Menopause marks a significant transition in a woman’s life, typically occurring between the ages of 45 and 55. While most attention is given to the decline in estrogen and progesterone, the thyroid gland also plays an important role during this time. The relationship between thyroid function and menopause is complex, as thyroid issues can complicate menopause by mimicking or intensifying symptoms like weight gain, hair loss, and hot flashes. Because of this overlap, it’s essential to understand how thyroid health and menopause are connected.(1)(2)(3)
Menopause and Thyroid Function
During menopause, fluctuations in reproductive hormones can affect the thyroid gland, a butterfly-shaped organ located at the base of the neck. The thyroid regulates several bodily functions, including metabolism, energy levels, and temperature regulation, by producing thyroid hormones, primarily thyroxine (T4) and triiodothyronine (T3). The most common thyroid issues that emerge during or after menopause are hypothyroidism (underactive thyroid) and hyperthyroidism (overactive thyroid). Both conditions share symptoms with menopause, which can complicate diagnosis.(3)(4)(5)
Hypothyroidism and Menopause
Hypothyroidism, or an underactive thyroid, occurs when the thyroid does not produce enough thyroid hormones. It’s often caused by autoimmune conditions where the body’s immune system attacks the thyroid gland. Declining estrogen levels during menopause can affect the way the thyroid functions. Low thyroid hormone levels can lead to the following symptoms:
Weight gain
Fatigue
Depression
Cold intolerance
Dry skin
Hair loss
These symptoms often have a strong overlap with those of menopause, which can sometimes lead to the condition being overlooked or misdiagnosed. Studies show that hypothyroidism tends to become more common in women after menopause, likely due to a mix of hormonal changes and the natural aging process.(1)(3)(4)(7)
Hyperthyroidism and Menopause
On the other hand, hyperthyroidism happens when the thyroid gland produces too much thyroid hormone, causing high thyroid levels. While it's less common than hypothyroidism, it can still occur during menopause. Symptoms of hyperthyroidism can include the following:
Weight loss
Rapid heartbeat
Increased sweating
Nervousness or irritability
Heat intolerance
Hot flashes are a hallmark of menopause, but hyperthyroidism can aggravate this symptom. Women experiencing hot flashes should consider whether thyroid function is contributing to the intensity or frequency of these episodes.(3)(4)(8)
Common Thyroid and Menopause Symptoms
The symptoms of thyroid dysfunction and menopause can be strikingly similar. Understanding the overlap can help in distinguishing between the two and managing symptoms appropriately.
Weight Changes
Weight gain is a frequent concern during menopause, largely because hormonal changes can slow down the metabolism. An underactive thyroid can further contribute to weight gain by reducing the production of thyroid hormones. Together, menopause and low thyroid function can make it especially tough to manage weight.
Estrogen helps regulate how the body distributes fat, and as its levels drop during menopause, many women notice weight gain, particularly around the abdomen. Similarly, hypothyroidism slows metabolism, making it easier for the body to store fat. By addressing both conditions through lifestyle changes and medication, women may find it easier to manage weight gain.(2)(3)(4)(6)(7)
Hair Loss
Hair loss is another common symptom associated with both menopause and thyroid dysfunction. The drop in estrogen levels during menopause can lead to thinning hair, while hypothyroidism can cause diffuse hair loss across the scalp. Women experiencing both menopause and thyroid dysfunction may notice more pronounced hair thinning.
Fortunately, hair loss related to thyroid issues often improves with appropriate management of thyroid hormones. Meanwhile, hair loss caused by menopause may benefit from hormone replacement therapy (HRT) or other treatments aimed at balancing estrogen levels.(4)(7)(8)
Hot Flashes
Hot flashes are one of the most well-known symptoms of menopause, but they can also be connected to thyroid dysfunction. Women with an underactive thyroid may feel unusually cold, while those with an overactive thyroid may feel hot and sweaty — symptoms that can easily be confused with menopausal hot flashes.
