Stroke may have unusual symptoms in women. Find out how you recognize them so you can take action.
Defined as a "short episode of neurological dysfunction following focal or retinal ischemia, whose clinical symptoms last less than one hour without acute stroke," the transient ischemic event is a serious medical problem, the risk of the occurrence of a stroke being very high (20%) in the first 48 hours. A transient ischemic stroke (AIT) precedes, most often with 48 hours, the occurrence of a stroke. It is therefore a diagnostic and therapeutic emergency, providing a unique opportunity to apply appropriate treatments that reduce the risk of developing an established stroke.
Symptoms of AVC or AIT
- Visual issues
- Difficulties in speaking
- Difficulty to understand even simple things
- Issues of balance or gait
- Tingling, numbness
- Failure to move limbs or facial muscles
When women have a stroke, there may be other symptoms different from those of classical ones.
- Shortness of breath
- Chest pressure or chest pain
- Rapid or irregular heart beats
Women with high risk of stroke
One in five women will suffer a stroke at a given point in time (statistical data is valid for the US).
Hypertension is the most important risk factor in the occurrence of stroke that can be altered by both women and men. There are several important differences between the two sexes in terms of prevalence, pathophysiology and treatment of hypertension.
Numerous studies have shown that women have normal blood pressure values over most of their life compared to men, but this changes with aging. Given the increase in the incidence of high blood pressure compared to men after the age of 55, it is believed that an important role is played by hormones, given that women are already at menopause at this age.
However, there were no differences in the efficacy of the specific drug classes used in the treatment of hypertension between the two sexes. Although the number of women undergoing treatment to lower blood pressure is higher for men than we refer to the total number of cases, there is no superior treatment response and these results could be explained by the complexity of the physiological mechanisms underlying hypertension in women (hyperactivation of the renin-angiotensin-aldosterone system, arterial rigidity, treatment compliance, etc.).
Differences between the two sexes in the regulation of blood pressure are complex due to the role that ovarian hormones have it in the regulation of blood pressure.
Three out of 10,000 pregnant women will suffer stroke during pregnancy compared to 2 out of 10,000 young women who are not pregnant. Physiological changes occurring in pregnancy, especially vascular stasis, edema and hypercoagulability caused by activated protein C resistance, low protein S levels, and high fibrinogen levels make pregnancy and post-partum a period of increased risk of developing a stroke.
Pregnancy related hypertension is the major cause of hemorrhagic and ischemic stroke in pregnant and postpartum women and the risk is particularly high in women prone to develop preeclampsia. In the latter case, treatment with aspirin may be indicated starting with the second trimester (12th week of pregnancy) to lower the risk of preeclampsia.
Regarding treatment with birth control pills this could double the risk of stroke. Thorough blood pressure control is recommended before starting a pill-based treatment. Smoking is contraindicated in association with such treatment as the risk of stroke is significant, as many studies have shown.
Contrary to previous recommendations, hormonal therapy in menopause increases the risk of stroke and is no longer recommended for primary or secondary prevention. However, in some cases, the risk of stroke is inferior to the benefits, and the decision to start hormone replacement therapy should be taken after a discussion with your gynecologist.
Since 2014, the American Heart Association and American Stroke Association have highlighted the increase in stroke incidence among women suffering from migraine. Combining smoking and the use of birth control pills increases the risk of stroke. A special case is however menstrual migraine for which the benefit of hormonal treatment may outweigh the risk of stroke, and the decision to treat it should be taken after a multidisciplinary consultation with the neurologist and gynecologist.
Atrial fibrillation increases the risk of stroke among women by 4 times and is more common among women than men over 75 years of age. The simplest method of prevention is the early detection of this arrhythmia and the introduction of anticoagulant treatment taking into account the risks and benefits of such treatment.