‘I eventually managed to slide out but I fell over because the whole of my left side felt weak,’ says Angharad, now 22.
‘I crawled to the bathroom, but I couldn’t work out how to tear off the toilet paper. I just stared at it.’
It was 7.30 am and, convincing herself she was just overtired, she dragged herself back to bed and fell back to sleep.
She woke 20 minutes later feeling fine and went to have a shower.
‘But when I got in, I couldn’t figure out what the tap was for,’ says Angharad, who was then studying primary education at university in Carmarthen, Wales.
Alerted by the sound of Angharad crying, her flatmate Beth ran in and found her on the floor, completely hysterical.
‘I thought I was shouting for Beth, but no words were coming out,’ says Angharad.
‘Beth rang my mum, who works five minutes away as a practice nurse.
'As soon as she arrived, she knew something was seriously wrong and took me straight to A&E.’
In the car and waiting room, Angharad continued to have odd episodes of struggling to get any words out and weakness, lasting a few minutes each.
In fact, these episodes were transient ischaemic attacks, also known as mini strokes.
These can be a sign a major stroke is about to occur — and Angharad suffered a large stroke less than an hour after arriving at hospital, while sitting in the waiting room.
‘The left side of my face suddenly drooped, my left side was paralysed and I couldn’t utter a word,’ she recalls.
Brain scans confirmed a stroke, and that her brain showed an area of dead matter, but Angharad was surprised to learn of the diagnosis.
‘I thought strokes only happened to elderly people.’
She was wrong. In fact, strokes are becoming more commonplace among the young — and women especially may have additional risk factors that increase their chance of having one.
Strokes occur when the blood supply to the brain is interrupted, and there can be various causes for this.
The most common is an ischaemic stroke, which is responsible for 85 per cent of cases and occurs as a result of a blood clot or clump of fat blocking a blood vessel in the brain.
Another example is a haemorrhagic stroke that is caused by a bleed in the brain.
About 152,000 strokes happen in the UK a year. Some 30,000 women a year in England and Wales die as a result of a stroke — three times the number who die from breast cancer.
For men and women, strokes are most common in over-55s, but disturbingly the number of under-55s having a stroke is on the rise.
In England, the number of cases rose from 9,321 in 1998 to 16,415 in 2010. So why is this happening?
‘It’s thought that the rise is down to an increase in eating salty, fatty foods and obesity,’ says Caroline Watkins, professor of stroke and older people’s care at the University of Central Lancashire.
Having a high salt intake is the single biggest risk factor for stroke because it increases blood pressure and causes artery walls to harden and narrow — making a blood clot more likely.
Smoking, being overweight and drinking excessive amounts of alcohol are also stroke risks because they, too, increase blood pressure.
High-fat foods are also a problem as they can lead to the build-up of fatty plaques in your arteries.
And a high-sugar diet can also increase your stroke risk, says Professor Watkins.
Sugar damages the arteries and can lead to diabetes, which leads to raised blood sugar levels. These can trigger fatty deposits or clots on the insides of the blood vessel walls.
Yet women have other risk factors too.
Doctors suspected that Angharad’s stroke was brought on as a result of being on the combined pill (which contains both oestrogen and progestogen).
This, along with pregnancy and taking hormone replacement therapy (HRT), can increase women’s chances of having a stroke because they raise risk of clots and high blood pressure.
‘Oestrogen can increase the likelihood of the blood clotting and this may increase your risk of ischaemic stroke,’ says Dr Kate Holmes, deputy director of research at the Stroke Association.
In 2000, a large analysis of research studies published in the medical journal JAMA found that there was an increased risk of stroke associated with taking the contraceptive pill, although pills that contain smaller amounts of oestrogen had less of a risk.
And in February, the European Medicines Agency reported how women taking so-called ‘third generation’ contraceptive pills, such as Yasmin, Femodene and Marvelon, were nearly twice as likely to develop blood clots that can trigger strokes as those on older varieties and six times more likely than women on no pills at all.
It’s thought that it is the particular types of synthetic oestrogen these newer pills contain, such as gestodene, desogestrel, drospirenone, etonogestrel and norelgestromin — that increase the risk.
However, these contraceptives are popular because they have fewer side-effects than traditional forms.
‘The risk of stroke caused by the contraceptive pill is low, but it’s higher if you have other risk factors,’ says Dr Holmes.
The combined pill should be used with caution if you have any of the following risks and not used at all if two or more apply: you’re a smoker or stopped less than a year ago; you have high blood pressure; you’re over 35 and a smoker; you have a family member who has had a blood clot under 45; you’re overweight; you’ve had a clot or stroke in the past; you have diabetes with complications; you have migraines.
Angharad had none of these.
‘I knew the Pill increased risk of blood clots, but not stroke,’ says Angharad. ‘I came off it immediately after my stroke and now use a coil.’
Despite the extra stroke risks for women (men have an overall higher risk of stroke, but women have more risk factors), a recent poll from the Stroke Association found one in eight women are unaware that they could suffer a stroke.
The charity described the finding as ‘extremely worrying’ and adds: ‘This should serve as a wake-up call to women of all ages to be aware of the steps they can take to reduce their stroke risk’.
After her stroke, Angharad stayed in hospital for a week and was put on an anti-coagulant, which reduces the likelihood of a clot forming, and a statin, which lowers cholesterol.
‘After a few days, I could walk slowly to the toilet with help.
'I started speaking after the stroke, but very slowly and I struggled with certain words, like please and thank you.
'I could see them in my head, but just couldn’t get them out.
‘My left side was still very weak and I couldn’t wash myself, so Mum did it for me. I felt overwhelmed.’
She set her mind to getting better quickly and, six weeks after her stroke, returned to university to study, while continuing to have physio.
Six months later, Angharad collected her degree — on time — while her proud parents wept in the audience.
She is now studying to become a primary school teacher, but tires easily; her left side is also a little weaker — ‘I always carry my shopping with my right hand,’ she says — and she struggles to find the right words when she’s tired. Yet she’s grateful she had a stroke.
‘It’s made me so much more determined to succeed,’ she explains.
Angharad’s story underlines the fact that stroke symptoms should never be ignored, regardless of age.
A 2013 study found that women arrived at hospital, on average, 27 minutes later than men, but minutes can make a difference for getting the best treatment.
‘Don’t wait until later, tomorrow or next week if you notice symptoms — it could be too late,’ says Professor Watkins.
‘And pay attention to what others say, as you may not always feel a stroke or mini-stroke symptom yourself.
‘For example, if a friend comments that your face drooped for a few seconds, don’t ignore it.
'You may not have felt it, but it could be a sign of an impending stroke.’
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