Underactive Thyroid And Menopause: What You Should Know
There is a clear link between hypothyroidism and perimenopause. Perimenopause is associated with gradual reduction in the amount of estrogen over time, while hypothyroidism is associated with the thyroid not producing sufficient amounts of thyroid hormones. Both conditions tend to manifest at the same time and have similar symptoms.
Symptoms associated with both perimenopause and hypothyroidism include fatigue, weight gain, alterations of the menstrual cycle, mood swings, brain fog, and aches and pains. In fact, the symptoms of perimenopause and hypothyroidism are so similar and hypothyroidism is so common in middle-aged women that doctors often suggest women simply get tested for thyroid function during perimenopause so they can start treatment immediately if they do have an underactive thyroid.
Hypothyroidism Vs Menopause: Us Prevalence
The 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.
How Your Doctor Can Tell If You Actually Have A Thyroid Problem
Thyroid disorders are more common among women. Women with a family history of thyroid problems or autoimmune issues are at higher risk, says Dr. Kellis. And as we get older, those risks increase.
Thyroid disorders are often diagnosed around the time of menopause, or between the ages of 45 and 55, says Dr. Kellis. Many women pass off their thyroid issues for menopause because the symptoms are similar and it seems like theyre at the right age.
The good news: A simple blood test can help rule out a thyroid disorder. If the test doesnt find irregular thyroid hormone levels, then menopause is probably your answer and youll need to work with your doctor to manage it.
If Hrt Isnt Working Check Your Thyroid
While hormone replacement therapy is not used as extensively as it was in the past, women with debilitating menopausal symptoms are sometimes prescribed estrogen, progesterone, or combination HRT. If your HRT is not resolving your symptoms, however, this is an indicator that you should pursue a comprehensive thyroid evaluation.
Causes And Risk Factors Of Premature Ovarian Failure / Premature Menopause
This is a common cause of premature ovarian failure. In fact, some research has shown that up to a third of the women with premature ovarian failure have it due to an autoimmune disorder.
When this happens, your bodys immune system mistakenly attacks itself. In effect, your body senses part of itself as an invader so it sends out antibodies to destroy this perceived threat.
In the case of premature menopause, you may have antibodies to your own ovarian tissue, to your endometrium, or to one or more of the hormones regulating ovulation.
These antibodies attack your reproductive system, and may interfere with and ultimately destroy your ovarian function. If you have a family history of autoimmune disorders or have one yourself , this may be the cause for your premature menopause.
Some cases of hereditary premature menopause are caused by defects on an X chromosome. Its a very complicated topic, but, briefly, heres what happens:
1. Fragile X syndrome
Women have two X chromosomes and, even though only one of these chromosomes is active, a defect on either one can cause premature menopause. This defect appears to interfere with the production of eggs.
So if you are a fragile X carrier, you have a lesser number of eggs in your ovaries, which in turn leads to an earlier menopause generally at least six to eight years before other women.
2. Turners Syndrome
Where Can I Find Support
Hyperthyroidism impacts you physically, psychologically, and emotionally. Its critical that you have a strong network of people you trust and can turn to for support.
It starts with your family. Since thyroid disease runs in families, being honest and open with your relatives is the best policy, as you might be alerting them to a problem they didnt even know to look out for.
To help you build your own support network outside of those closest to you, check out the Graves Disease & Thyroid Foundations community resources to find a support group near you. If you dont want to leave home, their online forum is another great resource for connecting and widening your net.
Psychological Wellbeing & Emotions
The diagnosis of a premature or early menopause can bring many changes and challenges: when menopause does not come at the age and stage of life you expected it to, it can have a major impact on your wellbeing. Women who experience premature or early menopause can be at greater risk of depression, anxiety and mood changes.
It can be very upsetting for some women to experience menopause in their 20s or 30s when they expected it to happen in their late 40s or 50s. Often this is a time of feelings of loss, sadness and grief. These feelings are very common, along with the feelings of losing your body image, fertility, femininity and sexuality, and feeling old before your time.
It can take some time to diagnose a premature or early menopause. Not knowing what is wrong, having no control over symptoms and not knowing what the future holds can be frightening. Some women with early menopause talk of ‘loss of womanhood’ and ‘loss of dreams’.
Associated illnesses, such as cancer and chemotherapy or surgery to remove ovaries, may also alter the course of your life. Plans, dreams and expectations must be re-thought and that can be very challenging and distressing.
During this time, women can experience a sense of loss of control, loss of ability to plan and loss of self-image, but often there is no one with whom to share the grief. Girlfriends might not understand because they are not yet experiencing menopause, and, for some, mothers haven’t yet reached menopause either.
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How You Can Relieve Thyroid Dysfunction And Depression In Perimenopause
Diagnosing low thyroid can be tricky. Even though your oestrogen/progesterone levels are unbalanced and affecting your thyroid hormones action, a routine thyroid test may show your thyroid hormones are at perfectly normal levels. Thats because your thyroid is putting out hormones that can be measured they just cant do what theyre supposed to do.
