7 Stroke Symptoms in Women

Traditional stroke symptoms are the same for women and men and can be remembered through the acronym F.A.S.T.: "F" for face drooping; "A" for arm weakness; "S" for speech difficulty; and "T" for time to call 911.

But women are more likely to have additional symptoms, including nausea, loss of consciousness or appearing confused.

Another fact that may not be well-known: Strokes are more common in women.

“Stroke can present in very different ways,” explains Felipe De Los Rios La Rosa, M.D., stroke program director at Baptist Health Miami Neuroscience Institute. “First of all, it's important to understand that it's a very common condition. One out of four women will have a stroke at some point in their lives, and one out of five people overall. It's very common.”

Women also are more likely to have migraines, which can double their risk of clot-caused strokes, according to a 2023 review of research in the Journal of Stroke. Migraines with aura are particularly associated with increased stroke risk and can include flashing lights or even a loss of vision, the study found. Such symptoms of migraine with aura, along with numbness or weakness, can overlap with stroke --  which can make the diagnosis more challenging and lead to possible delays in diagnosis.

Stroke Symptoms in Women

• Sudden weakness or numbness especially on one side of the body
• Confusion or trouble speaking
• Vision problems
• Dizziness or balance issues
• Severe headaches
• Shortness of breath
• Nausea or vomiting

Women Carry More Risk from High Blood Pressure

Guidelines from the American Heart Association and American College of Cardiology define high blood pressure as a systolic (top number) of 130 or higher or a diastolic (bottom number) of 80 or higher. A reading of less than 120/80 is considered normal.

Research has shown that a woman with a systolic blood pressure of 120 to 129 – a range defined as elevated blood pressure – has the same risk of stroke as a man with a systolic reading of 140 to 149.

The American Stroke Association (ASA) has issued the first update in ten years to its “better primary stroke prevention” guidelines that strongly emphasize improved screenings. They also include a broader focus on lifestyle changes such as better nutrition, weight management, being physically active and smoking cessation.

“The guidelines now also include more sex-specific recommendations for stroke prevention in women with a history of adverse pregnancy outcomes, those with endometriosis and early menopause,” explains Brian Snelling, M.D., stroke program director at Marcus Neuroscience Institute, part of Baptist Health Brain & Spine Care. 

According to the American Heart Association, higher stroke risk in women might be due to:

• Pregnancy –The risk of stroke in pregnant women is about 30 per 100,000, with the highest stroke risk during the third trimester and post-partum. Those with high blood pressure should be treated with medications and monitored closely.
• Preeclampsia – This is high blood pressure that develops during pregnancy. Preeclampsia may triple the risk of stroke later in life. If you have any history of high blood pressure, talk to your health care professional about taking low-dose aspirin starting in the second trimester.
• Birth control pills – Birth control pills have become much safer over time, but women who are already at risk of stroke should take extra precautions. Get screened for high blood pressure before the pill is prescribed. And never smoke while taking oral contraceptives.
• Hormone therapy–  When used in the initial years after menopause, hormone therapy may provide some cardiovascular benefits. However, using hormone therapy later in menopause does not appear to have a protective effect against coronary heart disease and stroke, and may raise a woman’s cardiovascular risks. Speak with your health care professional about whether hormone therapy is right for you.
• Migraines with aura – Migraine with aura is associated with ischemic stroke in younger women, particularly if they smoke or use oral contraceptives. Smokers with migraines accompanied by aura should quit immediately.
• Atrial fibrillation – This increases stroke risk among women over age 75 by 20 percent.

• F: Face drooping. One side of the face is drooping or numb, or the smile is uneven.
• A: Arm weakness. One arm is weak or numb. One arm may drift downward when both are lifted at the same time.
• S: Speech difficulty. Slurred speech, difficulty speaking, inability to repeat a simple sentence correctly when asked.
• T: Time to call 911. Call 911 immediately if you or a loved one experiences the above symptoms. If possible, write down when the symptoms first appeared so you can share this information with doctors.

Learn about stroke services at Baptist Health.

Felipe De Los Rios La Rosa, M.D., stroke program director at Baptist Health Miami Neuroscience Institute.

 

Brian Snelling, M.D., stroke program director at Marcus Neuroscience Institute at Boca Raton Regional Hospital, part of Baptist Health.