While women and men share many of the same risk factors for stroke, such as high blood pressure, diabetes, high cholesterol, family history and smoking, some factors put women at greater risk.

Migraines. Women are three times more likely than men to experience migraine headaches, a risk factor for stroke. When researchers at Johns Hopkins University gathered results from 21 separate studies involving 622,381 men and women, they found that those who experienced migraine headaches had a 2.3 times greater chance of ischemic stroke than did people who didn't get migraines. For men and women who reported experiencing aura along with migraines—seeing flashing lights, zigzag lines and blurred side vision—the risk of stroke was 2.5 times higher, and in women alone, 2.9 times higher. The results were published in 2010 in the American Journal of Medicine.

Hormone therapy. Hormone therapy may increase the risk of stroke and other cardiovascular disease in women older than 60 or in women who began estrogen use more than 10 years after their last menstrual period.

Atrial fibrillation. AF is a common form of rhythm disturbance that occurs when the upper chambers of the heart (atria) do not contract in a rhythmic pattern but instead quiver chaotically. The abnormal rhythm can cause a blood clot to form in the atria, then travel to a cerebral artery and cause a stroke.

A 2009 review in Gender Medicine found that women have a significantly higher risk of AF-related stroke than do men. The review suggested that treatment differences for AF in women were responsible for the higher risk level. For example, physicians are reluctant to use the anticoagulant drug warfarin because of a higher bleeding risk in women.

Aging. Before menopause, women have a significantly lower risk of stroke than do men. In menopause, estrogen levels drop substantially and low-density lipoprotein (LDL) cholesterol levels begin to rise, which spurs along the process of atherosclerosis, the gradual buildup of plaques that narrows arteries and can lead to ischemic strokes.

Although stroke can occur at any age, aging is a significant risk factor—for both sexes. The risk doubles every 10 years after age 55 for both men and women. Two-thirds of all strokes occur after age 65. Because women tend to live longer than men, this may account for the fact that more women experience stroke, and die of it, than men do.

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

Published: 15 Jul 2013

Last Modified: 06 Oct 2015