You’re Probably Wondering: Is It Menopause or a Thyroid Disorder?

When a woman is in her 40s or 50s and starts experiencing symptoms like irregular periods, heavy sweating, thinning hair, weight changes, brain fog, fatigue, insomnia, or mental health problems – what does she have? I’m assuming you said the obvious response: menopause. 

…but it just might be an undiagnosed thyroid problem instead.

You’re Probably Wondering: Is It Menopause or a Thyroid Disorder?

Both conditions have just about everything to do with hormones, and symptoms are extremely similar. Yet treatment options are entirely different. If you avoid proper thyroid treatment thinking you’re just dealing with menopause, your health can deteriorate.

Women are more likely than men to have thyroid issues, and middle-aged women have a higher risk than younger women. In fact, the age range most likely to be diagnosed with a thyroid disorder is 45 to 55. The common age range to experience menopause? 48 – 55.

See where one could get easily confused? 

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In fact, the American Association of Clinical Endocrinologists (AACE) estimate that millions of women with symptoms of menopause have a thyroid condition they know nothing about.

In this article, we are going to dive into the commonalities and links between menopause and thyroid issues, so you can sort out your health, find the appropriate treatment, and feel your best once again.

How Are They Similar? Understanding Menopause vs. Thyroid Disorders

Let’s take a closer look at both menopause and thyroid disorders – you will quickly see why they often get confused by women in their 40s and 50s: almost all symptoms are shared.

1. The Deal on Menopause (and Perimenopause)

In menopause, periods cease and a woman becomes infertile due to the depletion of eggs and lowered reproductive hormones – especially estrogen. The symptoms we associate with menopause are also experienced in the time known as perimenopause, a transitional phase when the reproductive hormones begin to decline. 

The symptoms of menopause and perimenopause include:

  • Hot flashes/sweating
  • Mood swings
  • Depression
  • Anxiety
  • Brain fog
  • Fatigue
  • Insomnia
  • Weight gain
  • Thinning skin
  • Dry skin
  • Racing heart
  • Missed, irregular, or ceased periods
  • Low libido
  • Vaginal dryness

2. The Deal on Thyroid Disorders

Your thyroid is a small gland in your neck that produces and releases two important hormones: T3 (triiodothyronine) and T4 (thyroxine). These hormones regulate all sorts of things like metabolism and heart rate. Interestingly, the metabolism process of every cell in the body is regulated by your thyroid. 

Your pituitary gland (often called the “master” gland, for good reason!) releases something called Thyroid Stimulating Hormone (TSH) to encourage your thyroid’s proper hormone production and release. Sometimes this system works perfectly; other times it goes wrong.

When you have hypothyroidism, you have too little T3 and T4. Symptoms include:

  • Fatigue
  • Sensitivity to cold
  • Constipation
  • Dry skin
  • Weight gain
  • Puffiness
  • Muscle aches, tenderness, stiffness, weakness
  • Hoarseness
  • Irregular menstrual periods
  • Thinning hair
  • Impaired memory
  • Depression
  • Slow heart rate

When you have hyperthyroidism, you have too much T3 and T4. Symptoms include:

  • Fatigue
  • Insomnia
  • Change in appetite
  • Change in weight
  • Diarrhea
  • Intolerance to heat
  • Irritability or nervousness
  • Heart palpitations
  • Muscle weakness
  • Light/missed/irregular periods
  • Infertility
  • Thinning hair

Which One? Diagnosing Menopause vs. Thyroid Disorder

The best bet is to talk to your doctor as soon as you start experiencing those hallmark menopause symptoms in case they are actually thyroid disorder symptoms. 

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Your doctor will order a simple blood test to confirm or deny a thyroid issue. They will test your levels of TSH, T3, and T4 to see if they are too low, too high, or just right (in that case, you’re most likely dealing with menopause!)

If your doctor brushes off the idea of a thyroid condition, you aren’t alone. Only about 25% of women who went to the doctor for menopausal symptoms got a thyroid blood test. One woman says of her experience:

I had [menopausal] symptoms, and was told by my GP it was “probably menopause.” Very frustrating. But another doctor really listened to me, checked and it was my thyroid. There are different standards for TSH levels, so you really need someone who knows what they are doing. She also told me I was “nowhere near menopause.”

In short: ask for the thyroid test anyway!

