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. The thyroid, a butterfly-shaped gland in the neck, 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?

Why the Confusion?

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 perimenopause.
  • Perimenopause and hypothyroidism often occur in women of very similar age ranges:
    • Perimenopause may begin as early as age 35 or 40; 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.

Furthermore, undiagnosed thyroid problems are a common problem. In comparison to men, women are significantly more likely to have thyroid problems. And 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 suffer from a condition known as subclinical thyroid disease. The majority of these women will have an underactive thyroid condition (hypothyroidism).

Is Treating Hypothyroidism Important?

Most patients with symptomatic hypothyroidism will get treatment to help reduce symptoms. But for women that have low thryoid levels but do not have symptoms, the answer is not so clear. Some researchers believe that hypothyroidism, particularly when it is subclinical (not dramatically impacting a woman’s quality of life), should be carefully monitored, but not necessarily treated. This was the conclusion of a study that was published in the Journal of General Internal Medicine. In this study, the researchers evaluated a variety of quality-of-life and blood lipid parameters in 37 women with subclinical hypothyroidism who were randomly assigned to receive either placebo or thyroid replacement therapy. The group receiving thyroid replacement showed no significant clinical improvement in quality of life or serum lipid parameters, when compared to the group receiving only placebo.

On the other hand, there are those that believe not treating subclinical hypothyroidism increases a woman’s risk of several serious complications, including decreased heart function, increased risk of blood vessel disease, and heart attack. For example, researchers evaluated 1,149 postmenopausal women to determine if there was a relationship between subclinical hypothyroidism and aortic atherosclerosis and myocardial infarction (heart attack) in postmenopausal women. The study concluded that subclinical hypothyroidism is indeed a strong indicator of risk for atherosclerosis and myocardial infarction in elderly women. A brief but comprehensive review of this topic by Dr. Annamarie Ibay and colleagues concluded that there is as yet insufficient evidence to justify treating most adults with subclinical hypothyroidism. Another study also found that subclinical hypothyroidism was associated with increased risk of heart failure in 70-year-olds (this study evaluated both women and men).

The Bottom Line

If you are experiencing symptoms of hypothyroidism—such as fatigue, memory loss, depression, problems with thinking—talk with your healthcare provider so the two of you can determine whether further testing is needed. If so, this 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 also relatively simple and generally very effective. A synthetic thyroid hormone called levothyroxine (Synthroid, Levothroid) can be given orally, usually resulting in complete resolution of symptoms.