11 Tips for Managing Menopause and Thyroid Disease

by Mary Shomon Patient Advocate

When you’re a woman over 40, symptoms such as fatigue, brain fog, and weight changes are common. But are they due to a thyroid condition, or is it related to menopause? Let’s explore what you need to know about perimenopause, menopause, and your thyroid, and how to manage your symptoms for optimal health and wellness.

woman in her 40's sitting on the couch
iStock

Perimenopause Starts Around Age 40

Menopause is defined as the point when it’s been a full year since your last menstrual period. For women in the United States, this occurs around age 51. You may not realize that perimenopause starts as early as your late 30s, as changes in hormones begin to cause symptoms such as fatigue, brain fog and fuzzy thinking, and weight changes. You are also more likely to develop a thyroid condition as you age. This makes it confusing to tell if symptoms are due to perimenopause, thyroid disease, or both.

The Symptoms of Perimenopause/Menopause and Thyroid Are Almost Identical

Hypothyroidism can also cause amenorrhea (absence of menstrual cycles). It can be confusing to determine if your symptoms are due to perimenopause/menopause and/or thyroid disease because the signs and symptoms are almost identical.

woman getting blood drawn
iStock

Always Check Your Thyroid First!

If you have menopause and/or thyroid symptoms, your first step should be to ask for a comprehensive thyroid evaluation. Testing for thyroid disease — including a thyroid stimulating hormone (TSH), Free T4, Free T3, and antibody levels — can help detect an undiagnosed thyroid condition. According to the American Association of Clinical Endocrinologists, only 25 percent of women who discuss menopause with a doctor is also tested for thyroid disease. That means, it’s up to you to ask. Thyroid diseases may run in families.

calendar with menstrual products
iStock

If Your Periods Stop or Are Irregular, It May Be Thyroid … Not Menopause

An erratic menstrual cycle is common during perimenopause. And the most definitive sign that menopause is underway is that your menstrual periods stop. If your periods are irregular or have stopped, you and your doctor may assume that it’s related to perimenopause/menopause. Menstrual issues are, however, common symptoms of untreated thyroid conditions. Always ask for a complete thyroid evaluation to rule out your thyroid as a cause for any menstrual irregularities.

woman's hand taking pill
iStock

Thyroid Treatment May Resolve Your Perimenopausal/Menopausal Symptoms

In some cases, symptoms attributed to perimenopause/menopause may be partially or fully resolved when you get your thyroid condition properly diagnosed and optimally treated. If you are experiencing symptoms and are diagnosed with a thyroid problem, talk to your healthcare provider about the benefit of pursuing thyroid treatment before considering hormone replacement therapy (HRT) for menopause.

woman looking at package for medication
iStock

If HRT Isn’t Working, Check Your Thyroid

While hormone replacement therapy (HRT) 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.

mature woman going for a walk
iStock

Get Moving!

Regular exercise and physical activity can reduce inflammation, help improve your sleep and mood, and resolve many perimenopausal/menopausal symptoms. Don't overdo it with debilitating workouts that raise stress hormones and cause burnout. My favorite program is the “Mindful Movement for Healthy Hormones and Menopause Management” DVD from exercise physiologist Teresa Tapp.

women meditating
iStock

Try a Mind-body Approach

If your symptoms aren’t relieved by traditional medical treatments, consider mindfulness practices, especially guided meditation. Research shows that guided meditation and mindfulness approaches such as meditation, yoga, and breathwork can help improve a variety of menopausal symptoms. My recommendation is Demo DiMartile’s guided meditation CD/MP3 audio, Hormonal Balance: Restoring Inner Peace & Power.

Melatonin is a Master Hormonal Conductor

You may think of melatonin as a sleep or jetlag remedy. But it’s a support for hormone function. For me, after years of erratic periods during perimenopause, supplementing with 3 mg of melatonin nightly regulated my cycle and relieved morning fatigue for years. While more studies need to be done on the effect that melatonin has on thyroid hormone levels, you can learn more about the hormonal power of melatonin—including improved T4-to-T3 conversion and elimination of morning depression in menopausal women—in this special report on the Reversal of Aging.

Maca powder.
iStock

Maca May Be a Helpful Natural Solution

For centuries, the root vegetable maca has been a natural remedy for menopausal symptoms — a use now supported by research. Maca doesn’t contain hormones; it helps your body balance estrogen, progesterone, and other hormones – including the thyroid – more effectively. This can relieve symptoms such as hot flashes and low sex drive. (Avoid improperly-prepared maca. If not heated, it can aggravate thyroid problems.) I recommend therapeutic-grade Royal Maca from Whole World Botanicals — one of my menopause go-tos.

doctor and female patient talking
iStock

See a Menopause Expert

Some endocrinologists have expertise in managing perimenopause/menopause, but many don’t. Similarly, some gynecologists have expertise in managing thyroid conditions, but many don’t. You may want to consult with Certified Menopause Practitioners (CMP) for additional guidance. The North American Menopause Society has a directory of CMPs at its “Find a Menopause Practitioner” online database.

Mary Shomon
Meet Our Writer
Mary Shomon

Mary Shomon is a patient advocate and New York Times bestselling author who empowers readers with information on thyroid and autoimmune disease, diabetes, weight loss and hormonal health from an integrative perspective. Mary has been a leading force advocating for more effective, patient-centered hormonal healthcare. Mary also co-stars in PBS’ Healthy Hormones TV series. Mary also serves on HealthCentral’s Health Advocates Advisory Board.