Oct 7, 2026 · 49 min · 13 segments
On this episode, the science of menopause and the aging brain. Women are more vulnerable to strokes, yet they're historically underreported and underdiagnosed. On this episode, the science of…
Enrique LeiraGuestHannah RoederGuestNow, when most people think of stroke, they may think of, of it as, uh, something that happens to older men.
Yeah, when we look at, um, sex and age, they're sort of a complicated interplay.
So certainly age is still one of the strongest predictors of, of who's gonna have a stroke.
Um, but over the different age groups, the relative risk between women and men changes.
So in young adults, um, there's a higher risk in women that's thought to be driven by things like pregnancy and perhaps some contribution from oral contraceptive use.
But then for much of, like, middle age, men have a higher risk of, of stroke in most age groups.
Um, but then after menopause, the, um, risk for women starts to accelerate and really catches up to men in the, in the older age groups.
And then women are also more likely to have, um, stroke overall when we look at the whole lifetime, in part driven by longevity.
So y- as you said, in that 10 years, um, from the onset of menopause, the risk of stroke in, in women doubles.
You know, and that's been known for a while, that after menopause, the risk of stroke in women starts to go up, and it was thought to and seen to correlate with estrogen levels, um, going down.
Uh, so in the 1990s, there was this idea that perhaps giving estrogen, estrogen supplementation, um, would help, um, with preventing strokes, which was certainly, like, a reasonable, um, idea and proposition.
But actually, over a series of several trials, um, what they saw is that estrogen or hormonal therapy in the studies that they looked at led to an increased risk of stroke, so that we know that, um, estrogen, that hormone therapy can, um, increase risk of clotting, but with the important caveat that that's most increased, um, in a certain specific populations, and there's a lot of things that sort of modulate that risk.
Now, when most people think of stroke, they may think of, of it as, uh, something that happens to older men.
Yeah, when we look at, um, sex and age, they're sort of a complicated interplay.
So certainly age is still one of the strongest predictors of, of who's gonna have a stroke.
Um, but over the different age groups, the relative risk between women and men changes.
So in young adults, um, there's a higher risk in women that's thought to be driven by things like pregnancy and perhaps some contribution from oral contraceptive use.
But then for much of, like, middle age, men have a higher risk of, of stroke in most age groups.
Um, but then after menopause, the, um, risk for women starts to accelerate and really catches up to men in the, in the older age groups.
And then women are also more likely to have, um, stroke overall when we look at the whole lifetime, in part driven by longevity.
So y- as you said, in that 10 years, um, from the onset of menopause, the risk of stroke in, in women doubles.
You know, and that's been known for a while, that after menopause, the risk of stroke in women starts to go up, and it was thought to and seen to correlate with estrogen levels, um, going down.
Uh, so in the 1990s, there was this idea that perhaps giving estrogen, estrogen supplementation, um, would help, um, with preventing strokes, which was certainly, like, a reasonable, um, idea and proposition.
But actually, over a series of several trials, um, what they saw is that estrogen or hormonal therapy in the studies that they looked at led to an increased risk of stroke, so that we know that, um, estrogen, that hormone therapy can, um, increase risk of clotting, but with the important caveat that that's most increased, um, in a certain specific populations, and there's a lot of things that sort of modulate that risk.
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