Stroke in Women: Causes, Risk Factors, and Warning Signs
Neurological DisordersStroke
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What Causes Stroke in Women?

What Causes Stroke in Women?
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Updated on May 12, 2025
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Strokes are caused by a disruption in the blood supply to the brain, either because of a blocked artery in the brain, or because of bleeding from a blood vessel in the brain.

The risk factors that make a stroke more likely are largely the same for women as for men: high blood pressure, atrial fibrillation (irregular heartbeat), obesity, lack of physical activity, poor diet, and smoking.

But women have risk factors for stroke that men don’t, including the onset of menopause and, for some women, pregnancy complications and the use of oral contraceptives.

Women are also more likely than men to have autoimmune conditions, some of which raise the risk of stroke.

Here’s what to know about risk factors in women, how to reduce your chances of having a stroke, and the signs and symptoms of stroke that warrant immediate medical attention.

Types of Stroke

There are two types of strokes.

  • Ischemic stroke: This type of stroke occurs when a blood clot or a fatty deposit blocks an artery leading to the brain, reducing or completely stopping the blood flow. It is the most common type of stroke; approximately 85 percent of all strokes are classified as ischemic.

  • Hemorrhagic stroke: A hemorrhagic stroke occurs when a blood vessel in the brain bursts, leading to bleeding in or around the brain.

Stroke Causes and Specific Risk Factors in Women

Many stroke risk factors are common to both men and women, but certain risks are unique to or at least more common in women.

In 2024, the American Heart Association and the American Stroke Association released amended guidelines and screening recommendations for women, specifically for those who:

  • Have been diagnosed with endometriosis
  • Experienced menopause before age 45
  • Experienced hypertension during their pregnancies
  • Lost ovarian function before age 40

The association recommends that healthcare providers screen for these conditions as part of their evaluation of a woman’s risk for stroke.

Estrogen

The estrogen naturally produced in the body has a protective effect on cardiovascular health, including on stroke risk.

But when estrogen is taken in oral contraceptives, as part of postmenopausal hormone therapy, or for any other reason, it increases the clotting factors in blood, which can increase the risk of an ischemic stroke. While for most women the use of oral contraceptives containing estrogen is safe, those who have migraine with aura, are older than 35, smoke cigarettes, or have other stroke risk factors, may be at higher risk for stroke and should discuss the safety of using oral contraceptives with their doctor.

In postmenopausal women, the normal drop in estrogen levels is associated with a rise in cardiovascular risk, including risk for stroke.

Pregnancy

Pregnant women are three times more likely than women of the same age who are not pregnant to have a stroke, because of the increased risk of high blood pressure and blood clots during pregnancy.

Serious complications of pregnancy, gestational diabetes and preeclampsia — which causes severe high blood pressure — also raise stroke risk significantly.

Autoimmune Conditions

Autoimmune diseases disproportionately affect women, and some of those diseases can increase stroke risk, due to the fact that they cause inflammation, which in turn causes plaque buildup in the arteries, narrowing blood vessels and blocking blood flow. Some conditions may also increase the risk of blood clots.

Autoimmune conditions that can raise the risk of stroke include:

Migraine With Aura

Migraine is another condition that affects more women than men, and migraine with aura, in particular, is associated with a slightly higher risk of stroke, although scientists do not know exactly why.

Experts recommend that women who have migraine with aura make an effort to lower any other stroke risk factors they may have, including smoking, high blood pressure, and obesity.

Race

Race may raise stroke risk for some women.

Research has shown that Black women may be at a higher risk of stroke than white women of the same age. In a recent study, Black women who were diagnosed with high blood pressure before the age of 45 had twice the risk of stroke. Additionally, the findings showed that Black women with high blood pressure before age 35 had three times the risk of a stroke.

Perspectives
Portrait of a person
Jayme Kelly
Stroke Survivor
"I didn't know I was having a stroke because I didn't fit into any of the risk factors for having one."
Transcript Available

Are Strokes More Common in Women Than Men?

Stroke is more common in women than men in the United States: Around 55,000 more women than men have a stroke each year, and it’s the third leading cause of death for women in the United States, killing more than 90,000 women per year.

Age at Stroke

One reason women may have more strokes than men is that women typically live longer than men, and the risk of having a stroke increases with age. Women also tend to experience strokes at an older age than men, which may contribute to the higher mortality rate seen in women.

One study found that young women who survived an ischemic stroke tended to have far worse functional outcomes than men, so age may not be the only factor influencing stroke severity in women.

“Strokes still occur more often in older folks,” says Jennifer Wong, MD, a cardiologist and the medical director of noninvasive cardiology at MemorialCare Heart and Vascular Institute at Orange Coast Medical Center in Fountain Valley, California, “but we are seeing strokes occur at younger ages more often than previous years.”

Post-Stroke Outcomes

A stroke is life-changing, and women are more likely than men to experience severe disability following a stroke. According to one study, the post-stroke care women received in and out of the hospital may account for the increased disability and lower quality of life.

“Unfortunately, research has shown us that women tend to have a higher mortality rate and worse post-stroke outcomes than men,” says Hera A. Kamdar, MBBS, an assistant professor in the department of neurology at Wexner Medical Center in Columbus, Ohio.

