NEW YORK (Reuters Health) - Women face different risk factors for stroke and experience worse outcomes after stroke, compared with men, according to four related articles in a focused update online February 8 in the journal Stroke.

In one report, Dr. Kathryn M. Rexrode from Brigham and Women's Hospital, in Boston, and colleagues summarize stroke risk factors unique to women, including endogenous hormone levels, exogenous hormone therapy, pregnancy, parity, and ages at menarche and menopause.

“The degree to which women are more likely than men to experience stroke as their first manifestation of cardiovascular disease is not well appreciated," Dr. Rexrode told Reuters Health by email “We wanted to delve into why - what factors might disproportionately affect women.”

Her team identified nine clearly established female-specific stroke risk factors: early age at menarche (<10 years); early age at menopause (<45); low endogenous levels of dehydroepiandrosterone (DHEAS); postmenopausal treatment with oral estrogens; use of combined oral contraceptives; exogenous estrogen use in transgender women; pregnancy; gestational diabetes; and hypertension in pregnancy or preeclampsia.

“The fact that these risk factors unique to women have not been formally studied in clinical risk prediction models, to see whether they would improve our estimation of risk in women, is surprising and an area for future research,” Dr. Rexrode said. “I also think that women themselves do not fully appreciate the risk of early menopause or a history of pregnancy complications. We need to do a better job of educating patients and findings ways to mitigate their risk.”

In another report, Dr. Lynda D. Lisabeth from University of Michigan, Ann Arbor, and colleagues examined sex differences in patient-reported outcome measures (PROMs) in the first 12 months after stroke.

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