What to Know About Menopause if You Have Hypothyroidism – Everyday Health

If youre living with hypothyroidism, youre likely already familiar with the common symptoms, which can include fatigue and weight gain. But if youre a woman around the age of menopause which can range from 40 to 58, with the average onset at age 51 you may also experience identical issues, according to the North American Menopause Society (NAMS). So if youre in middle age, it can be hard to know whats really going on, and how to get relief.

Read on for what you should know about your menopausal years if you have hypothyroidism.

Menopause is a natural transition that women experience, and its the permanent end of menstruation. After a woman has had her final period and doesnt menstruate for 12 consecutive months, shes been through menopause, according to the NAMS.

During perimenopause the time leading up to menopause and menopause, hormonal fluctuations are common. This can even be when hypothyroidism develops in some women. One theory is that fluctuation in estrogen levels may increase inflammation, creating the ideal environment for development of autoimmune diseases such as Hashimoto's thyroiditis, which may lead to hypothyroidism, explains Cheryl R. Rosenfeld, DO, a spokesperson for the American Association of Clinical Endocrinologists, partner at North Jersey Endocrine Consultants, and adjunct clinical associate professor of medicine at the Touro College of Osteopathic Medicine in New York City. The drop in estrogen is what causes menopausal symptoms.

Hypothyroidism occurs when the thyroid gland does not make enough thyroid hormone. The most common cause is inflammation of the thyroid, but it may also be due to a number of other causes, including too much or too little iodine in the body, taking medications such as lithium, and inflammation of the thyroid, according to the American Thyroid Association (ATA).

Even if youve had hypothyroidism for a while, when you reach menopausal age, the lines between hypothyroidism and menopause can start to blur. Symptoms of hypothyroidism can be confused with symptoms due to the menopause transition, says Ekta Kapoor, MBBS, an endocrinologist in the Menopause and Women's Sexual Health Clinic at the Mayo Clinic in Rochester, Minnesota.

These same symptoms can include:

Rosenfeld cautions against using synthetic thyroid hormone medication to alleviate menopause symptoms in women with normal thyroid function. "While there is a great deal of overlap in the symptoms, if the thyroid blood tests are normal, it would be wrong to treat a person without thyroid disease with thyroid hormone or to increase thyroid hormone in a person with hypothyroidism to alleviate symptoms of menopause," she says. "Thyroid hormone is not a cure-all for symptoms it is a treatment for hypothyroidism."

If youre looking for a clue as to whats causing your issues, check your body heat hot flashes and night sweats are unique to menopause, says Dr. Kapoor. But there is an exception: Over-replacement with thyroid hormone can also cause hot flashes and night sweats, notes Kapoor. So work with your healthcare provider to ensure you are getting an appropriate amount of thyroid hormone treatment. If you are and youre still waking up sweating, thats a good indication that you are indeed experiencing menopause symptoms.

Hypothyroidism can worsen menopause symptoms. So rather than shrug off your symptoms, its important to maintain hypothyroidism treatment during menopause. Undertreated thyroid disease may cause increased cholesterol, leading to atherosclerosis and possibly heart attack or stroke, says Rosenfeld. In addition, hypothyroidism may cause high blood pressure, leading to similar heart complications. Overtreatment with thyroid hormone is also a known cause of osteoporosis, Kapoor adds.

Healthcare providers know to adjust thyroid treatment based on your current needs, and that includes during menopause. When estrogen levels drop at the time of menopause, people who are on levothyroxine to treat hypothyroidism may experience a change in their thyroid hormone needs, usually downward, says Rosenfeld. And conversely, hormone therapy which is commonly used to treat menopause symptoms can necessitate the opposite. If a woman treated with thyroid hormone starts estrogen, her dose of levothyroxine may have to be increased, says Kapoor.

A study published in December 2018 in the journal Climacteric stated that the decision to use hormone therapy for menopause should be individualized in women with thyroid disorders such as hypothyroidism.

The bottom line: Work closely with your healthcare provider so your thyroid symptoms and your menopause symptoms can be kept to a minimum.

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What to Know About Menopause if You Have Hypothyroidism - Everyday Health