Thyroid Disease and Menopause: Are They Linked? 

If you have thyroid disease, you know it can make you feel below par in many ways. But even if you don’t have a diagnosis, knowing more about thyroid disease will serve you well in middle age. 

To that end, here’s a quick quiz for you.  

Fatigue, weight changes, and hair loss are all signs of ______________ in women. 
A. perimenopause 
B. menopause 
C. thyroid disease 
D. all of the above  

If you chose “D” as the answer, you’re correct. Thyroid disease has shared symptoms with perimenopause and menopause, including fatigue, weight gain, hair loss—and many more.  

So sometimes, women in middle age may blame certain symptoms on menopause, when they actually have an undiagnosed thyroid problem, too. (1, 2)   

A bit about thyroid disease 

The thyroid gland, which is shaped like a butterfly, sits mid-neck in front of your windpipe. It makes hormones that regulate your metabolism and help with a gazillion other processes affecting every part of your body. (3) 

There are two main types of thyroid dysfunction: overactive and underactive. 

• With overactive thyroid (hyperthyroidism), your thyroid makes too much thyroid hormone. (4) 

• With underactive thyroid (hypothyroidism), your thyroid doesn’t make enough thyroid hormone. (5) 

And when it comes to middle age, here’s the kicker: The risk of developing hypothyroidism or hyperthyroidism increases as you age. (6) That means as a perimenopausal or menopausal woman, you’re at higher risk of developing thyroid disease.   

When thyroid problems and menopause collide 

If you already have thyroid disease when you hit perimenopause or menopause, it can be difficult to know which condition is causing certain symptoms. Are you gaining weight and losing your hair due to your hypothyroidism or perimenopause? Is it hyperthyroidism or menopause that’s keeping you from falling asleep at night? Oftentimes, the symptoms of thyroid disease and menopause overlap. (1,2) 

Here’s a chart to show how this overlap may occur: 

Overlapping symptoms of thyroid disease and peri/menopause 

 
Chart references: Hypothyroidism (5,6,7), hyperthyroidism (4,8), peri/menopause (9) 

 
While research is still investigating this connection, we know that estrogen and thyroid hormones can influence each other, which may cause your symptoms to get worse. (10) Hypothyroidism, especially, can intensify menopause symptoms. (1)  

So, the double whammy of thyroid symptoms and menopause symptoms can be a challenge, especially when you’re not sure which condition is causing which symptoms. 

Your thyroid medication choice matters 

Did you know that declining estrogen levels may alter the amount of thyroid medication you need? That’s why it’s critical to get your thyroid levels checked and modify the dose, if needed.  

Belmar offers compounded thyroid medication – including desiccated thyroid tablets and synthetic T4 and/or T3 tablets or powder capsules, customized for individual needs. Whether you need T3 or T4, or a combination of both, a compounded dosage form can ensure you get the hormone support your body needs. To read more about available compounded thyroid options, click here.

Like with other aspects of life, it’s about balance. Optimizing hormone balance for both your thyroid condition and menopause could be a game-changer. (11) 

Consider thyroid testing to help protect your health 

You may already know that postmenopausal women are at increased risk for both osteoporosis and cardiovascular disease. But once again, the thyroid can come into play, because having untreated thyroid disease may intensify these risks. (12,13) Thyroid dysfunction that isn’t addressed can also lead to depression and cognitive impairment. (6)  

That means untreated thyroid disease during menopause can be a double whammy for your bones, brain, and heart. Yikes! 

Since addressing an underlying thyroid disorder may help manage your menopause symptoms and may also help lower your risk of serious health issues, it’s critical to get your thyroid tested. (1) 

Thyroid testing and compounded medications 

To get a thyroid screening, you need a physical exam and a thyroid blood test. (14)  

The first blood level most providers check is thyroid-stimulating hormone (TSH), which is produced by the pituitary gland in the brain. TSH tells your thyroid gland to make the main thyroid hormone called T4. Your body converts some of your T4 into T3, the active form of thyroid hormone that does all kinds of jobs to keep you healthy. 

