Prospective randomized trials of alternate forms of hormone therapy are ongoing. As stated in previous guidelines, neither hormone therapy nor SERMs should be used for the primary or secondary prevention of stroke. Migraine with aura is associated with an increased risk for ischemic and hemorrhagic stroke in women, especially in women under the age of 55 years. Data are insufficient to recommend specific strategies to treat migraine while lowering stroke risk. However, since an association exists between migraine frequency and stroke risk, guidelines support treatments to reduce migraine frequency. Smoking cessation is strongly recommended for women with migraine headaches with aura. Obesity, abdominal obesity, and metabolic syndrome are independent risk factors for stroke; however, there is no clear evidence that obesity has a stronger impact on stroke risk and stroke outcomes in women compared to men. On the other hand, studies show that metabolic syndrome imparts a higher stroke risk in women and accounts for more stroke events in women than in men. Adherence to healthy lifestyle behaviors (maintaining a normal body mass index, eating a diet rich in fruits and vegetables, drinking a moderate amount of alcohol, abstaining from smoking, exercising regularly) has been shown to reduce stroke incidence in women and improve stroke outcomes in both men and women. Guidelines recommend healthy lifestyle practices for primary stroke prevention in women with cardiovascular and stroke risk factors. Further research is needed to develop lifestyle interventions tailored for women that are effective for primary and secondary stroke prevention. Atrial fibrillation is a major risk factor for stroke, and the risk of stroke from atrial fibrillation increases with age. More women over the age of 75 years have atrial fibrillation compared to men. Anticoagulation is effective in reducing stroke risk. 