A nationwide study in Finland found that the increased risk of ischaemic stroke (IS) in women with atrial fibrillation (AF) has decreased over time. The study, which followed patients with AF from 2007 to 2018, showed that women had a higher IS rate than men in 2007–08, but this association weakened over time and became non-significant by 2017–18. The risk was particularly pronounced in high-risk patients, while no significant association was found in low- or moderate-risk patients. The decline in IS risk was attributed to improved management of stroke risk factors and better access to oral anticoagulant (OAC) therapy. The study suggests that female sex may no longer need to be considered as a separate risk factor when estimating IS risk and OAC therapy needs in AF patients. However, women still tend to be under-treated with OACs and experience more severe stroke events when they occur. The study highlights the importance of considering gender differences in stroke risk and the need for further research to understand the changing trends in AF-related stroke risk across different populations.A nationwide study in Finland found that the increased risk of ischaemic stroke (IS) in women with atrial fibrillation (AF) has decreased over time. The study, which followed patients with AF from 2007 to 2018, showed that women had a higher IS rate than men in 2007–08, but this association weakened over time and became non-significant by 2017–18. The risk was particularly pronounced in high-risk patients, while no significant association was found in low- or moderate-risk patients. The decline in IS risk was attributed to improved management of stroke risk factors and better access to oral anticoagulant (OAC) therapy. The study suggests that female sex may no longer need to be considered as a separate risk factor when estimating IS risk and OAC therapy needs in AF patients. However, women still tend to be under-treated with OACs and experience more severe stroke events when they occur. The study highlights the importance of considering gender differences in stroke risk and the need for further research to understand the changing trends in AF-related stroke risk across different populations.