you suspect a stroke in yourself or others, the American Stroke Association developed this easy to remember stroke identification tool: BE FAST.

B – Balance Is the person suddenly having trouble with balance or coordination?

E – Eyes Is the person experiencing suddenly blurred or double vision or a sudden loss of vision in one or both eyes without pain?

F - Face Drooping Does one side of the face droop or is it numb? Ask the person to smile.

A- Arm Weakness Is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward?

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 like, “The sky is blue.” Is the sentence repeated correctly?

T - Time to call 911

If the person shows any of these symptoms, even if the symptoms go away, call 911 and get them to the hospital immediately

Many women report symptoms not often associated with strokes in men. These can include:

• nausea or vomiting
• seizures
• hiccups
• trouble breathing
• pain
• fainting or loss of consciousness
• general weakness
• sudden and severe headache

If you’re unsure whether your symptoms are that of a stroke, call 911. Your brain—and future— can’t wait.