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Stroke Smart Magazine

May/June 2008

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Myth vs. Reality: The TRUTH about Women and Stroke

By Verna Noel Jones

Does the use of birth control pills increase stroke risk? Many people think so. But an in-depth look at the numbers may prove this and many other beliefs about women and stroke to be more myth than reality.

Stroke survivor Marianne Thomas, of Hatfield, Pa., admits to concerns about her long-time birth control use. Thomas was on and off the pill since age 20, in-between the births of each of her four children.

In March of 2007 she had an ischemic (clot caused) stroke. She was 50 years old and had
been on the pill for 14 years straight. She thought perhaps birth control was the cause.

Not likely, says Dr. Dawn Kleindorfer, associate professor in the department of neurology at the University of Cincinnati.

“There’s no reason for women to have mass panic about birth control pills,” she says. The
increase in stroke risk is minimal, unless the woman smokes. Smoking increases the risk
by 35 times. However, keep in mind that the initial risk is incredibly small.

Hormonal therapy for postmenopausal women also has been linked to stroke, but again, only
minimally. The Women’s Health Initiative Study showed that for every hip fracture that was prevented through hormone use, there were eight more strokes in women. Even so, hormones pose a relatively small risk, says Kleindorfer.

Migraines have been blamed for stroke in women as well. Again, this poses a very small risk. Even more kooky, some people suspect something in aluminum pots. (Wait. Don’t toss them out. It’s not true.) While it’s easy to blame such outside factors, a stroke is much more likely to result from lack of exercise, high blood pressure, and obesity.

High blood pressure is the number one risk for stroke in women, especially among those who have already had a stroke or heart attack. “The problem with blood pressure is that you don’t feel anything until something bad happens,” says Kleindorfer. “So it’s important to have your blood pressure checked regularly by a doctor. And if blood pressure [medicines] have been prescribed for you, don’t stop taking them.”

Diabetes and smoking are tied for the second biggest stroke risk factors in women. Like blood pressure, diabetes is a health condition that doesn’t make you feel bad unless your blood sugar levels are really high. Therefore, checking your sugars on a regular basis is a must, says the doctor.

Smoking is the easiest stroke risk factor to modify. Those who smoke the most cigarettes over the longest time period have the highest risk. Yet once they stop smoking, their risk goes back to normal within five years, says Kleindorfer.

Cholesterol and diet come in third on the list, largely through their connection to other factors. If women are obese because of a poor diet, that could lead to diabetes and high blood pressure.

A recently reported survey showing that strokes have tripled among women ages 35 to 54 links the stroke rate increase to extra belly fat. Women who have increased abdominal fat are likely to be fat overall, a factor that again circles back to top two risk factors high blood pressure and diabetes.

Most likely, Marianne Thomas’ stroke was related not to her use of birth control pills but to other factors, such as high blood pressure and limited exercise. Thomas, like all women who have had strokes, was taken off birth control after the stroke to help prevent blood clots that could lead to another stroke.

After eight weeks of physical therapy, Thomas took her health care into her own hands by joining CurvesŪ to increase her cardio exercise and movement. She also takes medicine to keep her blood pressure low.

“Women need to be aware of and focus on the most important risk factors. Generally, if you’re not exercising, if your blood pressure is out of control, if you’re 25 percent  overweight, these are much more likely to cause a stroke than things like birth control,” says Kleindorfer.


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National Stroke Association’s mission is to reduce the incidence and impact of stroke by developing compelling education and programs focused on prevention, treatment, rehabilitation and support for all impacted by stroke.

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