Symptoms Of Stroke In Women

Heart attack and stroke are two leading causes of death worldwide. 

As such, they should not be overlooked. 

But stroke is a very complex ailment with different subtypes and settings. 

Sometimes, we can have patients with a silent stroke who don’t realize it.

In this article, we will cover the aspects of this concerning women. 

We will talk about the signs and symptoms of a stroke in women and how the disease manifests in females. 

Are there warning signs days before a stroke when you’re a woman? 

How does it happen in pregnant women?

Keep reading to find out.

What is a stroke?

A stroke is a usual name given to acute infarction of the brain. For one reason or another, the brain arteries stop supplying oxygen to the tissues. 

The brain tissues suffer from low oxygen and low energy levels. Sometimes they are destroyed in the process.

There are two main forms of stroke. They are:

  • Ischemic stroke: It happens when the arteries are clogged with fatty deposits, blood clots, or a combination of both. It usually happens suddenly, which is why it is also known as acute ischemic infarction.
  • Hemorrhagic stroke: In this case, there is a hemorrhage of the brain arteries. The blood flow that should be feeding the brain is now draining somewhere else. 

In both cases, patients display signs and symptoms depending on the part of the brain involved in the alteration.

Are strokes a widespread issue in women?

This health condition is more commonly heard in males. But it is a common cause of death in men and women. 

The incidence of stroke is 62.8 per 100,000 people in males and 59 per 100,000 in women. Males are more likely to suffer from this problem, but the difference is not dramatic.

We should also highlight that despite being more common in males, it is more lethal in women. Stroke causes death in 26.3% of cases in males and 39.2% of cases in women. 

This is a strikingly high level of mortality. It is also important to say that the incidence increases as we age. 75% of patients with stroke are 64 years or older (1).

doctor

Signs and symptoms of a stroke in women

Ischemic stroke symptoms in women are the same as the signs of a stroke in men. However, there is an essential element that makes a distinction. Women usually experience more subtle symptoms.

Between a man and a woman with a stroke of the same severity in the same area, the woman is more likely to overlook the problem. 

That’s not because women neglect their stroke symptoms. It is because they might not be as noticeable. But the brain damage and consequences are the same, sometimes more lethal in women, as noted above.

The main signs and symptoms of the disease depend on the area of the brain affected by stroke. They may include (2):

Numbness or weakness in some body parts

This is perhaps one of the most prevalent symptoms. It causes the classic face to droop on one side of the body.

Difficulty walking

Patients may have weakness in one of the legs. They may also feel dizzy and experience a sudden loss of balance. 

Severe headache

The onset of headaches is usually sudden and intense. In some cases, it can mimic a migraine headache, especially in women who repeatedly suffer migraines.

Vision problems

One side of the visual field or both can be compromised. It is not always a noticeable change because the other side makes up for the defect. 

Speech difficulty and other cognitive problems

Patients can also display speech problems. They are not only caused by muscle weakness in the tongue and mouth. The main reason is that the disease affects some parts of the brain that coordinate speech. 

Other functions can also be affected, causing cognitive impairment, unresponsiveness, and other symptoms.

What does a stroke feel like?

Based on the signs and symptoms listed above, you can figure out what a stroke feels like. In most cases, patients experience headaches and fatigue. 

They feel tired and weak and start noticing changes in their face muscles. If you ask them to smile, the changes in face movements become more noticeable.

There are also some unusual stroke symptoms and others that are not noticeable. For instance, some people may experience aphasia or unilateral neglect. The former causes communication problems. The latter affects attention to one side of the visual field but not the other. 

These stroke symptoms are more difficult to describe than muscle weakness or headache. Sometimes patients may not be completely aware of the changes and coordination problems they experience.

As mentioned above, signs and symptoms of stroke in a woman can be easily overlooked. Mini stroke symptoms in women can also arise in a transient ischemic attack. This episode lasts a few minutes. 

The problem is temporary, and stroke-like symptoms are not maintained for long. Thus, it is even easier to overlook.

That’s why in 2014, the American Heart Association issued a few guidelines specific to women. They should receive extra attention and prevention tips, especially if they suffer from cardiovascular disease (3).

Are there any warning signs before a stroke?

Can you find any warning signs of a stroke in a woman? The most important warning signs are those listed above. They can only be evaluated after a stroke happens.

Stroke has sudden and unexpected symptoms because your brain can be affected only a few minutes after cutting the blood flow. 

You can’t predict when something like this is about to come, and there are no signs of a stroke before it happens.

What you can do is evaluate your cardiovascular risk. For example, you can run a study to assess atherosclerosis in the blood.

You can check your blood pressure regularly and pay special attention to it when pregnant. You can also rule out atrial fibrillation. Doing so would help you catch the problem before it happens (3).

What causes a stroke?

Depending on the cause of the stroke, it can be divided into ischemic or hemorrhagic.

Causes of ischemic stroke are usually related to atherosclerosis or clotting problems. A blood clot travels through the bloodstream and clogs the brain arteries. Blood vessel spasms can also lead to a transient stroke when the vessel lumen reduces temporarily.

Hemorrhagic stroke causes usually involve high blood pressure, coagulation problems, or arterial malformations in the brain.

Causes of a stroke in a woman show no difference, but women have a slightly higher risk. They have additional risk factors, as we will review below.

