The hormonal rollercoaster that marks perimenopause—the often yearslong on-ramp to menopause—is well known to bring some in-your-face symptoms: hot flashes, insomnia, anxiety, joint pain, to name a few. But that same phase of fluctuating and ultimately dropping estrogen levels can also trigger some much less noticeable shifts throughout your body, which may in turn raise your risk for certain health conditions, namely stroke.
Before hitting those perimenopausal years, women generally are less likely than men to have a stroke, which happens when blood flow to your brain is limited due to a blocked (or broken) vessel. But at perimenopause and beyond, women’s stroke risk mirrors or even exceeds that of men, Mollie McDermott, MD, director of the stroke division at Michigan Medicine, tells SELF. In fact, this spike is a big reason why, over the course of a lifetime, women have a higher likelihood of stroke (20%) versus men (roughly 15%).
Read on to learn why the threat of stroke looms large as you approach menopause, and the risk-reducing habits that become ever more critical in this phase of life.
Why stroke risk rises in perimenopause
The dips in estrogen that characterize this stage set off a cascade of changes in your body that could affect blood flow to your brain, many of which feed into or fuel one another. For starters, we know estrogen plays a role in keeping blood vessels supple and pliable, so a lack thereof could make them rigid or stiff, Mindy Goldman, MD, an ob-gyn in San Francisco and chief clinical officer at Midi, a telehealth platform for midlife, tells SELF. These kinds of vessels are, then, more prone to constriction, upping your risk for a blockage.
Narrower, less flexible blood vessels can also elevate your blood pressure, as can other effects of perimenopause, like sleep struggles, stress and anxiety, and metabolic shifts, as well as simply aging. That tends to coincide, too, with changes in lipid (a.k.a. fat) profiles, particularly a rise in “bad” LDL cholesterol and triglycerides, Somi Javaid, MD, a Cincinnati-based ob-gyn, founder of women’s health care platform HerMD, and member of the plusOne wellness collective, tells SELF. After all, a drop-off in estrogen can make your liver less capable of processing and clearing fats. Taken together, these cardiovascular shifts raise your odds of developing sticky plaques in your arteries that can trigger a stroke.
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