During menopause and with an underactive thyroid, the complaints overlap strongly: fatigue, weight gain, mood swings and poor sleep belong to both. So an underactive thyroid around age fifty is easily mistaken for "just menopause". You do not tell the difference by feel, but with blood values: TSH and free T4 for the thyroid, FSH and oestradiol for menopause.
Both can be at play at once, and that is exactly when it helps to know what causes what. Below you will read how to tell them apart.
Why do menopause and the thyroid look so alike?
Your sex hormones and your thyroid work together. Oestrogen influences how much thyroid hormone is freely available in your blood, and that balance shifts during menopause (Krassas et al., 2010). On top of that, the risk of an underactive thyroid rises with age, exactly in the period when menopause occurs.
The result: two different causes with almost the same complaints. For the thyroid side, see our explanation of underactive thyroid symptoms in women.
Menopause complaint or thyroid? A comparison
Some complaints point a little more to menopause, others to the thyroid. The table helps you make the distinction; only a blood test gives certainty.
| Complaint | Fits menopause | Fits underactive thyroid |
|---|---|---|
| Hot flushes and night sweats | Yes, characteristic | Rarely |
| Feeling cold constantly | Less typical | Yes, characteristic |
| Irregular periods | Yes | Possible, often heavier |
| Weight gain | Often | Often |
| Dry skin and hair loss | Possible | Yes, characteristic |
If you mainly notice hot flushes, menopause is the likely cause. If you feel cold constantly with dry skin, the thyroid deserves attention. When in doubt, measure both.
Which values give clarity?
For the thyroid you look at TSH and free T4. For menopause, at FSH and oestradiol. Measured together, you see at once which way your complaints point, or whether both are involved.
For the menopause side, read which hormones to test around menopause. Many women's hormone panels include TSH by default, precisely because of this overlap.
What if both are involved?
It happens that a woman in menopause also develops an underactive thyroid. Then it helps to know which part of your complaints comes from what, so a next step is targeted. An underactive thyroid during menopause sometimes needs separate attention alongside menopause itself.
At Lunara the Menopause test measures the menopause hormones, and you can include the thyroid values for a fuller picture. This article belongs to our overview of thyroid symptoms in women.
Frequently asked questions
Does an underactive thyroid start more often around menopause?
The risk of an underactive thyroid rises with age, so it comes to light relatively often around menopause. Whether menopause truly causes it cannot always be said; a blood test gives clarity on the values.
Can I test both at the same time?
Yes. Thyroid values (TSH, free T4) and menopause hormones (FSH, oestradiol) can be measured in one blood draw. So you do not need two visits to tell them apart.
Does hormone therapy also help with thyroid complaints?
Hormone therapy targets menopause complaints, not the thyroid. If your complaints come (partly) from the thyroid, that calls for its own approach. Discuss this with your GP.
References
- NHG-Standaard Schildklieraandoeningen (M31). Nederlands Huisartsen Genootschap. Available via nhg.org.
- Krassas GE, Poppe K, Glinoer D. Thyroid function and human reproductive health. Endocr Rev. 2010;31(5):702-755. PMID: 20573783.
- Chaker L, Bianco AC, Jonklaas J, Peeters RP. Hypothyroidism. Lancet. 2017;390(10101):1550-1562. PMID: 28336049.
Every blood test result through Lunara includes a professional assessment by a BIG-registered doctor. For treatment decisions, discuss your results with your GP.
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