Stroke can cause similar symptoms in females and males, including a drooping face, arm weakness, and slurred or challenged speech. However, females may be more likely to experience more subtle symptoms.

Stroke is the fifth leading cause of death for females in the United States. Females account for around 60% of the total number of stroke deaths per year.

Understanding the risk factors, symptoms, and signs can help improve a person’s outcome. This article reviews the symptoms of stroke in females, other common symptoms, and what to expect from recovery.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

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According to the Centers for Disease Control and Prevention (CDC), males and females have similar stroke symptoms.

However, the American Heart Association (AHA) points out that symptoms in females may be more subtle. This can make it more difficult to distinguish stroke symptoms from other conditions.

Females may have a higher chance of experiencing vague symptoms, such as fatigue and general weakness, instead of weakness on one side of the body. They may also be more likely to attribute stroke symptoms to stress.

According to the CDC, common stroke symptoms in females and males include sudden onset of the following:

  • trouble seeing in one or both eyes
  • weakness or numbness in the arm, face, or leg, often only on one side of the body
  • difficulty walking, loss of balance, lack of coordination, or dizziness
  • severe headache with no known cause
  • confusion, trouble speaking, or difficulty understanding speech

About 1 in 5 females ages 55–75 years will experience a stroke, reports the CDC.

Certain risk factors put different groups of people at a higher risk of stroke.

The main risk factor for stroke in females is high blood pressure, also called hypertension. Around 2 in 5 females have high blood pressure, according to the CDC.

Other stroke risk factors in females include:

  • having depression
  • having high blood pressure during pregnancy
  • using certain oral birth control medications, especially if they also smoke

Females are also more likely to live longer than males, and the risk of stroke increases with age. This means more females typically have a stroke than males.

Females also have some additional unique risk factors. These include:

  • a lifetime of exposure to the hormone estrogen
  • use of hormone replacement therapies for menopause
  • not ever breastfeeding
  • pregnancy issues, such as preterm delivery and preeclampsia

FAST is an acronym that health organizations and healthcare professionals use to help people recognize the signs and symptoms of stroke.

  • F – Face: One side of the face droops or does not respond when a person smiles.
  • A – Arms: One arm drifts downward or does not raise fully when a person raises their arms above their head.
  • S – Speech: A person’s words become slurred or harder to understand.
  • T – Time: If any of these symptoms occur, a person should call 911 immediately and note the time when symptoms first began. This can help healthcare professionals determine the best course of treatment.

Stroke treatment is time sensitive. The sooner treatment starts, the better the outcome for the person.

Treatment can often start in the ambulance on the way to the hospital. The CDC recommends a person call 911 instead of driving themselves to the hospital.

Treatment in females vs. males

According to a 2022 study analyzing the impact of sex and gender on stroke, females have a disproportionately large burden of disability and death related to stroke.

Researchers further note that a person’s sociocultural gender roles also contribute to differences in risks, diagnosis, treatment, and outcomes.

Ischemic stroke

The same 2022 study notes that there is still controversy regarding the differences in access, efficiency, and safety of two common treatments for ischemic stroke:

  • Endovascular thrombectomy: This procedure uses an image-guided instrument to remove a blot clot or blockage.
  • Tissue plasminogen activator (tPA): This intravenous (IV) medication is used to treat clots.

Both treatments help restore blood flow to the brain following an ischemic stroke.

The CDC mentions tPA as a first-line treatment for ischemic stroke. The CDC does not list endovascular thrombectomy.

The 2022 study mentioned above suggests females have a higher chance of receiving an endovascular thrombectomy than males. Researchers also noted that evidence suggests females have a 13% lower chance of receiving tPA.

Researchers suggest this discrepancy may have implications for why females have a worse outcome than males after a stroke, as tPA is generally effective for females and males.

One possible issue is a delay in seeking emergency help.

The AHA points out that women are more likely to dismiss their symptoms as something else or have subtle symptoms. Women are more likely to call a primary doctor instead of 911. They also tend to drive themselves to the hospital instead of contacting emergency services.

Treatment with tPA is time dependent. Treatment must occur within 4.5 hours of symptom onset for maximum effectiveness. As a result, delays in seeking treatment can lead to missed opportunities to use the medication.

Hemorrhagic stroke

Hemorrhagic stroke has fewer treatment options for females and males.

The same 2022 study notes there are few known differences between females and males regarding treatment for hemorrhagic stroke.

Researchers state that treatments typically involve:

  • managing blood pressure in the brain
  • surgery
  • reversing anticoagulant-associated hemorrhage

The Office on Women’s Health adds that a person will likely require ongoing rehabilitation services following a hemorrhagic stroke.

A stroke blocks oxygenated blood from reaching the brain. Brain cells die off quickly when they do not receive oxygen and blood.

Following the initial treatment to restore blood flow, many people require rehabilitation therapy to restore or maintain typical functions. This can include physical, occupational, speech, and other types of therapy.

The goals of rehabilitation typically include:

  • regaining independence
  • relearning lost or impaired skills and abilities
  • learning to cope with any lingering limitations

Some people may opt not to use a rehabilitation program and instead choose hospice care or assisted living facilities.

A person cannot change all risk factors, such as age. But they can take steps to change modifiable risk factors, such as high blood pressure.

The CDC notes that 4 out of 5 strokes are preventable.

A person can consider the following to reduce their risk of stroke:

  • using aspirin to help reduce the risk of blood clots (before taking aspirin, a person needs clearance from a qualified healthcare professional)
  • managing high blood pressure with lifestyle strategies and medication
  • quitting smoking, if applicable
  • managing cholesterol with lifestyle strategies and medication
  • getting regular exercise throughout the week
  • eating heart-healthy meals that include vegetables, fruits, whole grains, and lean proteins
  • limiting saturated fat, salt, and processed foods
  • managing other health conditions, such as diabetes
  • attending regular health checkups with a doctor

People can talk with a healthcare professional about the risks of stroke and how they can reduce them.

The following section answers some frequently asked questions about stroke in females.

What does a stroke feel like for a woman?

Females have a higher chance of experiencing subtle or less common stroke symptoms than males. Some symptoms females may experience with a stroke can include the sudden onset of:

  • numbness or weakness in the arm, leg, or face, often on one side of the body
  • trouble walking or balance issues
  • speech issues
  • severe headache
  • difficulty seeing
  • confusion

What are the warning signs of a stroke days before?

Stroke symptoms start suddenly. They do not come on gradually over a few days. This is due to the rapid death of brain cells associated with limited blood supply.

However, some people experience a transient ischemic attack (TIA), also called a ministroke. TIA causes stroke-like symptoms that typically last only a few minutes. TIAs are often indicators a stroke may be coming.

According to the American Stroke Association, about one-third of people who have a TIA will have a stroke within 1 year. About 15% of people who have a stroke had a TIA before their stroke.

Stroke symptoms in females may go unreported, delaying effective early treatment. This may be due to females experiencing more subtle symptoms, associating them with other issues, such as stress, or calling a primary doctor instead of 911.

Symptoms in females can include well-recognized symptoms, such as a drooping face, slurred speech, and weakness in one arm. Symptoms in females can also include fatigue, a general feeling of being unwell, vision issues, headache, or dizziness.

One common theme is the sudden onset of symptoms. A person should call 911 if they experience any sudden symptoms, even if they are unsure they fit the definition of stroke.