Why symptoms are different
PR Image Factory/ShutterstockIf you're at risk for a stroke, one acronym could save your life: FAST, developed by the American Stroke Association (ASA), which stands for face drooping, arm weakness, speech difficulty, and time to call 911. But these aren't the only or even most obvious stroke symptoms in women, says Cheryl Bushnell, MD, professor of neurology at Wake Forest Baptist Medical Center. "We have no idea why the stroke symptoms might be different for women. We need research on this topic." Women also have unique risk factors—their hormones can play a role—making stroke the third leading cause of death in women.
Fainting or seizures
Nutlegal Photographer/ShutterstockYou might be tempted to minimize a fainting spell, but it could be a stroke: Women tend to suffer strokes to the back of the brain more often than men, says Diana Greene-Chandos MD, FNCS, assistant professor of neurosurgery and neurology at The Ohio State University Wexner Medical Center. Known as posterior circulation strokes, they cut off "blood flow to the occipital lobes, brainstem, cerebellum, and part of the temporal lobe. The top of the brainstem is where the consciousness center lies," Dr. Greene-Chandos says, and cutting blood flow to this part of the brain can lead to fainting. She notes, however, that fainting "could also be related to a hyperventilation response to any type of stroke, as a fear response," and that seizures, another of the stroke symptoms in women, can also be confused with a loss of consciousness. Make sure you know these seven signs of stroke you might be ignoring.
Dan Kosmayer/ShutterstockAlthough women would think chest pain and shortness of breath are signs of a heart attack, it could be a stroke. "This is consistent again with posterior circulation problems from the bottom of the brainstem where the respiratory drive centers lie," says Dr. Greene-Chandos. Early recognition of stroke signs is crucial, says Kathryn Rexrode, MD, chief of the Division of Women's Health, Brigham and Women's Hospital. "It is important to get prompt emergency care if you are experiencing stroke symptoms since some strokes can be stopped by use of thrombolytic, or clot-busting, drugs," she adds.
leungchopan/ShutterstockAccording to a survey from Dr. Greene-Chandos and colleagues at The Ohio State University Wexner Medical Center, only ten percent of women surveyed knew that hiccups, combined with atypical chest pain, are among the early stroke symptoms in women. "Hiccups are consistent with posterior circulation problems from the brainstem," Dr. Greene-Chandos says. "The brainstem holds swallowing and the drive to breathe," along with other functions. Find out more things your hiccups are trying to say about your health.
Sudden behavioral changes or agitation
Prostock-studio/ShutterstockWomen are half as likely to report a non-traditional stroke symptom compared to men, according to findings from the University of Michigan; the most common of these symptoms was a shift in a woman's mental state. Dr. Greene-Chandos believes this could be consistent with a posterior circulation stroke, which could target areas responsible for memory and personality. However, the frontal lobe is also tied to personality, so behavior changes "could be due to a frontal lobe stroke as well," she says.
Nausea or vomiting
Africa Studio/ShutterstockA stroke in the cerebellum can also lead to dizziness, nausea, and vomiting, Dr. Greene-Chandos says. "This is consistent with posterior circulation problems from either the brainstem or the cerebellum." It can also be seen in intracranial hemorrhage-type of strokes as well, she says, in which a bulging blood vessel (an aneurysm) bursts and causes bleeding into the brain. These are the scary signs of a brain aneurysm everyone should know.
altanaka/ShutterstockWhile changes in your vision are a relatively common sign, according to the National Stroke Association, women's visual symptoms may include hallucinations. Your occipital lobes—"the powerhouse of interpretation of visual input," Dr. Greene-Chandos says—can be damaged by posterior circulation problems.
Taking birth control pills or HRT
Andrey_Popov/ShutterstockIn Dr. Greene-Chandos' study, only 11 percent of women surveyed knew that taking hormones like the birth control pills or hormone replacement therapy (HRT) could raise stroke risk. According to the American Stroke Association, the pill can double your chances of having a stroke. New research by Dr. Rexrode looked at why these hormonal treatments are problematic. "Oral estrogens tend to increase clotting factors made by the liver, leading to higher risk of blood clots," Dr. Rexrode says. Some women also see their blood pressure rise on oral contraceptive pills. Your doctor should take your blood pressure before prescribing the pills and watch for changes. If you already have high blood pressure, make sure to tell your doctor before taking the pill or HRT.
Early menopause or early menstruation
Daisy Daisy/ShutterstockStarting either one of these life changes ahead of schedule can alter a woman's risk, according to Dr. Rexrode's research. Starting menstruation before ten years of age or menopause before a woman turns 45 can put her at higher risk of a stroke. "During the years that woman is menstruating, she produces higher levels of estrogen and other hormones," Dr. Rexrode says, and it may be that the shortened exposure to these hormones bumps up risk—though researchers are still searching for the reason. You might be able to lower your stroke risk by eating this one food every day.
Some pregnancy complications
Narong Jongsirikul/ShutterstockPreeclampsia—dangerously high blood pressure during pregnancy—can raise your stroke risk later on in life. (These are the silent signs of preeclampsia every woman should know.) So can the pregnancy complication of gestational diabetes. Preeclampsia is a sign of stress on the circulatory system, and it can predict the risk of developing high blood pressure later in life, explains Dr. Bushnell. "Also, gestational diabetes is associated with an increased risk of diabetes—both hypertension and diabetes are very important stroke risk factors." That's why the ASA's new stroke guidelines for women, authored by Dr. Bushnell, recommend that doctors consider a patient's health during pregnancy. Dr. Rexrode notes that pregnancy itself also boosts stroke risk.