If a thyroid condition has been ruled out, doctors will rarely do tests to confirm menopause if the woman is in the appropriate age range. However, a blood test can check hormone levels if you want to be sure.

Ok, got it. So, What Can I Do? Treating Menopause vs. Thyroid Disorders

Below you will see why a proper diagnosis is so important. The way these two conditions are treated are vastly different. 

Menopause Treatments

Because menopause is completely natural and supposed to happen to each woman, receiving treatment for menopause is not mandatory. If you choose to do so, it will only be to improve your symptoms and help you live a healthier, happier life during your 40s, 50s, and 60s. These options include:

  • Hormone Replacement Therapy (HRT): While hormone therapy (estrogen therapy) may be one of the more effective choices for symptom management, it doesn’t come without controversy or risk. It may increase chances of heart disease, stroke, or cancer. However, it can also help prevent bone loss. Talk to your doctor about the risks and benefits.
  • Vaginal Estrogen: This is not nearly the same amount of estrogen as hormone therapy; it’s just enough to reduce symptoms of vaginal discomfort, dryness, and pain during intercourse. Because of the low dose, it doesn’t come with the same risks as HRT.
  • Symptom-Related Prescriptions: Depending upon your symptoms or correlated conditions (osteoporosis, for example), your doctor may give you other prescriptions to prevent or treat these other problems separately. 
  • Natural Supplements: Quite a few herbs have been shown to alleviate menopausal symptoms, including black cohosh, vitex, and ashwagandha. These may be particularly helpful in managing hot flashes and mood. Getting enough vitamin D and E as well as your B vitamins is important as well. 

Thyroid Treatments

Unlike Menopause, a thyroid disorder treatment plan is mandatory. They are often long-term solutions you may use the rest of your life.

  • Thyroid Medication: Those with hypothyroidism will take synthetic T3 and T4 to boost their levels (an alternative is actually thyroid hormones from pigs!); those with hyperthyroidism will take an anti-thyroid medicine that reduces the amount of hormone your thyroid makes. Those with hyperthyroidism may also be prescribed beta blockers (the same medication that lowers high blood pressure) to reduce symptoms.
  • Natural Supplements: Though you should talk to your doctor before starting a supplement when you have a thyroid condition, ingredients like zinc, selenium, iodine (for hypothyroidism – the thyroid uses iodine to create its hormones), and ashwagandha may be beneficial to boosting the thyroid’s health and appropriate production of hormones.
  • Diet Changes: People with both hypothyroidism need to avoid cruciferous veggies as they can inhibit T3 and T4. On the other hand, those cruciferous veggies may be helpful to those with hyperthyroidism. Both thyroid conditions can benefit from avoiding gluten and soy.

The Ways Menopause and the Thyroid Are Connected

We know that menopause and thyroid disorders can show up very similarly despite having different treatments, but does one actually have anything to do with the other? Possibly…and they can make each other worse.

First off, changes in hormones affect other hormones. So, when your estrogen plummets during menopause or your T3 and T4 skyrocket in hyperthyroidism, other hormones may become out of balance as well.

One 2011 study discovered there is plenty of evidence showing estrogen can directly impact thyroid cells. That means when your estrogen goes down through your perimenopausal and menopausal years, your thyroid could be affected as well.

On the flip side, it has been shown that a thyroid disorder can potentially make your menopause worse. One study showed proper thyroid treatments (like synthetic TSH, T3, or T4) can improve menopause symptoms – and may even help you avoid hormone replacement therapy. (Another reason to get your thyroid checked!) We also know that those with thyroid disorders are more likely to have an early onset of menopause (sometimes before 40).

Finally, menopause and hypothyroidism can both reduce your bone density and increase your chance of heart disease. So, when put together for women in their 40s, 50s, or 60s, the conditions can bump up your risk of osteoporosis and heart disorders.

Good news: with proper treatment, these troubling connections can be greatly reduced.

Is It Menopause or a Thyroid Disorder? 

If you are a woman in your middle years and start experiencing any of the symptoms mentioned in this article, it is a great idea to make a visit to your doctor. Do not just assume it’s that time of your life and there’s nothing you can do about it. 

If you avoid proper thyroid treatment, not only will your general health be at risk, but you will never feel like you get over those miserable symptoms. And if your thyroid comes back perfectly normal, you can start the process of talking to your doctor about symptom-relief options during your perimenopause and menopause years.