Hypothyroidism vs. menopause: Differences in symptoms, causes, and treatment

By: Dr. Victor Marchione | Women's Health | Monday, May 16, 2016 - 03:00 PM

hypothyroidism vs. menopauseHypothyroidism and menopause may be two different conditions, but they do have a connection, thus women may want to have a better understanding of these two health situations, including the symptoms, causes, and possible treatments.

Hypothyroidism happens when your thyroid gland doesn’t produce enough of certain hormones. Women who are over the age of 60 are most likely to have hypothyroidism. It upsets the normal balance of chemicals in the body. In the early stages, many people with hypothyroidism don’t notice any symptoms, but in time, if untreated, it can lead to a number of health problems.

Menopause, like puberty, is a normal part of a woman’s life. It’s a time when menstrual period ends. A woman going through menopause experiences changes in her hormones and notices changes in her body just before and after menopause. The transition has three phases: perimenopause, menopause, and postmenopause. Perimenopause can begin many years before a woman’s last period. Some symptoms can arise due to changes in hormones. Menopause is next, and following one full year without a period a woman is considered to be in postmenopause.

Hypothyroidism and menopause connection

So just what is the hypothyroidism and menopause connection? There are many factors that trigger thyroid imbalances in women. Stress, nutritional issues, and hormonal changes are some of them. Older women are more prone to hypothyroidism. Autoimmunity develops more with aging and can cause thyroid imbalance. Autoimmune thyroid imbalance is when your own cells attack the thyroid gland. Premenopausal levels of the hormone estrogen help our immune system handle our own cells, but a decline in estrogen makes this process less efficient. When a woman goes through menopause, the body produces fewer hormones.

If a person already has low thyroid function they will be familiar with symptoms like low energy, lower sex drive, weight gain, worsening memory, and, perhaps, hair loss, but these are the same signs people experience in menopause. Gynecologists report that low thyroid function can in some cases make menopause symptoms worse.

The American Association of Clinical Endocrinologists (AACE) states that millions of women with menopause-like symptoms could be suffering from thyroid disease and not realize it, because many symptoms overlap with menopause. A survey by AACE showed that only one in four women who have talked about menopause with their doctors have also been tested for thyroid disease. The thyroid is vital to good health. It plays an important role in regulating body metabolism and impacts the heart, brain, kidney, and the reproductive system. It also influences our muscle strength and appetite.

Hypothyroidism vs. menopause: U.S. prevalence

thyroidThe thyroid is a two-inch long, butterfly-shaped gland that weighs less than one ounce. It is located in the front of the neck below the voice box. Essentially, it stores hormones and releases them into the bloodstream. Those hormones affect metabolism, brain development, breathing, heart and nervous system function, body temperature, muscle strength, skin moisture level, menstrual cycle, weight, and even cholesterol level. About 4.6 percent of the U.S. population has hypothyroidism.  Hypothyroidism and early menopause has been well documented. Some women with hypothyroidism have experienced menopause before age 40 or during their 40s.

In 1998, there were about 477 million postmenopausal women in the world, but our global population is aging. By 2025, that number is expected to climb to 1.1 billion. Age is not always a factor though. There are some people who experience menopause prematurely. Women who receive cancer treatment, surgical removal of ovaries, or those who have a family history of early menopause may stop having a period earlier than expected. Some studies also show that early menopause has been linked to smoking, a history of heart disease, and never having children.

Difference between hypothyroidism and menopause, signs and symptoms

Hypothyroidism and menopause symptoms can be similar, but they also have some distinct characteristics.

If you suffer from hypothyroidism, you may in fact barely notice symptoms like fatigue. But as your metabolism continues to slow down, more signs could emerge. Below is a list of possible hypothyroid symptoms.

  • Sensitivity to cold
  • Dry skin
  • Weight gain
  • Constipation
  • Muscle weakness
  • Elevated cholesterol level
  • Puffy face
  • Pain, stiffness, or swelling in joints
  • Irregular menstrual periods
  • Thinning hair
  • Slowed heart rate
  • Depression
  • Impaired memory

When it comes to menopause, you might notice a change in your period at first. For example, your periods may not be regular anymore, or they may be short or longer. You could also bleed less than you normally would.

Here are some other typical menopause symptoms:

  • Hot flashes
  • Vaginal dryness
  • Loss of bladder control
  • Trouble sleeping
  • Lower sex drive
  • Irritability or moodiness
  • Fatigue
  • Weight gain
  • Memory problems

Comparing hypothyroidism and menopause causes

Hypothyroidism increases mortality risk among heart failure patientsHypothyroidism occurs when the gland that produces and dispenses hormones fails. This could be due to an autoimmune disease. Autoimmune diseases take place when your immune system produces antibodies that attack your own cells. Sometimes, this can involve the thyroid gland. For some reason, it seems that the antibodies impact the thyroid’s ability to produce hormones.

People who have hyperthyroidism, which is too much of thyroid hormone, are treated with radioactive iodine or with other anti-thyroid medications. Unfortunately, in some cases, this treatment can lead to permanent hypothyroidism.

