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Perimenopause, Menopause and Hypothyroidism

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In this article, you will find information about perimenopause, menopause and hypothyroidism including what are the symptoms for low thyroid function, what is hypothyroid, how do you get a low thyroid problem, and many more.

About perimenopause and menopause
Perimenopause is the time when your body begins its transition into menopause where the levels of estrogen and progesterone hormones fluctuate irregularly. You become menopausal when your period ceases and doesn't come back for a year. You might go through many years of perimenopause stage before you actually become menopausal. The fluctuation of reproduction hormones may manifest in various perimenopause symptoms which are also suffered by menopausal women such as weight gain, painful breast, irregularity of menstrual cycles, skin dryness, loss of libido, fatigue, etc. Read also When does Perimenopause Start? and What Age does Menopause Start? for more information about perimenopause and menopause.





1 => Thyroid gland
2 => Parathyroid gland

Functions of the thyroid glands
The thyroid gland is one of the major endocrine glands of the body. It secretes thyroid hormones directly into the bloodstream that helps control much of metabolism, stimulate growth and influences almost all the cells' functions in the body such as heart rate, temperature, and stamina/energy.

What is Hypothyroidism?
Hypothyroidism is a condition in which the thyroid gland produces very low or inadequate levels of much needed thyroid hormones. Insufficient amount of thyroid hormone will slow down metabolism resulting in mental and physical changes. Some of mental and physical changes caused by low thyroid function may include unintended weight gain, low body temperature, mentally retarded, slow down of heartbeat, food digestion and muscle contraction.

What are the symptoms for low thyroid function (hypothyroidism)
The symptoms for low thyroid function (hypothyroidism) are varied and mostly mimic symptoms of perimenopause. Common symptoms of hypothyroidism are weight gain, low basal body temperature, brittle fingernails, cold sensitivity and cold hands and/or feet. Other symptoms of hypothyroid include fatigue, weakness, muscle and joint pain, sleep problems, abnormal menstrual periods, hair loss, low sex drive, infertility, loss of concentration, swelling in the face, hands and feet, slowed speech, constipation, paleness, premature graying of hair, headaches, decreased appetite, depression and/or mood swings.

Causes of hypothyroidism
Low thyroid function can be due to a variety of causes, including congenital defects, history of thyroid radiation, treatment for an overactive thyroid (Graves disease), removal of the thyroid gland (thyroidectomy), iodine deficiency, and medication side-effects, such as lithium, amiodarone and iodine. The most common cause of hypothyroid is an autoimmune disorder called Hashimoto’s thyroiditis in which the thyroid tissue is attacked and mistreated as a threat.

Perimenopause, menopause and hypothyroidism
Both perimenopause and hypothyroid occur commonly in midlife women. Perimenopause happens for all women while cases of hypothyroidism increase with advancing age especially in women, thus, it is possible that perimenopause and hypothyroidism occur in the same time. Moreover, many of the common symptoms in perimenopause and menopause resemble low thyroid problem such as sleep disturbances, perimenopause depression, and decreased energy and memory. This is why many midlife women were misdiagnosed as going through perimenopause when they are actually suffering from undiagnosed hypothyroid or both. Hence, it is important to discuss your problems with your doctor to avoid delay in diagnosis and treatment of hypothyroidism. Moreover, menopausal women should be routinely screened for thyroid disease as part of their annual examination.

Perimenopause symptoms versus hypothyroidism symptoms

Hypothyroidism, perimenopause / menopause and weight gain - both hypothyroidism and perimenopause / menopause are associated with weight gain. Too little thyroid will slow down the metabolism, and in many cases, lead to unintended weight gain. Weight gain in menopause and perimenopause is also very common which is believed to be related to overproduction of estrogen and underproduction of progesterone.

Low basal body temperature - Coldness sensation is one of the symptoms for low thyroid that is also occurred in perimenopause and menopause. In hypothyroidism, the coldness is intermittent, and it is not preceded by hot flash and sweating. While in perimenopause and menopause, the coldness or chilling sensation is typically come from the evaporation of sweats after an episode of hot flash and night sweat.

Sleep disturbances - Both hypothyroid and perimenopause / menopause may cause sleep disturbances. Perimenopausal and menopausal women may experience mid-sleep wakening and unable to get back to sleep. Hypothyroidism sufferers may already have slept many hours, but still feel very tired waking up.

Low energy and fatigue - Both hypothyroid and menopause / perimenopause may cause low energy and fatigue. The typical type of tiredness in hypothyroid woman is that she feels tired and needs more and more sleep most of the time. While in perimenopausal and menopausal woman, the low energy and fatigue are often caused by mid-sleep wakening she experienced in the night.

Abnormal menstrual cycles - Both low thyroid function and perimenopause cause periods changes and heavy bleeding. It is very common for women to experience irregular and heavy bleeding during perimenopausal stage. Contrarily, abnormal menstrual cycles rarely occur in hypothyroidism and if they do occur, they often come every two weeks with heavy bleeding. However, perimenopausal women with hypothyroidism usually have regular periods.

Diagnosis of hypothyroidism
Laboratory tests like the T4 test or the serum TSH are the most common and effective ways to diagnose hypothyroid. You may consider taking a TSH (thyroid stimulating hormone) test if you experience the following symptoms:

  • Coldness sensation in the middle of your body
  • Tiredness even after long hours of sleep
  • Unintentional weight gain
  • Swelling in the neck when swallowing

Treatment for hypothyroidism
The goal of hypothyroidism treatment is to replace the deficient thyroid hormone with thyroid hormone replacement therapy such as Levothyroxine and alleviate many symptoms of low thyroid function. Since high levels of thyroid will increase bone loss and be dangerous for your heart, the hormone dosage is adjusted gradually until the lowest effective dose is obtained. Once treated, most patients can live a normal life, but life-long therapy is often needed.

Going through perimenopause or menopause and having hypothyroidism don’t mean you can't live a quality life. If you suspect the signs and symptoms you felt are more likely to be caused by an undiagnosed low thyroid problem than perimenopause or menopause, do not hesitate to let your doctor know. If needed, he will recommend having your TSH checked. If you do have an under-active thyroid gland, your doctor probably will prescribe thyroid replacement therapy accordingly to fill-in the lack of thyroid hormone. This treatment will help improve your metabolism and eventually enhance the quality of your life whether you are in the perimenopausal or menopausal stage.

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Disclaimer: This information is not presented by a medical practitioner and is for educational and informational purposes only. It is not intended to be a substitute for professional advice, diagnosis, or treatment.