Warning signs aren't always the same as in men

You may have heard that heart attack symptoms can be different for a woman than for a man, but did you know that the same holds true for stroke?

Given that women make up more than half of the nearly 700,000 Americans who annually experience a first or second stroke—and that women are more likely than men to die as a result of stroke—it's crucial to recognize the different ways that stroke may present in a woman.

A 2011 study in the journal Gender Medicine examined 449 cases of first ischemic stroke (the most common type, caused by a blood clot), 60 percent of which involved female patients. Researchers found that women most commonly experienced symptoms of generalized weakness, fatigue, disorientation and mental status change. Men, in contrast, most commonly experienced paresthesia (numbness or tingling), ataxia (loss of muscle coordination) and double vision.

The study findings don't account for all the gender differences in symptoms. Women who are having a stroke may also experience sudden onsets of:

  • shortness of breath
  • face, arm or leg pain
  • hiccups
  • nausea
  • chest pain
  • heart palpitations

Awareness is lacking

Unfortunately, many women aren't aware of the non-traditional symptoms that may signal a stroke. Nor are they familiar with even the classic warning signs, which are the same for both sexes.

A study in the journal Stroke in 2009 reported that while a majority of women surveyed could identify speaking problems, weakness and numbness as warning signs, only about one in three knew that vision changes, dizziness and problems of balance, headache and confusion also signaled stroke.

And when it came to identifying risk factors for stroke, only 3.3 percent of the women surveyed knew that atrial fibrillation (AF) makes women with this heart rhythm irregularity especially vulnerable to ischemic stroke. Even more worrisome was that the 215 women who participated in the survey, ranging in age from 50 to 73, all had at least one risk factor for stroke—which they often did not identify as actually placing them at risk.

What this means is that essential treatment could be delayed because a woman may not realize she is having a stroke and needs immediate medical assistance. Understanding the risk factors and treatment for stroke specific to women may help save lives and reduce or prevent permanent disability.

Publication Review By: Lawrence Appel, M.D., and Rafael H. Llinas, M.D.

Published: 16 Jul 2013

Last Modified: 16 Jul 2013