Factors that increase stroke in women

For women, the risk for stroke can increase as you manage heart conditions and or during your pregnancy journey. “One in five women will have a stroke, it's the No. 3 killer of women each year,” said Grace Gearhart, DO, a family medicine provider who specializes in obstetrics at Ascension Medical Group Via Christi on East Central. “Pregnancy, preeclampsia and birth control all contribute to increased risk of stroke.”

Women are most at risk for an embolic ischemic stroke. Medications and health conditions increase the risk of a clot forming, which may travel to the brain and cause a blockage. Ischemic strokes are accountable for more than 85% of all strokes.

Hemorrhagic strokes are a less common type of stroke, usually caused by uncontrolled high blood pressure. It’s also possible to experience a “mini stroke” or a transient ischemic attack (TIA). It’s a temporary blockage that can appear with stroke-like symptoms and can be a warning that a larger stroke may happen in the future.

Knowing the risk factors and the signs for stroke can help you seek out care when you need it. Dr. Gearhart breaks down how your stroke risk is affected and what you can do about it.

Reproductive health risks

Up to 12% of pregnancies are affected by high blood pressure, which can increase the risk of a stroke.

Preeclampsia is a more severe high blood pressure. It can cause:

• Headaches
• Low birth weight
• Premature delivery
• Swelling of the hands and face
• Vision issues

Blood pressure can go back to normal after giving birth, which is when the risk for a stroke can be at its highest. Stroke is most common in the peripartum (the time before, during, and after birth) and postpartum, which is (first six to eight weeks after childbirth) periods.

A stroke is most likely to happen in the last month before delivery and in the first six weeks after giving birth. Do prenatal check-ups and don’t miss important dates, listen to your body and know the signs of a stroke.

Oral contraceptives also warn about side effects like an increased risk of blood clots, high blood pressure, and other side effects. Oral contraceptives with more estrogen can affect the blood-clotting proteins. It can make your blood too thin or thick. When blood is too thick, a clot can more easily form somewhere in the body. It can then travel to your brain and cause a blockage, which is an embolic ischemic stroke.

Hormone replacement therapy

It’s been proven that hormone replacement therapy (HRT) doesn’t lower the risk of a stroke. When women are postmenopausal, which starts 12 months after her final menstrual period, estrogen production from the ovaries is decreased noticeably.

This time can come with symptoms like hot flashes or night sweats, for which women have used HRT to treat. The risk for an ischemic stroke, a stroke caused by a blockage of blood flow to the brain, increases when a woman begins HRT after a decade or longer of the start of her menopause.

If you want to use HRT, do it with as little of a dose as possible for the shortest time possible. Stay committed to your wellness checks and schedule an appointment when you don’t feel well or notice changes.

Migraines with aura and smoking

Migraine with aura can increase the risk of stroke already, and smoking significantly elevates that risk further.

A migraine with aura is a classic migraine, which is joined with sensory disturbances called aura. This can be:

• Difficulty speaking
• Numbness
• Seeing flashing or brighter lights
• Tingling
• Vision changes

If these occur, you are nearly two times as likely to have an ischaemic stroke in your lifetime compared to those without migraine. Smoking is what increases your likelihood of stroke significantly.

If you have migraines, your care team can help you with your lifestyle risks to help lower the risk. It is especially important to quit smoking and using tobacco products, since these can narrow your arteries, raise your blood pressure and increase blood clotting, which leads to stroke.

Atrial fibrillation

If you have a heart beat that is too slow, fast or irregular, chances are you could have atrial fibrillation, or AFib.

As you get older, your risk can increase. It can also increase from thyroid disease, sleep apnea and other lifestyle choices, like smoking.

Heart valve disease and high blood pressure more often leads to AFib in women. It can feel like a racing heart, flutters or skipped beats called palpitations, shortness of breast or chest pain. Women experience less-common symptoms like fatigue and weakness. This can also make strokes more severe than men.

The heart rhythm irregularity can form blood clots in the heart, which can increase the risk of stroke and heart-related complications if it is not treated.

Remember, this diagnosis can be managed with proper treatment. Give yourself the care of paying attention to any symptoms and don’t delay help if you notice anything unusual.

B.E. F.A.S.T. when you notice a stroke

If you have any known risk factor for stroke, it’s important to remember the signs of a stroke with the acronym “B.E. F.A.S.T.”

This means watching for:

• Balance changes or loss of balance
• Eyes and vision changes
• Face drooping or numbness
• Arm weakness
• Speech that is slurred
• Time, get help immediately

The best thing to do when you’re having a stroke is to call 9-1-1 and get help right away.

The risk of stroke can be managed

You can reduce the risk of stroke with small changes to your daily routine.

Reduce your blood pressure and weight by limiting your salt, calorie and cholesterol intake. You can also try to increase the amount of vegetables, fruits, fish, whole grains and low-fat dairy to help with your diet goals. Pair better eating with getting 30 minutes or more of exercise five days a week like walking, golf or biking and incorporating activity every day.

If you are a smoker, quitting can help significantly reduce your risk of stroke and other health issues. If you have AFib or diabetes, it’s important to collaborate with your doctor to treat and maintain your condition with regular follow-ups.

Taking care of your health is something that women often put off, so making time for checkups and monitoring any changes is so important. You know your body and, even though it can be scary, be sure to advocate for yourself when something changes. Ask for tests, labs, monitoring and whatever else is necessary to help avoid a stroke and other major health issues.

Comprehensive stroke care in Wichita

From emergency surgeries, radiography and clot-busting medication administration, the Comprehensive Stroke Center at Via Christi St. Francis works to provide emergency care for stroke patients. Our team continues your care through its neurocritical care unit through recovery using physical, occupational and speech therapies, case management and collaboration for follow-up care at the Via Christi Outpatient Stroke Clinic.