Generally speaking, adequate thyroid treatment will reverse thyroid hormone insufficiency and depression. Its important to be aware, however, that people with hypothyroidism-induced depression are often misdiagnosed and treated as having a psychiatric illness. As a result, they are frequently prescribed antidepressants.
Unfortunately, antidepressants can be addictive. Also, they can have dangerous side effects. They can, in fact, actually worsen depression even trigger homicidal or suicidal impulses and they wont fix an oestrogen-dominance problem or a low-thyroid problem.
To reverse low thyroid and depression during perimenopause, you will need thyroid testing, but the standard TSH test doesnt detect most cases of low thyroid and wont give you the answers you need.
You need a restorative medicine physician skilled in bioidentical hormone restorative therapy who offers comprehensive, full-panel thyroid testing. That includes total T3 and total T4 tests, along with a TSH test. He or she will also do full testing of your sex hormones in order to assess their status.
How The Thyroid Works During The Menopausal Transition
During the perimenopause transition period, aging ovaries tend to produce unpredictable levels of the reproductive hormones progesterone and estrogen.
This irregular hormonal activity can be confusing for the body, resulting in erratic periods, mood swings, and hot flashes. Vaginal dryness, breast tenderness, night sweats, fatigue, difficulty sleeping, and forgetfulness are also quite common during perimenopause. Most women experience fluctuating hormonal symptoms in the eight years to a decade leading up to the actual menopause.
Hypothyroidism and menopause transition seem to go hand-in-hand, since both usually affect middle-aged women. This has led researchers to believe there might be a connection between perimenopause and thyroid function.
It all comes down to estrogen levels which decrease dramatically during the menopausal transition. As a result, menstruation cycles become longer, farther apart, and generally unpredictable. This stifles the hormonal balance throughout almost the entire body, including the pituitaryâs TSH and thyroid hormones.
Irregular estrogen levels may also affect thyroid function. Specifically, estrogen affects the thyroid glandâs ability to produce enough triiodothyronine and thyroxine to meet the needs of the body. In response, the pituitary gland releases more TSH into the bloodstream in an attempt to stimulate the thyroid.
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Overactive Vs Underactive Thyroid
The thyroid is a butterfly-shaped glandlocated at the front of your neck. It produces hormones that help regulateyour bodys metabolism and keep your brain, heart, muscles and other organsworking properly. But sometimes it does too much or too little, as seen in:
- Hyperthyroidism: An overactive thyroid may make you feel nervous, irritable and shaky. You may notice a racing heart, excessive sweating, heat intolerance, frequent bowel movements, thinning hair, weight loss and irregular periods.
- Hypothyroidism: An underactive thyroid gland may slow down your body functions. What to look for: slower thinking, depression, feeling cold, constipation, muscle weakness, abnormal periods and a slower metabolism leading to moderate weight gain.
Loss of memory, or brain fog, is another, often-overlooked, sign of a thyroid issue, adds Dr. Kellis. Though rare, losing hair around the ends of your eyebrows is another sign.
What Are The Signs And Symptoms Of Hyperthyroidism
At first, you might not notice the signs or symptoms of hyperthyroidism. Symptoms usually begin slowly. But, over time, a faster metabolism can cause symptoms such as:
- Weight loss, even if you eat the same or more food
- Eating more than usual
- Diarrhea or more bowel movements than normal
- Fewer and lighter menstrual periods than normal
- Changes in your eyes that can include bulging of the eyes, redness, or irritation
Hyperthyroidism raises your risk for , a condition that causes weak bones that break easily. In fact, hyperthyroidism might affect your bones before you have any of the other symptoms of the condition. This is especially true of women who have gone through menopause or who are already at high risk of osteoporosis.
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Can Thyroid Disease Cause Problems Getting Pregnant
Both hyperthyroidism and hypothyroidism can make it harder for you to get . This is because problems with the thyroid hormone can upset the balance of the hormones that cause ovulation. Hypothyroidism can also cause your body to make more prolactin, the hormone that tells your body to make breastmilk. Too much prolactin can prevent .
Thyroid problems can also affect the . Your periods may be heavier or irregular, or you may not have any periods at all for several months or longer .
Exercise To Maintain A Healthy Weight Even If You Have Hashimotos
Regular exercise can do a lot for a womans health in general.
Boosting mood, energy, outlook and even regulating sleep are known positive side effects of a regular exercise routine.
For Hashimotos, exercise helps to maintain a healthy weight, builds muscle to help strengthen metabolism and produces sweat which is a great detox pathway.
For women in menopause, exercise can help to deter hot flashes, which can improve a womans overall comfort and happiness.
My women clients who work out regularly tell me that they have relatively few symptoms of menopause.