Risk factors of a stroke

Stroke risk factors are also similar in men and women. But the latter have more of them.

These risk factors are common for men and women (2):

  • Age: Brain stroke is more prevalent as we grow older
  • Arrhythmia: Patients with atrial fibrillation create more blood clots. They are more likely to travel and clog the brain arteries.
  • High blood pressure: When uncontrolled, hypertension strains and sometimes ruptures the blood vessels.

These additional risk factors are only found in women (4):

  • Preeclampsia: It features high blood pressure during pregnancy. It increases a woman’s risk of a stroke.
  • Birth control pills: They can increase the risk of a stroke in women who smoke.
  • Migraines: In young women with migraines, it is recommended to stop smoking. The combination is apparently associated with a higher stroke risk.

How to help someone having a stroke

Knowing the most common stroke signs and symptoms will help you rapidly detect the problem. That’s the first step to help.

Follow the F.A.S.T. method to help someone with a stroke:

  • Face: Ask the person to smile and see if they display a facial droop.
  • Arms: Ask the person to raise their arms and see if one of them is weaker or immobile.
  • Speech: Ask the person to repeat a phrase after you and see if their speech sounds strange.
  • Time: If you suspect a stroke, call a health provider immediately. Keep around an emergency number at hand for these cases.

Treatment options

The treatment of a cerebral stroke needs close monitoring and observation. Thus, most patients will be held in the emergency room for hours or hospitalized. 

Instead of looking for home therapies, search promptly for medical help to get emergency treatment. It may include:

  • Anticoagulants: This is only in the case of ischemic stroke. The medications are closely monitored to avoid side effects.
  • Supportive treatment: It includes blood pressure management and everything required to keep the vital signs. It also includes pain medications in case it is needed.
  • Emergency endovascular procedure: In some cases, patients may need a surgical procedure.

After leaving the emergency room, your doctor will probably prescribe additional home care recommendations and treatment. Be attentive to any recommended lifestyle changes and attend physical therapy to recover faster.

Complications

Why is it so important to look for medical help right away? It’s because acute stroke side effects can be long-lasting and very severe. 

When the blood supply is cut for a long time, brain cells die and won’t be recovered. The affected area and its functions are lost.

Additional to the disability of losing cognitive, sensory, and motor function, being closely monitored will prevent these complications:

  • Brain edema
  • Pneumonia
  • Urinary tract infections
  • Seizures
  • Bedsores
  • Limb contractures
  • Deep venous thrombosis
  • Clinical depression

Outlook

Patients with a stroke can recover from this ailment, especially those with a transient ischemic attack. But when brain damage is extensive, the outlook is not very good. It depends on the portion of brain tissue affected by the disease.

The 1-year survival after a stroke is 77%. But the prognosis is worse in patients with diabetes, heart disease, and survivors of a previous stroke (5).

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How to reduce your risk of stroke

Stroke prevention strategies rely on screening high-risk patients, especially if they are females. 

Here is what the American Heart Association recommends (3):

  • Prescription of low-dose aspirin and calcium supplement in pregnant women with a history of high blood pressure.
  • Closer monitoring for pregnant women with moderate or severe high blood pressure.
  • Screening all women for hypertension before recommending birth control pills.
  • Quit smoking, especially in women with migraine headaches.
  • Screening for arrhythmia after the age of 75 years.

Conclusion

Stroke in females has the same signs and symptoms, but women are more likely to experience subtle symptoms. Thus, they do not always seek medical help, especially in the case of transient ischemic attacks. 

Stroke is more common in males but more lethal in females. They have additional risk factors men do not have. 

As such, women with hypertension and heart disease should start early prevention strategies to avoid stroke in later years.

There are no warning signs of an impending stroke because it is a sudden and unexpected episode. Thus, the best course of action is to reduce your cardiovascular risk by quitting smoke, eating healthily, and exercising as instructed by your doctor.

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Sources

  1. Towfighi, A., & Saver, J. L. (2011). Stroke declines from third to the fourth leading cause of death in the United States: historical perspective and challenges ahead. Stroke, 42(8), 2351-2355. https://pubmed.ncbi.nlm.nih.gov/21778445/ 
  2. Hui, C., Tadi, P., & Patti, L. (2022). Ischemic stroke. In StatPearls [Internet]. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK499997/ 
  3. Bushnell, C., McCullough, L. D., Awad, I. A., Chireau, M. V., Fedder, W. N., Furie, K. L., … & Walters, M. R. (2014). Guidelines for preventing stroke in women: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke, 45(5), 1545-1588. https://pubmed.ncbi.nlm.nih.gov/24503673/ 
  4. Demel, S. L., Kittner, S., Ley, S. H., McDermott, M., & Rexrode, K. M. (2018). Stroke risk factors unique to women. Stroke, 49(3), 518-523. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5909714/ 
  5. Adams, H. P., Davis, P. H., Leira, E. C., Chang, K. C., Bendixen, B. H., Clarke, W. R., … & Hansen, M. D. (1999). Baseline NIH Stroke Scale score strongly predicts outcome after stroke: a report of the Trial of Org 10172 in Acute Stroke Treatment (TOAST). Neurology, 53(1), 126-126. https://pubmed.ncbi.nlm.nih.gov/10408548/ 

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