Gender considerations in stroke management

Background: Stroke is a major cause of morbidity and mortality in the general population and especially in older women. Review Summary: The incidence of stroke differs between men and women of a range of ages, with a higher lifetime risk for women than men. Pregnancy and the postpartum period are times of increased risk of stroke. Use of exogenous estrogen, especially in vulnerable populations, increases stroke risk. Women and men have different responses to primary and secondary stroke prevention. Women may not be offered acute ischemic stroke treatment as frequently as men; and female stroke survivors have worse outcomes. Conclusions: Gender-related differences in stroke are attributed to the hormonal changes that women experience through their lifetime, diverse risk factors for stroke in men and women, and specific lifestyles, and comorbid conditions. Neurologists need to be aware of aspects of stroke that are particularly relevant to women.