Thyroid surgery could diminish or stop hormone production and lead to hypothyroidism. Radiation therapy and other medications can contribute to hypothyroidism as well.

As far as menopause goes, it is normally caused by a natural decline in reproductive hormones. As women age, their bodies make less estrogen and progesterone. These are the hormones that regulate menstrual cycles. Early 50s is the average age for menopause. However, menopause can also be caused by a hysterectomy or partial hysterectomy, by chemotherapy and radiation therapy, or by primary ovarian insufficiency. Primary ovarian insufficiency occurs when a woman’s ovaries don’t produce normal levels of reproductive hormones due to genetic factors or autoimmune disease. In these cases, hormone therapy is often recommended until the natural age of menopause to protect the brain, heart, bones, and muscles.

Hypothyroidism vs. menopause: Risk factors and complications

Anyone can get hypothyroidism, but those over the age of 60 or with an autoimmune disease are at an increased risk for the condition. Below we list other possible risk factors.

  • Having a family history of thyroid disease
  • Having been treated with radioactive iodine or anti-thyroid medications
  • Having received radiation in your neck or upper chest
  • Having had thyroid surgery
  • Having been pregnant or delivered a baby in the past six months

When hypothyroidism goes untreated it can lead to health problems, including goiter (which is enlargement of the thyroid gland), peripheral neuropathy (damage to nerves that carry information from your brain and spinal cord to the rest of your body), heart problems, mental health issues, as well as myxedema, which is intense cold intolerance and drowsiness followed by lethargy and unconsciousness. Untreated hypothyroidism has also been associated with infertility and birth defects. Babies born to those with untreated thyroid disease are at a higher risk of birth defects than babies born to healthy mothers.

The difference between hypothyroidism and menopause is that menopause is a natural point in a woman’s life. It is true that some factors may cause a woman to go through menopause early, including smoking, family history, cancer treatment, and hysterectomy. But it is important to know that many women who go through this phase of their lives are actually relieved since they no longer have to worry about pregnancy or discomfort associated with menstrual cycles. Some women are even lucky enough not to experience symptoms like hot flashes or they have mild symptoms.

Difference in hypothyroidism and menopause, diagnosis and treatment

hormone balanceAlthough hypothyroidism and menopause can be connected, they are diagnosed and treated differently. Diagnosis of hypothyroidism is based on symptoms and blood tests that measure TSH, which stands for thyroid stimulating hormone. Sometimes, the level of thyroid hormone thyroxine can help in diagnosing the condition. Since the TSH test is considered the best screening test, most doctors will check this first and follow up with a thyroid hormone test if they deem it necessary. The TSH test is important because it can help a doctor determine the right dosage of medications to treat the thyroid problem.

Typical treatment for hypothyroidism involves daily use of a synthetic hormone. It is an oral medication that helps restore hormone levels and reverse the symptoms of the condition. Many patients report a noticeable change in symptoms after taking medication for just one or two weeks. The required dosage of your medication may have to change over time, so your doctor will want to check TSH level at least once a year. Even diet can play a major role during the treatment process of hypothyroidism. Some foods can deteriorate the hypothyroidism condition even more, so managing with hypothyroidism suitable diet can be helpful.

Tests aren’t normally conducted to determine if you are in menopause. Signs and symptoms can usually indicate to a doctor that your body is in transition. As far as treatment is concerned, most women do not require anything. In the majority of cases, it is a matter of learning to cope with the symptoms. In some cases though, there are treatments that can be administered, including those listed below.

  • Hormone therapy
  • Vaginal estrogen
  • Low-dose antidepressants
  • Gabapentin (Neurontin) to reduce severe hot flashes
  • Medications to prevent or treat osteoporosis

Perhaps the easiest way to look at both hypothyroidism and menopause is to remember that hormones are the body’s little messengers. When something goes wrong with those messengers we can experience the symptoms described above, and while on the surface they may sound like no big deal, when it comes to hypothyroidism, we can’t take these changes in our body lightly – our bodily structure and function are at stake. As for menopause, it can be an inconvenience, especially if you experience extreme symptoms. The key is to understand whether you are going through a natural change in life or if the change is due to something more complicated like hypothyroidism.


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Sources:
http://www.mayoclinic.org/diseases-conditions/hypothyroidism/home/ovc-20155291
https://www.nia.nih.gov/health/publication/menopause
http://www.womenshealthnetwork.com/thyroid-health/hypothyroidism-in-menopause.aspx
http://www.webmd.com/menopause/guide/symptoms-thyroid-vs-menopause
http://www.niddk.nih.gov/health-information/health-topics/endocrine/hypothyroidism/Pages/fact-sheet.aspx
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https://www.atlastnaturals.com/pages/Risk-Factors-of-Menopause.html
http://www.mayoclinic.org/diseases-conditions/menopause/basics/definition/con-20019726
http://www.mayoclinic.org/diseases-conditions/perimenopause/basics/risk-factors/con-20029473


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