Stroke kills more women in France than breast cancer

In France, stroke kills more women than breast cancer, with around 18,000 annual deaths from stroke compared to 12,000 from breast cancer, according to Santé publique France. Women are more affected than men after the age of 75, and the disease does not affect both sexes at the same age.

Women face higher stroke risks and delays in care

Overall, more women die from stroke and are more often left with severe disabilities. However, women still delay calling emergency services when they first notice symptoms. "There is a sociological factor: women tend to prioritize family life over their health," said a practitioner. "With a stroke, every minute lost means two million neurons lost and kilometers of brain wiring lost."

Hormonal factors increase stroke risk in women

Three hormonal factors in women's lives—use of the pill, pregnancy, and menopause—contribute to stroke risk. In addition to the usual risk factors shared with men (high blood pressure, diabetes, smoking), women have vulnerabilities associated with hormonal changes.

Hormonal risks and medical warnings

The pill: "It is really important to be careful when prescribing the estrogen-progestin or combined pill to a woman who smokes or has migraines with aura," warned a neurologist. She recalled the available alternatives: "The intrauterine device, even if it is impregnated with progestins, is possible. Pure progestins, either the microprogestin pill or subcutaneous implants, are also possible."

Pregnancy and menopause as risk factors

Pregnancy: "During pregnancy, gestational hypertension can develop, which can trigger preeclampsia. This increases the risk of stroke during pregnancy and the days that follow, but also throughout her life after." Pregnancy also promotes weight gain and diabetes. Menopause: "This is also a key stage due to the decrease in estrogen and the change in metabolic profile. Weight gain increases blood pressure, bad cholesterol increases, and good cholesterol decreases."

Migraine and atrial fibrillation as specific risks

Dr. Karine Blanc-Lasserre warns against a common practice: Migraine with aura and atrial fibrillation are two risk factors specific to women. Migraine with aura and atrial fibrillation are two notable stroke risk factors in women. "We do not know very well for what reasons migraine with aura modifies vascular risk," explained the specialist. "Several avenues are being explored: an effect on the arteries' walls, common genetic mechanisms or an increased frequency of patent foramen ovale, an anatomical feature in the heart that can increase risk in young people."

Distinguishing stroke from migraine

To distinguish a regular migraine attack from an emergency, one criterion prevails: "Symptoms suggestive of a stroke are always sudden in onset. A typical migraine aura develops gradually. Once a sudden deficit appears, it is not a usual crisis, but a life-threatening emergency." Atrial fibrillation, generally more common in men, is more dangerous in women: it multiplies the risk of stroke by 2 in women, compared to 1.5 in men.

Atypical symptoms delay treatment

Nearly 30 percent of women have atypical symptoms. According to Inserm, nearly 30 percent of women present so-called atypical symptoms: sudden fatigue, dizziness, a state of confusion or sometimes chest pain. "Since women are more likely to recognize themselves as stressed, their symptoms can be attributed to excessive stress or a migraine with aura. This delayed diagnosis contributes to the fact that women arrive at the hospital later, die more often or are left with more severe disabilities," said Dr. Karine Blanc-Lasserre.

Recognizing stroke symptoms in women

She emphasizes avoiding confusion: "These atypical symptoms should not be overemphasized. The symptoms suggestive of a stroke are the same as for men, and they occur suddenly: facial asymmetry (deviated mouth); weakness in an arm, leg or half of the body; difficulty speaking (trouble speaking, articulating or understanding). Other signs can appear suddenly: balance problems or loss of vision in one eye."

Stroke prevention and future projections

Stroke: "One can limit the risks by 80%." Mechanically, a stroke corresponds to a stop in blood flow in the brain: "In 80% of cases, an artery becomes blocked. If it is not unblocked quickly, it causes a cerebral infarction. In 15% of cases, the artery ruptures and causes a hematoma that damages the affected part of the brain." Due to the aging population, chronic stress, pollution and cannabis consumption among young people, projections predict a 50% increase in cases by 2050. The specialist tempers: "By following the doctor's prescriptions correctly, one can limit the risks by 80%. These lifestyle habits consist first of regularly monitoring blood pressure (main risk factor and direct cause of stroke), consuming fruits and vegetables, not smoking, practicing at least 30 minutes of walking three times a week and limiting alcohol consumption."