Gender Puts Women More at Risk for Stroke

Melissa Ojeda will always remember the day of Nov. 4, 2017. After attending a bike rally in Galveston, Texas, Melissa and her husband joined up with some friends for a post-rally get-together. Periodically throughout the evening, Melissa’s friends asked if she was alright, because her drink was spilling out of the side of her mouth. Melissa assured everyone that she was fine, even though she started to slur her speech and developed a visible facial droop.

Melissa’s husband rushed her to the local hospital once she became mute and lethargic, where it was confirmed that Melissa had suffered a stroke. Melissa reports a two-day memory loss after the gathering.

In the battle of the sexes, here’s one that women like Melissa – often unknowingly – take the lead in: About 55,000 more women than men have strokes every year. Strokes kill more women than men annually, making it the #3 leading cause of death in women. In Texas, 48,103 women have suffered from strokes in the past eight years according to the Texas Department of State Health Services, 2017 Annual Report.

After a week of inpatient care, Melissa was admitted to Mesquite Rehabilitation Institute, where she actually serves as the Regional Operations Assistant. “I make my living helping those who need rehabilitative care,” she says. “I never thought I would need it myself.”

Prior to her stroke, 44-year-old Melissa was extremely active. She had participated in multiple 5K runs and a half-marathon, making the stroke even more surprising to her.

Gender misconception about strokes is common, according to Dr. Adam Carter, Medical Director of Mesquite Rehabilitation Institute. “Most people don’t realize that women suffer strokes more frequently than men,” he says. “If you’re a woman, you share a lot of the same risk factors for strokes as a man does, but a woman’s risk is also influenced by hormones, reproductive health, pregnancy, childbirth and other gender-related factors.”

For example, birth control pills may double the risk of stroke, especially in women with high blood pressure or who smoke. And, according to the American Heart Association, hormone replacement therapy – once thought to reduce stroke risk – in fact, actually increases it.

A recent study shared through the National Stroke Association listed the following factors to have been found to increase stroke risk in women:

  • Menstruation before the age of 10
  • Menopause before the age of 45
  • Low levels of the hormone dehydroepiandrosterone (DHEAS)
  • Taking oral estrogen or combined oral contraceptives

The study also showed that a history of pregnancy complications can also indicate higher stroke risk. These problems include gestational diabetes and high blood pressure during or immediately after pregnancy.

“Add this to other general risk factors for stroke like family history, high blood pressure, diabetes, high cholesterol, smoking, lack of exercise, and being overweight – and it becomes clearer as to why women can be more at risk for stroke than men,” Carter says.

Melissa spent three weeks in rehabilitative care receiving physical, occupational, and speech therapy. “I’ve always been complimented on my smile,” she says.  “I believe that a friendly smile can make a big impact in someone’s life. So after my stroke, I became very fearful that I would forever lose my smile. But thanks to my therapists, I now have my beautiful smile back, along with my confidence.”

With the continual support of her family, friends, and her rehabilitation team, Melissa has regained a great deal of her independence and has even returned to work part-time. “I’m incredibly thankful for everything the staff has done for me,” she says. “It’s truly a different experience to actually be a patient.”

Melissa says that because of her stroke, she has a new understanding of what it means to work in rehabilitative care. “I now have the entire experience, from staff to patient,” she says. Melissa now encourages others, especially her female friends, to be knowledgeable about stroke factors and prevention. She also empathizes with other stroke victims, reminding them that progress takes time and encouraging them to never give up.

“Whatever stage of life a woman is in, it’s important that she be aware of all the risk factors of stroke,” Carter says. “As it’s often said, ‘knowledge is power.’ And in this case, the more knowledgeable a woman is about her stroke risk factors, the more she’ll be able to understand how she can be affected and work with her physician or healthcare provider as appropriate to reduce them.”