Ask your provider to order a thyroid panel that may include TSH, total T4, free T4, total T3, free T3, and reverse T3. If you’re diagnosed with thyroid disease, they may also test for thyroid antibodies. (14) 

Once you have your test results, your provider can prescribe medication to address your unique needs in the form of synthetic T3 and T4, or desiccated thyroid.  

Get to the root cause of your symptoms 

While we still don’t know everything about how thyroid hormones and sex hormones interact during perimenopause and menopause, we do know they’re linked. (10)  

If symptoms are affecting your day-to-day life, don’t wait around to see if they improve. Be proactive. Talk to your provider about getting the full picture on what’s driving the symptoms. Check for thyroid disease, and if you have it, learn more about available therapies.  

If your thyroid levels are stable and you still have menopause symptoms, you may want to consider other hormone therapies, as well. Getting the therapy for your unique needs can balance your hormones—to help you feel better and protect your overall wellness. 

References:  

1. Panda, Subrat; Das, Ananya. Analyzing Thyroid Dysfunction in the Climacteric. Journal of Mid-life Health 9(3):p 113-116, Jul–Sep 2018. | DOI: 10.4103/jmh.JMH_21_18 
   Link: Journal of Mid-life Health 

2. Boucai L. Overview of thyroid function. Merck Manual. Revised February 2024. Accessed May 3, 2025. 
   Link: Overview of Thyroid Function – Endocrine and Metabolic Disorders – Merck Manual Professional Edition 

3. Hyperthyroidism. American Thyroid Association. Accessed May 3, 2025. 
   Link: Hyperthyroidism | American Thyroid Association 

4. Hypothyroidism. American Thyroid Association. Accessed May 3, 2025. 
   Link: Hypothyroidism | American Thyroid Association 

5. Gietka-Czernel M. The thyroid gland in postmenopausal women: physiology and diseases. Prz Menopauzalny. 2017 Jun;16(2):33-37. doi: 10.5114/pm.2017.68588.  
   Link: The thyroid gland in postmenopausal women: physiology and diseases – PMC 

6. Boucai L. Hypothyroidism. Merck Manual. Revised June 2024. Accessed May 3, 2025.  
   Link: Hypothyroidism – Endocrine and Metabolic Disorders – Merck Manual Professional Edition 

7. Boucai L. Hyperthyroidism. Merck Manual. Revised March 2024. Accessed May 3, 2025.  
   Link: Hyperthyroidism – Endocrine and Metabolic Disorders – Merck Manual Professional Edition 

8. Menopause Symptoms Checklist. National Menopause Foundation.  
   Link: NMF_SymptomChecklist2024_ENG-.pdf 

9. Santin AP, Furlanetto TW. Role of estrogen in thyroid function and growth regulation. J Thyroid Res. 2011;2011:875125. doi: 10.4061/2011/875125. 
   Link: Role of Estrogen in Thyroid Function and Growth Regulation – PMC 

10. Thyroid and menopause article. British Thyroid Foundation. Updated May 2023. Accessed May 3, 2025.  
    Link: Thyroid and menopause article 

11. Pearce EN. Thyroid dysfunction in perimenopausal and postmenopausal women. Menopause Int. 2007 Mar;13(1):8-13. doi: 10.1258/175404507780456746. 
    Link: Thyroid dysfunction in perimenopausal and postmenopausal women – PubMed 

12. Frank-Raue K, Raue F. Thyroid Dysfunction in Periand Postmenopausal Women-Cumulative Risks. Dtsch Arztebl Int. 2023 May 5;120(18):311-316. doi: 10.3238/arztebl.m2023.0069.  
    Link: Thyroid Dysfunction in Periand Postmenopausal Women-Cumulative Risks – PubMed 

13. Thyroid function tests. American Thyroid Association. Accessed May 3, 2025. 
    Link: https://www.thyroid.org/thyroid-function-tests/