A Woman’s Risk

Understanding the stroke dangers unique to females

Odds that a man or woman will experience a stroke double after age 55 for each additional decade lived. American women live longer than men: on average, 81 years versus 76 years. But these two facts only partly explain why women are more likely than men to experience a stroke—and to die from it.

The first guidelines for preventing stroke in women, published in 2014 by the American Heart Association/American Stroke Association, address women’s unique risks.

“The big (risks) are things that only affect women,” says Louise McCullough, MD, PhD, a neurologist and co-author of the guidelines. “One of those is pregnancy. But there also are things more common in women than in men.”

Smoking is a stroke risk for both sexes, “but if you’re a woman who smokes and uses birth control, that’s like waving a red flag,” McCullough says.
Prevention is especially crucial because women are one-third more likely to require nursing home care after a stroke, she says.

“A lot of that is age, because they’re having strokes five years later than men,” she says. “Some also may be widowed and not have anybody to go home to, so even if they have minimal disabilities, they end up in nursing homes.”
Women should be aware of these stroke risks:

Stroke risks unique to women:

  • Pregnancy, preeclampsia, gestational diabetes
  • Oral contraceptive use, postmenopausal hormone use 

Stroke risks stronger or more prevalent in women:

  • Migraine headache with aura
  • Atrial fibrillation
  • Diabetes
  • Hypertension
  • Depression
  • Psychosocial stress

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