Thyroid vs menopause – how to spot the difference

As you reach a certain stage of life, it isn’t uncommon to start noticing changes that can affect your mood, weight, or energy levels. But what could they signal? Are these changes the first signs of perimenopause or is something else going on? 

From reduced sex drive to difficulty sleeping, many of the symptoms of menopause and thyroid conditions can overlap and affect your mental and physical health. So, there’s no wonder that symptoms of a thyroid condition can be incorrectly put down to menopause (or even stress).  

If you're edging towards your fabulous 40s or 50s, or have surpassed the sweet 60s, let’s look at how to spot the signs of a thyroid condition, menopause, or perimenopause.  

In this blog we discuss:  

• What are menopause and perimenopause? 
• Can menopause symptoms be mistaken for a thyroid condition? 
• What are the main symptoms of a thyroid condition? 
• How do the symptoms of a thyroid condition and menopause overlap? 
• Is there a link between menopause and a thyroid condition? 
• How to spot the difference between menopause and a thyroid condition 
• Where to get support  
   

What are menopause and perimenopause?
 

Menopause is when your periods stop due to lower hormone levels, while perimenopause (meaning around menopause) is the transition period before you reach menopause. 

You’re likely to go through menopause between 45 and 55 years old, but it can happen earlier, either naturally or due to other reasons like having a hysterectomy. Perimenopause can start up to ten years before you go through menopause. 

A menopause diagnosis is made once you haven’t had a period for more than 12 consecutive months.  

The first signs of perimenopause include: 

• Irregular periods 
• Hot flushes and sleep problems 
• Mood changes 
• Vaginal and bladder problems 
• Decreasing fertility 
• Changes in libido 
• Loss of bone density
• Changing cholesterol levels 
   

Can menopause symptoms be mistaken for a thyroid condition?
 

Yes, it’s not uncommon for menopause symptoms to be confused with those of a thyroid condition because some symptoms of an underactive or overactive thyroid are like those during the transition to menopause.  

To make it even more confusing, a thyroid condition may not develop until you’ve hit menopause [2] as thyroid conditions are more common in women over the age of 60 [3]. 

What are the main symptoms of a thyroid condition?

There are two types of thyroid conditions – hyperthyroidism (overactive thyroid) and hypothyroidism (an underactive thyroid).  

Your thyroid hormones are vital for your [4]:  

• Metabolism   
• Growth   
• Development 

Underactive and overactive thyroid conditions can display different symptoms. However, there are common signs and symptoms that overlap between the two.  

Common signs of both hyperthyroidism and hypothyroidism include [5], [6]:   

• Tiredness  
• Loss of libido   
• Mental health conditions, such as depression and mood swings   
• Difficulty sleeping  
• Muscle aches and weakness  
• Irregular periods 
    

How do the symptoms of a thyroid condition and menopause overlap?

Some symptoms of a thyroid condition and menopause may present in similar ways. It’s quite common for women going through menopause to experience changes in body temperature (such as hot flushes and night sweats), changes in energy, or feel fatigued. And it wouldn’t be uncommon for someone with a thyroid condition to feel tired all the time or experience changes in body temperature (feeling hot or cold when everyone else is comfortable).   

This table shows how the symptoms of a thyroid condition and menopause overlap.  

Is there a link between menopause and a thyroid condition?
 

Perimenopausal and postmenopausal women are at increased risk of developing a thyroid condition, but there’s no straightforward evidence to suggest that menopause can cause a thyroid condition or vice versa [7].  

However, there's some evidence to suggest that symptoms of menopause can be worse if you have a thyroid condition [7]. If that applies to you, managing and treating your thyroid condition may help to manage menopausal symptoms [8].  
 

How to tell the difference between a thyroid condition and menopause
 

There's only one way to distinguish a thyroid condition from menopause with any certainty, and that’s through a blood test.  

To help detect a thyroid condition, you need to test your thyroid hormones.  

Thyroid hormone biomarkers include:  

• TSH  
• T4   
• T3 (though this is not routinely tested for)  

With our Advanced Thyroid Function Blood Test, you can take a detailed look at your thyroid function, including antibodies and thyroid nutrition. This can help you to investigate several causes of thyroid-related symptoms.  

While there's no specific test to diagnose menopause, you can check certain hormonal biomarkers alongside your symptoms.  

Menopausal test biomarkers include: 

• Oestradiol  
• FSH  
• LH  

With our Menopause Blood Test, you can test for all the above female hormone biomarkers plus the main thyroid function markers. Our doctors will interpret your results alongside your medical information and any symptoms you’re experiencing to let you know the best next steps. 

You can find more about the diagnosis of menopause in our blog: all you need to know about menopause.  

Where to get support

If you're over 50, your doctor may diagnose you with menopause without any further testing. However, if you suspect a thyroid condition is the cause of your symptoms, you may need further investigation. 

Have a look through our Thyroid Buying Guide, thyroid guide, or at our Menopause Blood Test.  

We also recognise that sometimes you may just need a friendly chat or support from others, so we have listed a few charities below that are here to help.  

Thyroid charities  

• Thyroid UK – Thyroid UK has a fantastic online community and information for everyone, including undiagnosed people.  
• British Thyroid Foundation – they have a whole area for support that includes patient stories, forums, and a list of support groups and telephone contacts.  

Menopause charities   

• The Menopause Charity – their website is full of information on HRT (hormone replacement therapy), menopause, and how to manage symptoms. There's also a community section that shares others' individual experiences.  
• The British Menopause Society – offers support to anyone going through either perimenopause or menopause. You can find an NHS or private menopause specialist through the British Menopause Society website.

Are you going through menopause? Take a look at registered nutritionist, Emma Bardwell's six ways to eat better for menopause. 

  References 

1. Patil N, Rehman A, Jialal I. Hypothyroidism. In: StatPearls [Internet]. StatPearls Publishing; 2020. Updated August 10, 2020. Accessed January 5, 2021.   
2. Cleveland Clinic. 2022. Thyroid Disease: Causes, Symptoms, Risk Factors, Testing & Treatment. [online] Available at: <https://my.clevelandclinic.org/health/diseases/8541-thyroid-disease> [Accessed 21 September 2022].   
3. Gietka-Czernel, M., 2017. The thyroid gland in postmenopausal women: physiology and diseases. Menopausal Review, 2, pp.33-37.  
4. InformedHealth.org. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. How does the thyroid gland work? 2010 Nov 17 [Updated 2018 Apr 19]. Available at: <https://www.ncbi.nlm.nih.gov/books/NBK279388/>   
5. nhs.uk. 2022. Underactive thyroid (hypothyroidism) - Symptoms. [online] Available at: <https://www.nhs.uk/conditions/underactive-thyroid-hypothyroidism/symptoms/> [Accessed 21 September 2022]. 
6. nhs.uk. 2022. Overactive thyroid (hyperthyroidism) - Symptoms. [online] Available at: <https://www.nhs.uk/conditions/overactive-thyroid-hyperthyroidism/symptoms/> [Accessed 21 September 2022]. 
7. Lu, Y., Li, J., & Li, J. (2016). Estrogen and thyroid diseases: an update. Minerva medica, 107(4), 239–244.
8. Santin, A. and Furlanetto, T., 2011. Role of Estrogen in Thyroid Function and Growth Regulation. Journal of Thyroid Research, 2011, pp.1-7.
9. British Thyroid Foundation. 2022. Thyroid and menopause. [online] Available at: <https://www.btf-thyroid.org/thyroid-and-menopause> [Accessed 21 September 2022].