While 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
In 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
Starting 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.
Preeclampsia—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.
Unfortunately, unsuccessful pregnancies may also be a predictor of stroke risk, if the miscarriages were due to a clotting disorder, according to the American Stroke Association. “The clotting factors increase the risk of developing clots in the heart or in the blood vessels of the brain, both of which can lead to stroke,” Dr. Bushnell says. Another sign of a clotting disorder is a history of clots in the legs, also called deep vein thrombosis (DVT). Make sure you know all of the silent blood clot symptoms to look out for.