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  • Symptoms of Menopause: Could Your Thyroid Be the Cause?

    Image for menopause article While many women of a certain age who experience symptoms such as dry skin, moodiness, insomnia, and irregular periods may jump to the conclusion that they are menopause-related, it is possible that their symptoms are actually due to hypothyroidism, a condition caused by an underactive thyroid gland that also tends to affect women 50 years and older.
    The thyroid is a butterfly-shaped gland in the neck. It may be small, but it is a veritable powerhouse when it comes to producing and regulating the hormones that affect every cell in your body. So how can you know if your symptoms are caused by menopause or hypothyroidism?

    Similar Symptoms

    There are several reasons why symptoms of hypothyroidism might be identified as symptoms of menopause:
      There is a great deal of overlap between the symptoms of hypothyroidism and those of initial phase of menopause (perimenopause). Similar symptoms include:
      • Dry skin
      • Fatigue
      • Weight changes
      Perimenopause and hypothyroidism often occur in women of very similar age ranges:
      • Perimenopause may begin as early as age 35 or 40 years. Symptoms can last up until menopause at age 45-50.
      • Hypothyroidism affects 1 out of 8 women aged 35-65 years old, and one 1 out of 5 women over the age of 65.
      The symptoms of hypothyroidism may become more pronounced due to the hormonal changes occurring during perimenopause. Here are some of the other symptoms you may experience with hypothyroidism:
      • Constipation
      • Anemia
      • Intolerance to cold
    Undiagnosed thyroid problems are a common problem. Since the risk of developing thyroid disease increases with increasing age, elderly women have a particularly high risk for such disorders. The majority of post-menopausal women with thyroid disorders will have either no or very subtle symptoms and have what is known as asymptomatic thyroid disease. So women may have it and not know.

    Is Treating Hypothyroidism Important?

    Most patients with symptomatic hypothyroidism will get treatment to help reduce symptoms. However, for women that have low thyroid levels but do not have symptoms, the answer is not so clear. Some research shows that hypothyroidism, particularly when it is asymptomatic, should be carefully monitored, but not necessarily treated.
    Research also shows that women without symptoms had no improvement in quality of life whether they had medication or not.
    Evidence is mixed that there is an increased risk for atherosclerosis (which could lead to a heart attack) in women without symptoms. Some doctors advocate treatment, others like to wait and see. Either way, the best advice is to talk to your doctor about your concerns and monitor your health through scheduled check ups.
    The American Association of Clinical Endocrinologists recommend treatment for asymptomatic women with a goiter or positive anti-thyroid peroxidase antibodies (determined from a blood test). In most cases, one or both of these generally leads to symptomatic hypothyroidism.

    The Bottom Line

    Talk with your doctor about symptoms you may be having. You and your doctor can make a plan to manage your symptoms and if necessary plan for further testing. Testing, if needed, usually requires no more than a simple blood test to measure the level of a substance called thyroid stimulating hormone (TSH). When the thyroid is underactive, the levels of TSH in the blood increase in an attempt to stimulate the thyroid to be more active.
    If you are found to have hypothyroidism, rest assured that treatment for hypothyroidism is relatively simple and generally very effective. A synthetic thyroid hormone called levothyroxine can be given orally, usually resulting in complete relief of symptoms.

    RESOURCES

    American Association of Clinical Endocrinologists http://www.aace.com/

    American Medical Women’s Association http://www.amwa-doc.org/

    CANADIAN RESOURCES

    Canadian Institute for Health http://www.cihi.ca/

    Thyroid Foundation of Canada http://www.thyroid.ca/

    References

    Hak AE, et al. Subclinical hypothyroidism is an independent risk factor for atherosclerosis and myocardial infarction in elderly women: The Rotterdam Study. Ann Intern Med. 2000;132:270-278.

    Hypothyroidism. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated November 19, 2012. Accessed November 21, 2012.

    Ibay AD, Bascelli LM, Nashelsky J. Management of subclinical hypothyroidism. Am Fam Physician. 2005;71(9):1763-4. Available at: http://www.aafp.org/afp/20050501/fpin.html . Accessed August 8, 2005.

    Jaeschke R, Guyatt G, Gerstein H, et al. Does treatment with L-thyroxine influence health status in middle-aged and older adults with subclinical hypothyroidism? J Gen Intern Med. 1996;11:744-749.

    Medical Guidelines for Clinical Practice for the Evaluation and Treatment of Hyperthyroidism and Hypothyroidism. American Association of Clinical Endocrinologist website. Available at: https://www.aace.com/files/hypo-hyper.pdf. Accessed November 21, 2012.

    Meier C. TSH-controlled L-thyroxine therapy reduces cholesterol levels and clinical symptoms in subclinical hypothyroidism. J Clin Endocrinol Metab. 2001;86:4860-4866.

    Menopause. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated June 11, 2012. Accessed November 21, 2012.

    Monzani F, Bello VD, Caraccio N, et al. Effect of levothyroxine on cardiac function and structure in sublinical hypothyroidism: a double blind placebo-controlled study. J Clin Endocrinol Metab. 2001;86:1110-1115.

    Rodondi N, Newman AB, Vittinghoff E, et al. Subclinical hypothyroidism and the risk of heart failure, other cardiovascular events, and death. Arch Intern Med. 2005 Nov 28;165(21):2460-6.

    Schindler AE. Thyroid function and postmenopause. Gynecol Endocrinol. 2003;17:79-85.

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