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Menopause and Strokes

Podcast Episode 14 transcript.

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Today's podcast aims to understand strokes and how they relate to menopause so that we empower ourselves to make informed decisions about our health.

Strokes can be a daunting topic because of the devastating consequences they can have, but it's so essential to discuss this topic, as the first step for women to reduce their stroke risk is awareness, like Knowing the signs and symptoms of a stroke. These may include sudden numbness or weakness in the face, arm, or leg, especially on one side of the body. Other warning signs can be sudden confusion, trouble speaking, difficulty understanding speech, or sudden severe headaches.

There are two types of strokes: ischaemic and haemorrhagic strokes.

Ischaemic strokes occur when a blood vessel supplying the brain is blocked, typically by a blood clot. Risk factors for an ischemic stroke include ageing, hypertension, diabetes, obesity, high cholesterol, smoking, chronic kidney disease, cardiovascular diseases, and going through early menopause before the age of 40.

Hormonal changes during menopause can affect a woman's cardiovascular system. In the ten years after menopause, the risk of stroke roughly doubles. Estrogen plays a protective role in maintaining blood vessel health, so when it starts being lost during menopause, the risk of developing blood clots is increased, which increases the risk of strokes.

Haemorrhagic strokes result from a ruptured blood vessel, leading to bleeding in the brain. These strokes are much less common than ischaemic strokes but can be more severe. Hormonal changes during menopause may weaken blood vessel walls, making them more susceptible to rupture. High blood pressure, which sometimes increases during menopause, is also a significant risk factor for haemorrhagic strokes.

A lot has been said in the past about HRT causing blood clots. Studies have shown that HRT tablets can increase the risk of an ischaemic stroke by a small margin, but we now have recent studies that show this is entirely avoided by using patches or gels. In general, if you have a history of a clot, diabetes, migraine or liver disease, you can still safely take HRT in the form of patches or gel.

If a woman on oral HRT is healthy and at low risk for clots, studies have also shown that the added effect of HRT is tiny. We want to reassure you that HRT is much safer than some people realize. If you are unsure of the proper treatment, discuss it with your doctor or menopause health practitioner.

Women in menopause need to prioritize their cardiovascular health. Regular exercise, a balanced diet, and a healthy weight are crucial for stroke prevention. Managing stress and keeping blood pressure in check is also very important. Consulting with healthcare professionals to monitor and address specific risk factors is a proactive step in taking control and safeguarding your future health.


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