It can be tricky to tell the difference between hot flashes caused by menopause and those related to thyroid issues. Keeping track of other symptoms, such as changes in weight, mood, or energy levels, can help guide diagnosis and treatment. In some cases, thyroid testing may be needed to know if thyroid function is contributing to these hot flashes.(2)(3)(4)(6)(8)
Mood Changes
Fluctuations in mood, including depression, anxiety, and irritability, are common during menopause and can also be tied to thyroid issues. Both menopause and thyroid dysfunction impact brain chemicals like serotonin, which play a key role in regulating mood. The hormonal changes that come with menopause, along with either low or high thyroid hormone levels, can make emotional symptoms feel more intense, resulting in more frequent mood disturbances.
Fortunately, HRT and thyroid hormone therapy can help stabilize these mood fluctuations, making it easier to manage emotional ups and downs during this time.(2)(3)(4)(6)(7)(8)
Fatigue
Fatigue is a common symptom of both menopause and thyroid dysfunction. In menopause, fluctuating estrogen levels can disrupt sleep patterns, leading to feelings of exhaustion. Similarly, an underactive thyroid (hypothyroidism) slows down metabolic processes, leaving women feeling sluggish and constantly tired. The combination of these factors can significantly increase fatigue, making it more difficult to keep up with daily activities.
Targeted therapies can help manage both conditions. By addressing menopause and thyroid dysfunction, women can often see improvements in their energy levels and overall well-being.(2)(3)(4)(6)(7)
Differentiating Between Thyroid and Menopause Symptoms
Although many symptoms of menopause and thyroid dysfunction overlap, a key difference is that thyroid dysfunction affects metabolism and often leads to persistent changes in energy levels and temperature regulation. For instance, hyperthyroidism is more likely to cause a racing heart, excessive sweating, and unexplained weight loss — symptoms that aren’t usually linked to menopause. On the other hand, hypothyroidism tends to cause cold intolerance, muscle weakness, and dry skin, which are also less common during menopause.
To determine if a thyroid disorder is present, blood tests measuring thyroid-stimulating hormone (TSH) and thyroid hormones (T3 and T4) are essential. These tests can help confirm whether thyroid issues are contributing to or causing the symptoms.(1)(6)
Thyroidectomy and Menopause: What to Expect
Women who have undergone a thyroidectomy, the surgical removal of the thyroid gland, often face unique challenges during menopause. Without a thyroid gland, the body can’t produce thyroid hormones on its own, requiring lifelong thyroid hormone therapy. This can make managing menopausal symptoms more complicated, as the need for hormone regulation increases.
Additionally, women who have had a thyroidectomy may experience more intense menopausal symptoms because their bodies are already adapting to the loss of thyroid function. These individuals need to work very closely with their healthcare providers to address both thyroid and menopausal symptoms effectively.(9)(10)
Managing Thyroid Issues and Menopause
Given the intricate relationship between thyroid health and menopause, it’s important for women to stay proactive about their health. Regular check-ups with healthcare providers, including thyroid function tests, can help detect any imbalances early. Depending on the diagnosis, treatment options may include one of, or a mix of, the following:(3)(4)(7)(8)
Hormone Replacement Therapy: For menopause, HRT can help alleviate symptoms such as hot flashes, night sweats, and mood changes by replenishing estrogen and progesterone levels.
Thyroid Hormone Therapy: If hypothyroidism is diagnosed, synthetic thyroid hormones may be prescribed to help restore normal thyroid function.
Lifestyle Modifications: Eating a balanced diet rich in iodine and selenium, which support thyroid function, and maintaining regular physical activity are essential to managing weight and energy levels.
Prioritizing Thyroid Health During Menopause
The link between thyroid function and menopause is clear, as both thyroid disorders and the changes that come with menopause affect many of the same bodily functions. Paying attention to this complex relationship can help empower women to seek the right treatments and enhance their quality of life during this transitional time. Maintaining thyroid health through regular monitoring and a comprehensive treatment plan is essential for effectively navigating the complexities of menopause.
Women experiencing symptoms such as fatigue, weight gain, hair loss, or hot flashes should consider discussing thyroid function with their healthcare providers. By addressing both thyroid and menopausal health, individuals can alleviate symptoms and improve their overall well-being.
