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thyroid dysfunction & menopause

Updated: Feb 18

IS THERE A LINK?

The organs within the endocrine system have an intricate connection. The balance of hormones is reliant upon the normal functioning of these organs. If one organ malfunctions, it creates a ripple effect with significant consequences affecting many hormones. The thyroid hormone is responsible for regulating metabolism and maintaining the basal metabolic rate of the body. It also plays a role in growth and development. The thyroid gland produces this essential hormone; it is a butterfly-shaped organ situated in front of the neck.


Hyperthyroidism occurs when the thyroid gland is overactive and produces excess amounts of thyroid hormone. Hypothyroidism occurs when the thyroid gland is underactive and produces inadequate amounts of thyroid hormone. Several causes lead to abnormal thyroid gland function, such as genetics, autoimmunity, nodules, medications, iodine deficiency, inflammation, or infections. The manifestation of thyroid dysfunction varies with each individual; no one person will present with the same set of symptoms.

The symptoms of hypothyroidism are:

● Slowed heart rate

● Increased sensitivity to cold

● Weight gain

● Constipation

● Tiredness, fatigue, lack of energy

● Dry skin, hair loss, or thinning of hair

● Forgetfulness, depression

● Joint pain, muscle aches

● Changes in the menstrual cycle (heavier flow, longer or irregular cycle)


The symptoms of hyperthyroidism are:

● Rapid or irregular heartbeat, palpitations

● Unintentional weight loss

● Increased sensitivity to heat

● Excessive sweating

● Tremors

● Diarrhea

● Nervousness, irritability, anxiety

● Changes in the menstrual cycle (heavier flow, longer or irregular cycle)


The symptoms of thyroid disorders can often be mistaken for symptoms of menopause. Therefore, before diagnosing thyroid disease, it is imperative to perform the thyroid function test. A thyroid function test is a blood test that measures the levels of thyroid hormones in the body. The three main parameters measured are T3, T4, and TSH. TSH levels (Thyroid Stimulating Hormone) are often considered to evaluate the type of thyroid dysfunction. High levels of TSH indicate hypothyroidism, whereas low levels of TSH indicate hyperthyroidism. Thyroid disorders are more common in women than in men. They can also cause the early onset of menopause. Hypothyroidism affects women more frequently than hyperthyroidism, and this rate increases with age. Hypothyroidism increases the risk for cardiovascular diseases, type 2 Diabetes Mellitus, depression, atherosclerosis, and cognition impairment. It also increases the risk of long-term complications of menopause, such as osteoporosis and cardiovascular diseases. The cumulative effects of thyroid disorders and menopause can significantly impair the quality of life of a woman.



Treating thyroid disorders can ease the symptoms or even delay the onset of menopause. The treatment of thyroid disorders include medications, surgery, or radiation. For hyperthyroidism, medications that inhibit thyroid hormone production are prescribed. Whereas, for hypothyroidism, exogenous thyroid hormones are typically prescribed. The symptoms of menopause can be managed with phytoestrogens, hormone replacement therapy (HRT), or bioidentical hormones. Women on thyroid medication will need to adjust their dose, as hormonal therapy can interfere with the metabolism and excretion of the medication.


The key to dealing with thyroid disorders in women with menopause is to maintain thyroid hormone levels. The cumulative effects of both conditions drastically increase the risk for other medical conditions, impair the quality of life, and may also shorten life expectancy. Therefore, it is vital to adjust the balance of hormones.













REFERENCES

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2) Panda, S., & Das, A. (2018). Analyzing Thyroid Dysfunction in the Climacteric. Journal of mid-life health, 9(3), 113–116. https://doi.org/10.4103/jmh.JMH_21_18


3) Kolanu, B. R., Vadakedath, S., Boddula, V., & Kandi, V. (2019). Evaluation of the Activities of Thyroid Hormones Among Pre- and Post-menopausal Euthyroid Women: A Cross-sectional Study from a Tertiary Care Teaching Hospital in India. Cureus, 11(3), e4259. https://doi.org/10.7759/cureus.4259


4) Kolanu, B. R., Vadakedath, S., Boddula, V., & Kandi, V. (2020). Activities of Serum Magnesium and Thyroid Hormones in Pre-, Peri-, and Post-menopausal Women. Cureus, 12(1), e6554. https://doi.org/10.7759/cureus.6554


5) Badawy A, State O, Sherief S. Can thyroid dysfunction explicate severe menopausal symptoms? J Obstet Gynaecol. 2007 Jul;27(5):503-5. doi: 10.1080/01443610701405812. PMID: 17701801.


6) Gietka-Czernel M. (2017). The thyroid gland in postmenopausal women: physiology and diseases. Przeglad menopauzalny = Menopause review, 16(2), 33–37. https://doi.org/10.5114/pm.2017.68588


7) Williams GR, Bassett JHD. Thyroid diseases and bone health. J Endocrinol Invest. 2018 Jan;41(1):99-109. doi: 10.1007/s40618-017-0753-4. Epub 2017 Aug 29. PMID: 28853052; PMCID: PMC5754375.


8) del Ghianda S, Tonacchera M, Vitti P. Thyroid and menopause. Climacteric. 2014 Jun;17(3):225-34. doi: 10.3109/13697137.2013.838554. Epub 2013 Nov 7. PMID: 23998691.

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