“Some reasons for this are that women may have atypical stroke symptoms, which can lead to delayed recognition and treatment; and women, particularly younger women, are more likely to be misdiagnosed given atypical clinical presentations,” Dr. Kamdar says.

Warning Signs of Stroke in Women

Common warning signs of a stroke can best be remembered using the BE FAST acronym:

  • Balance Do you feel wobbly or unsteady on your feet?
  • Eyes Are you seeing double or experiencing blurry vision?
  • Face Does one side of your face droop? Or is your smile lopsided?
  • Arms Do your arms or legs feel weak or numb?
  • Speech Are you having difficulty speaking or understanding those around you?
  • Time Call 911 or emergency services if any of these symptoms occur.

These aren’t the only signs of stroke, however. Women in particular may experience some different signs and symptoms.

“Women tend to have more vague symptoms such as generalized weakness or confusion,” Dr. Wong says. “Women also have reported other unusual symptoms such as facial pain, hiccups, and nausea.”

Less common signs and symptoms of a stroke that women shouldn’t ignore include:

  • Sudden severe headache
  • Confusion or disorientation
  • General weakness (as opposed to only on one side)
  • Nausea or vomiting

These less typical symptoms may often be attributed to other conditions, such as stress, viral illnesses, or exhaustion. But any sudden symptom or loss of function should raise concerns and prompt an individual to seek immediate medical help.

The Takeaway

  • Women have many of the same risk factors for stroke as men but also have some additional risk factors.
  • Pregnancy complications, autoimmune diseases, and migraine with aura can increase a woman's stroke risk.
  • Women are more likely than men to have atypical signs and symptoms of stroke, and those may be overlooked in the ER.
  • A stroke can be life-changing. Talk to your doctor about your personal risk factors and what you can do to lower your risk.
Additional reporting by Christina Frank.
EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
  1. Stroke: Causes and Risk Factors. National Heart, Lung, and Blood Institute.
  2. Brown RD. What Is a Stroke? A Mayo Clinic Expert Explains. Mayo Clinic. 2022.
  3. What Is Hemorrhagic Stroke? American Stroke Association.
  4. Bushnell C et al. 2024 Guideline for the Primary Prevention of Stroke: A Guideline From the American Heart Association/American Stroke Association. Stroke. October 21, 2024.
  5. How Estrogen Supports Heart Health. Cleveland Clinic. February 6, 2024.
  6. Abou-Ismail MY et al. Estrogen and Thrombosis: a Bench to Bedside Review. Thrombosis Research. August 1, 2021.
  7. Women and Risk of Stroke Infographic. American Heart Association.
  8. About Pregnancy and Stroke. Centers for Disease Control and Prevention.
  9. Øie LR et al. Migraine and risk of stroke. Journal of Neurology, Neurosurgery & Psychiatry. March 26, 2020.
  10. Migraine and Stroke Risk. American Migraine Foundation. November 1, 2024.
  11. Aparicio HJ et al. Abstract 101: Early Onset Hypertension Increases Risk of Midlife Stroke Among Black Women. American Heart Association. February 1, 2024.
  12. Rexrode KM et al. The Impact of Sex and Gender on Stroke. Circulation Research. February 17, 2022.
  13. Women ages 35 and younger are 44% more likely to have an ischemic stroke than male peers. American Heart Association. January 24, 2022.
  14. Carcel C et al. Sex differences in treatment and outcome after stroke: Pooled analysis including 19,000 participants. Neurology. December 10, 2019.
  15. Signs of a Stroke: Act Quickly with ‘BEFAST’. Cleveland Clinic. January 15, 2025.
  16. Is it fatigue — or a stroke? Women shouldn’t ignore these warning signs. American Heart Association. May 31, 2019.
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David Weisman, MD

Medical Reviewer

David Weisman, MD, is the director of the Clinical Trial Center at Abington Neurological Associates in Pennsylvania, where he has conducted numerous clinical trials into mild cognitive impairment and Alzheimer’s disease to develop disease-modifying drugs.

Dr. Weisman has dedicated his research career toward advancing new therapies for Alzheimer’s disease, focusing on clinical trials for the prevention and treatment of Alzheimer’s disease, mild cognitive impairment, and other dementias, and he devotes his clinical practice to memory and cognitive problems.

He received a bachelor's degree in philosophy from Franklin and Marshall College, then an MD from Penn State College of Medicine. After an internship at St. Mary’s Hospital in San Francisco, he completed his neurology residency at Yale, where he served as chief resident. He then went to the University California in San Diego for fellowship training in Alzheimer’s disease and other dementias.

Weisman has published papers and studies in journals such as Neurology, JAMA Neurology, Stroke, and The New England Journal of Medicine, among others.

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Alex Frost is a Cincinnati-based journalist who specializes in health, wellness, parenting, and lifestyle writing. Her work has been published by the Washington Post, The Atlantic, Healthline, Health, the Huffington Post, Glamour, and Popular Science, among others.

Alex is also the founder of an editorial marketing agency that offers brand strategy and content collaboration across platforms and projects, and she works as an educator and writing coach to journalists and freelancers at all stages of their careers.

She received a bachelor's degree in mass communications and journalism and a master's degree in teaching. In her free time, she enjoys spending time with her five kids in their various activities, and camping.

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