Rutgers Cancer Institute of New Jersey
195 Little Albany Street
New Brunswick, NJ 08903-2681
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 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?
There are several reasons why symptoms of hypothyroidism might be identified as symptoms of menopause:
Undiagnosed thyroid problems are a common problem. The majority of post-menopausal women with thyroid disorders will have either no or very subtle symptoms and have what is known as subclinical thyroid disease. So women may have it and not know it.
Most people with symptomatic hypothyroidism will get treatment to help reduce symptoms. However, for women who have subclinical (asymptomatic) hypothyroidism, the answer is not so clear. Some research shows that hypothyroidism, particularly when it is subclinical, 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 or stroke) in women without symptoms. Some doctors advise treatment, while 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 advise 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.
Talk with your doctor about symptoms you may be having. You and your doctor can make a plan to manage your symptoms and if needed, plan for further testing. Testing 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 simple and effective. A synthetic thyroid hormone called levothyroxine can be given orally, usually resulting in complete relief of symptoms.
American Medical Women’s Association
Hormone Health Network—Endocrine Society
Canadian Institute for Health
Thyroid Foundation of Canada
Gaitonde DY, Rowley KD. Hypothyroidism: An update. Am Fam Physician. 2012;86(3):244-251.
Garber JR, Cobin RH, et al. Clinical practice guidelines for hypothyroidism in adults: Co-sponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association. Endocr Pract. 2012;18(6):988-1028.
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 in adults. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T115914/Hypothyroidism-in-adults. Updated July 12, 2016. Accessed October 12, 2016.
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.
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 Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T114698/Menopause. Updated July 22, 2016. Accessed October 12, 2016.
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, et al. Subclinical hypothyroidism and the risk of heart failure, other cardiovascular events, and death. Arch Intern Med. 200528;165(21):2460-2466.
Schindler AE. Thyroid function and postmenopause. Gynecol Endocrinol. 2003;17(1):79-85.
Last reviewed October 2016 by Michael Woods, MD Last Updated: 10/24/2014