Women & Stroke

Stroke is often believed to afflict men more than women but statistics show that the opposite is true.

In the United States, around 55,000 more women have a stroke each year compared to men. Stroke has also been recognised as the number three cause of death in women and number four in men. According to Circulation, a journal of the American Heart Association, women face a greater risk of having a stroke than men.

It is important to note that although both men and women with conditions such as hypertension and diabetes have a similar risk of having a stroke, there are unique aspects of a woman’s health that may increase her risk.

Both men and women share the signs and symptoms of stroke such as feeling weakness or pain in the arms and legs, arm, jaw or throat pain and the more prevalent chest pain but women tend to describe their pain differently.

Oestrogen conundrum

One of the main differences between the sexes is a hormone called oestrogen. Oestrogen is the primary female sex hormone that plays a major role in a woman’s menstrual cycle and is thought to protect the arteries from damage, before menopause. Before menopause, oestrogen is naturally produced by a woman’s ovaries. However, there are many elements that may alter the effect of this important female hormone.

The consumption of oral contraceptives has increased among women and many women take Combined Oral Contraceptive (COC) pills. COCs contain both oestrogen and progesterone which prevent pregnancy by thickening cervical mucus, inhibiting the release of the ovary and altering the shape of the uterine wall.

Oral contraceptives increase the risk of stroke in women who are over the age of 35 and who smoke. Additionally, in some women, oral contraceptives may also increase the risk of blood clots which may lead to stroke as well.

Labour of love

Pregnancy is unique to women and while childbirth is a ‘labour of love’, it is also important to know that it affects a woman’s risk for stroke. According to the Heart and Stroke Foundation of Canada if a woman has medical conditions such as a ‘pre-existing blood vessel malformation’ or eclampsia (seizures in a woman with pre-eclampsia), a stroke could occur during childbirth or in the first few weeks after.

Another problem that crops up during pregnancy is pre-eclampsia. Pre-eclampsia is a pregnancy-related complication which is characterised by high blood pressure and protein in the urine. Excreting protein in the urine is an indication that there is a problem with the kidneys. The American Heart Association says that pre-eclampsia can the risk of stroke later in the mother’s life. With safe blood pressure medications that won’t harm the baby, pre-eclampsia can be managed until childbirth.

Other than pre-eclampsia, some women may develop gestational diabetes. As a woman’s body is flooded with pregnancy hormones, it may interfere with insulin levels. Gestational diabetes usually disappears after delivery but it also increases both the mother’s and baby’s risk of developing Type 2 diabetes down the road and this is a risk factor of stroke.

Drastic decrease

When a woman stops menstruating for 12 consecutive months, she has reached menopause. During menopause, there is a drastic decrease in oestrogen and progesterone in the body.

Some women could experience an increase in total blood cholesterol, Low Density Lipoprotein (LDL, bad cholesterol) and blood fat levels, decrease in High Density Lipoprotein (HDL, good cholesterol), increase in blood pressure, and increase in belly fat before (perimenopause) and after menopause. All of these changes are risk factors for stroke and heart disease as well.

Go for an overhaul

The best way to prevent stroke is to overhaul negative health habits. Separate the risk factors into the ones you can control such as smoking, high blood pressure, high blood cholesterol, diabetes, sedentary lifestyle and obesity and the ones you have no control over like your age, gender, family history and ethnicity.

Quitting smoking may seem like an impossible task and there is no doubt that it is a difficult habit to break but the discomfort of quitting is certainly worth extra few years of life. There are plenty of places and sources that can help you quit.

Good control of conditions such as diabetes, high blood pressure and high blood cholesterol could help reduce your risk of stroke. Exercising and eating right will help greatly when it comes to managing your weight, cholesterol, diabetes and blood pressure.

If you’re concerned about your risk of stroke, don’t hesitate to make an appointment with your general practitioner. He or she will be able to give you more insight and advice regarding stroke and its risk factors.

How to reduce your risk of stroke

Quit it – When you quit smoking, your risk of stroke could be reduced to the level of a lifetime non-smoker after just 5 years.

Move it – People who exercise more than 5 times a week have reduced risk of stroke. The Centre for Disease Control and Prevention in the US recommends at least 150 minutes of moderate activity (brisk walking, bicycling) per week along with at least 2 days of weight training exercises.

Kick it – Kick your drinking habit to the curb. Consuming alcohol can increase blood pressure and stroke risk. Moderation should be practiced so aim for not more than 2 drinks a day for men and 1 drink a day for women.

Eat it – Have more fruits, vegetables, whole grains and nuts. Cut down your intake of red meat and have more seafood instead. Limit your intake of sodium, solid fats, added sugars and refined grains. Increase physical activity and ingest less calories.

References: Circulation: American Heart Association; American Stroke Association; Heart and Stroke Foundation of Canada; Stroke.org; WebMD.

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