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How Is Early Menopause Is Diagnosed
No special tests are needed to determine the absence of menstrual periods, but sometimes women begin having symptoms of menopause and irregular periods. At that point, they may be tested to determine their ovarian function. For example, tests may be done to rule out pregnancy or other causes of missed menstruation, such as certain thyroid diseases. The level of follicle-stimulating hormone is often measured in the blood to determine whether a woman is nearing menopause and to ascertain the functional status of her ovaries. FSH stimulates the ovaries to produce estrogen, so levels of this hormone rise when estrogen levels drop. FSH levels that are higher than 40 mIU/ml are considered diagnostic of the menopause. Levels of ovarian hormones, such as estradiol, may be also measured, as low levels are suggestive of menopause.
What Are The More Serious Complications Of Hyperthyroidism
People with advanced and extreme hyperthyroidism face a ramshackle of problems, some of them life-threatening. The good news, though, is many patients do not reach this level of severity. Complications can include:
- Graves ophthalmopathy or Thyroid Eye Disease , which may soon be treatable using a new drug called Teprotumumab
- Irregular heartbeat, which can lead to:
- blood clots
- other heart problems
Bottom line: The longer you have an overactive thyroid and go without treatment, the greater the risk of lifelong complications, even after treatment. As over 60 percent of people with thyroid disease go undiagnosed, its important to listen to your body before reversible symptoms like weight loss and insomnia become life-threatening issues such as irregular heartbeat , bone loss , and infertility .
Do One Thing Right Now
Relax! Slowing things down is keyeven if it feels counterintuitive with all the sped up effects of the condition. The GDATF recommends practicing yoga, Tai Chi, self-hypnosis, and meditation.
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How Is It Diagnosed
To diagnose the menopause, a woman should have stopped periods for a minimum of 12 months. Therefore, menopause can only be identified retrospectively. However, there are other symptoms that can give an indication that a woman is undergoing the menopause, most commonly night flushes in combination with irregular periods. Another method is to measure the levels of hormones such as follicle stimulating hormone in a blood sample. This will be raised just before and after the menopause. This test may not give a decisive result and is not recommended in women who are either over 45 or who are taking the pill but usually indicates the ovaries are no longer secreting oestrogen or progesterone.
Menopausal symptoms can be treated with hormone replacement therapy . For women with a womb , HRT will contain both oestrogen and progesterone. For women who have undergone a hysterectomy only oestrogen replacement is required. There are many different hormone replacement options such as Bio-Identical HRT which is low dosage HR which replicates your own hormone molecular structure. They can be administered by pills, skin patches, skin gels or implants.
If you or your clients experience any of the symptoms of either condition or life phase dont wait, seek that specialist help. Whilst we can help with exercise and good nutrition it wont necessarily bring you all the relief you will need.
How Can Nutrition Help?
Foods such as fruit and vegetables contain these vitamins
How Is Early Menopause Diagnosed
The time leading into menopause is called perimenopause. During this time, you may have irregular periods and other symptoms that come and go.
Youre generally considered to be in menopause if you go 12 months without menstrual bleeding, and you dont have another medical condition to explain your symptoms.
Tests arent usually needed to diagnose menopause. Most women can self-diagnose menopause based on their symptoms. But if you think youre experiencing early menopause, you may want to see your doctor to be sure.
Your doctor can order hormone tests to help determine whether your symptoms are due to perimenopause or another condition. These are the most common hormones to check:
- Anti-Mullerian hormone . The
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Tsh Tests And Advanced Thyroid Testing
The TSH test is a great blood test that helps figure out if you have an early stage thyroid disorder. It measures the level of thyroid-stimulating hormone in your blood. It may detect hypothyroidism or hyperthyroidism way before the levels of thyroid hormone in the body go out of whack.
A high TSH level means that your thyroid is underactive and you possibly have hypothyroidism. On the other hand, a low TSH level typically indicates an overactive thyroid, and that the gland is producing too much thyroid hormone.
If thereâs an anomaly â for instance, a tumor or inflammation â that is hindering the pituitary gland from stimulating the thyroid gland enough, the test will also return a low TSH result. This is referred to as secondary hypothyroidism.
If your TSH test comes back as abnormal, there are other thyroid tests that your OBGYN, endocrinologist, or physician can order to get to the root issue of your thyroid imbalance including:
The most definitive way to know if youâve got a thyroid problem is through the above-mentioned blood tests.
Link Between Estrogen Dominance Thyroxine
I also see a lot of women in my practice who have Hashimotos .
When they go through peri- or menopause, they find their Hashimotos feels much worse than before the hormonal change.
That is because the thyroid hormones and sex hormones are intricately connected.
The Journal of Thyroid Research studied the effects of estrogen on another important hormone: thyroxine-binding globulin .
TBG is a type of globulin produced in the liver. TBG is a circulating protein.
The research showed that excess estrogen may increase TBG.
This is what matters: TBG binds to thyroid hormones T3 and T4, and carries them into the bloodstream, making them less available to the bodys needs.
Estrogen Dominance Excess TBG Less T3 and T4 Hypothyroidism
A research study from 2007 showed that women with a thyroid disorder and severe menopause experienced improved symptoms after getting treated for the thyroid disorder.
This suggests that improving thyroid function whether through medication or natural means can help manage perimenopause and menopause symptoms.
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