Hormonal changes caused by pregnancy or the use of oral contraceptives, as well as a longer life expectancy, are among the reasons why women have a higher incidence of strokes than males, according to experts on World Stroke Day on Tuesday.

Stroke is a leading cause of disability and mortality among all individuals globally. However, it is the third biggest cause of mortality in women, killing more women than men, according to the American Stroke Association.

Dr. Atul Prasad, Principal Director & Head of Neurology at BLK – MAX Super Speciality Hospital, told IANS that higher life expectancy, hormonal aspects caused by pregnancy and childbirth, oral contraceptives, and menopause.

Other key risk factors include hypertension, cardiac problems such as atrial fibrillation (an abnormal heart rhythm), and pollution.

“Women with a history of migraine with aura are more likely to have a stroke, particularly if they smoke or use oral contraceptives. Another is preeclampsia, a prenatal condition that doubles the risk of stroke afterward but is rarely evaluated.” Dr. Sumit Singh, Chief-Neurology at Artemis Hospitals

According to the experts, women frequently exhibit atypical or lesser-known stroke symptoms such as fatigue, general weakness, confusion or disorientation, nausea, or vomiting, which adds to delayed identification and treatment.

“Slurred speech, abrupt weakness, and facial drooping are common symptoms in both genders; however, women’s symptoms are frequently masked as dizziness, weariness, nausea, and even hiccups. Such unusual symptoms frequently cause a delay or misdiagnosis, and they have a significant role in deteriorating the outcome,” Singh said.

While the treatment and prevention of ischemic stroke are largely comparable in men and women, post-stroke rehabilitation programs for women must be more gender tailored.

“Women have worse outcomes, with depression and cognitive decline occurring more frequently and taking longer to recover than males. As a result, stroke recovery must be treated more holistically, with mental health care, social integration, and tailored physical therapy,” the doctor stated.

The primary strategies for preventing ischemic stroke are the same for men and women: control blood pressure, manage cholesterol, quit smoking, and live a healthy lifestyle.

Prasad did, however, emphasize the importance of women monitoring their stroke risk on a regular basis whether they are on birth control pills or undergoing hormone replacement therapy (HRT). Women with a history of preeclampsia require long-term follow-up.

According to former WHO Chief Scientist Soumya Swaminathan, the primary causes of increased abdominal obesity in India are unhealthy diets and physical inactivity.

Swaminathan, who is currently the Principal Advisor for the Health Ministry’s tuberculosis programme, advocated for increased access to healthy meals and exercise spaces in the country to combat obesity, which is already a global health concern.

Obesity is known to be a risk factor for diabetes, hypertension, and cancer, all of which are on the rise in India and around the world.

“Abdominal obesity – unhealthy diets and physical inactivity are driving this unhealthy trend,” Swaminathan wrote on X.

“More awareness, nutrition literacy, expanded access to healthier diets, and exercise spaces are required,” she said, citing a recent study on abdominal obesity published in the journal The Lancet Regional Health.

The study, headed by researchers from IIHMR University in Jaipur and Johns Hopkins University’s Bloomberg School of Public Health in the United States, used data from the National Family Health Survey (NFHS-5) conducted in 2019-21.

The findings revealed that abdominal obesity is more common among women (40%) than men (12%).

Approximately 5-6 out of every 10 women aged 30 to 49 are abdominally fat.

Women who are elderly or non-vegetarian are more likely to have abdominal fat. While abdominal obesity is more common in cities, the study found that it is also increasing in rural regions and is affecting lower and medium socioeconomic groups.

In India, BMI has traditionally been used to assess obesity. For the first time, the NFHS-5 measured abdominal obesity using the waist circumference of 6,59,156 women and 85,976 men (ages 15 to 49).

The study discovered that some women with a healthy BMI also have abdominal obesity.

Kerala (65.4%), Tamil Nadu (57.9%), Punjab (62.5%), and Delhi (59%) all had a high incidence of abdominal obesity, while Jharkhand (23.9%) and Madhya Pradesh (24.9%) had lower rates.

