Thyroid disorder and Menopause, The Commons, Uncommons and Complications

Menopause is the physiological discontinuation of a woman’s menstrual cycle when she is about 50-60 years old whereas hypothyroidism is a pathological underproduction of the thyroid hormone by the thyroid gland. The two often have confusing symptoms making it hard for a woman in her 50s to differentiate between the two.

Let’s compare and contrast the signs and symptoms of the two!

Menstruation cycles are affected in both, hypothyroidism and menopause. Therefore, irregular cycles or the absence of menstruation cannot be used to differentiate between hypothyroidism or menopause.

The chances of having hypothyroidism increases with age and menopause, too, appears late in a woman’s life.

Here are a few signs and symptoms common to both, menopause and hypothyroidism:

• Irregular menstruation cycles
• Fluctuations in libido
• Mood swings
• Changes in your weight
• Difficulty memorising and learning things
• Sleep disturbances

However, there are also a few signs and symptoms that are exclusive to menopause or hypothyroidism.

Menopause:

• Vaginal dryness
• Excessive sweating at night
• Increased frequency of urination

Hypothyroidism:

• Excessive hair loss
• Hypothyroidism can occur at earlier ages as well

So, how do you clinically differentiate between the two?

Well, it’s pretty simple. You just have to run a blood test that measures the level of your thyroid hormones and the follicle stimulating hormone. If the thyroid hormones are in the normal range, then you’re most likely to be menopausal whereas if your thyroid hormones are below the normal range, you may have hypothyroidism. If the level of your follicle stimulating hormone is low, you may be experiencing menopause.

Thyroid function tests include TSH (thyroid stimulating hormones), T4 (thyroxine) and T3 (liothyronine).

Our Pituitary gland in the brain secretes TSH which regulates the amount of T4 (Thyroxine) and T3 (Liothyronine) secreted from thyroid gland. A low TSH levels indicate higher T4 (Hyperthyroidism) and a high TSH levels indicate lower circulatory T4 (Hypothyroidism).

Influence of estrogen on thyroid hormones

Studies show that estrogen can be linked to thyroid hormone abnormalities. However, there is still a lot of research to be done in this field.

Complications associated with Thyroid disorders during Menopause

Osteoporosis:

Osteoporosis is a condition in which the bones become porous, fragile and prone to fractures.  In a cycle of bone turnover, the new cells are consistently replacing the old ones. Many factors control this process of bone turnover, one of those factors is the thyroid hormone.

The excess of thyroxine will increase the resorption of bone and will make it porous and fragile (osteoporosis).
Estrogen plays an essential role in the bone growth as well as metabolism. Decreased level of estrogen is responsible for bone resorption and osteoporosis in menopausal and post-menopausal women.
Hyperthyroidism in menopausal women puts an additional risk of osteoporosis and its complications.

Cardiovascular disease:

An underactive thyroid gland produces less than the required amount of thyroxine hormones. It often leads to slow heart rate and increases the risk for heart failure in the patient with the co-existing cardiovascular disease.

Whereas, an overactive thyroid gland is associated with palpitation, occasionally leading to atrial fibrillation eventually heart failure if not corrected by treatment.

Researchers are still investigating the positive effects of estrogen on the cardiovascular system. Estrogen is thought to provide flexibility and elasticity to the inner layer of arteries. It increases the good cholesterol (HDL) and consequently reduces bad cholesterol. During menopause, reduced level of estrogen puts the additional risk of cardiovascular disease in women with thyroid dysfunction.

So, the next time you feel any of these symptoms, make sure to get a blood test done so that your condition can be easily diagnosed!