Aside from showing a “emerging health risk for Indian women,” the study revealed “a double burden of malnutrition” in the country.

The researchers advised the government to take proactive steps “to design targeted interventions for the groups who have high abdominal obesity, particularly for women in their thirties and forties”.

Even though all women go through menopause at some stage in their lives, not many of them truly understand its impact on their health and well-being. It is a condition that isn’t spoken much about which makes it difficult for women to be prepared for this next chapter in their lives. Menopause can stir up various feelings.

For some, it’s the feeling of relief over no longer experiencing period cramps, and a sense of self-discovery and curiosity for what’s next. But what’s important to understand is that this phase also brings with it changes to a woman’s body and a drop in estrogen levels.

Due to these changes, women need to be aware of the common health conditions that can happen post menopause. Dr. Sheela Mane, Senior Consultant, Anugraha Nursing Home, Bangalore, said, “Studies based on women undergoing menopause in India found that the most commonly reported symptoms include hot flashes & night sweats along with other symptoms like sleep disturbances, anxiety, irritability, joint pain, and vaginal dryness. In a study conducted by the Indian Menopause Society, the incidence of these symptoms was found to be 75%.

While awareness around these symptoms is growing slowly, and we can assume that far fewer understand its impact on overall health, but there is still a growing need for more people to know the common conditions post menopause. Women may be at a greater risk of osteoporosis, heart disease, and muscle mass loss, largely due to reduced estrogen. Understanding the impact of menopause on bone and heart health can help them to prevent, recognize, or address them early on.”

Dr Rohita Shetty, Medical Affairs Head, Abbott India commented, “It’s important to help women understand the impact of menopause on bone and heart health. As per a survey by Abbott & Ipsos, 82% people believe that menopause affects a woman’s personal well-being. This makes it increasingly important to help women prioritize their health, during menopause and beyond.”

The most common condition post menopause is osteoporosis, which affects one in three women over the age of 50 years. This is due to reduced levels of estrogen, resulting in bone loss and lowered mass, which makes them fragile and at a greater risk of breaking. Today, roughly 61 million people in India live with osteoporosis, and 80% of them are women. Osteoporosis is often a ‘silent condition’ with no visible symptoms until there is a fracture.

At times, there may be height loss, which can be accompanied by back pain or a curved back. Injuries relating to osteoporosis may be serious and cause pain and long-term disability.

 Checking in with your doctor and understanding your risk factors can be vital. To strengthen your bones, some lifestyle steps you can consider include exercising frequently, having a healthy diet consisting of fruit, vegetables, and rich in calcium and Vitamin D, avoiding smoking, and cutting down on alcohol.

Women post menopause are also at a risk of losing muscle mass, which is vital for mobility, balance, and strength as they age. The loss of muscle mass, or sarcopenia, is accelerated in women, happening nearly a decade earlier than for men due to menopause. This comes with its own set of complications such as weight gain and makes simple tasks like climbing stairs more challenging.

Watch for fatigue and a drop in energy, as warning signs to consult a doctor. You can also proactively take steps to enhance muscle mass like – lifting weights for strength training, opting for full-body exercises that work several muscles, eating nutritious food, and getting good quality sleep.

With the onset of menopause, the risk of heart disease also increases. This is because estrogen deficiency may lead to changes in lipid levels such as increase in cholesterol.  Menopause-related hot flashes and night sweats can result in a greater risk for high blood pressure and other cardiovascular related risk factors.

In addition, women who experience natural menopause at a later age have a lower risk of cardiovascular disease. Factors that may lead to early start of menopause include worse cardiovascular health during reproductive years, smoking and possibly genetics. Research also shows depression during the menopause transition can lead to higher risk of cardiovascular disease. It’s important to find ways to cope – whether with counselling, cognitive behavioural therapy, or mindfulness methods, all while relying on social support.

To summarize, as women age, it’s important for them to get regular check-ups and screen for health conditions most common post menopause. By knowing what signs to look out for, you and your loved ones can better navigate life beyond menopause and embrace the next chapter of your life with ease.