You Think It’s Menopause, But Could It Be Your Thyroid?

Shared symptoms make it easy to confuse the two
Illustration of older womans neck and her thyroid

You’ve been irritable, you’ve gained weight and you’re not sleeping well. If you’re a woman in your mid 40s or 50s, you’re probably thinking menopause is to blame. But don’t jump to conclusions. These may be signs of an overactive or underactive thyroid gland.

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Other symptoms shared by menopause and thyroid disorders — fatigue, depression, hair loss and hot flashes — also make it tricky to tell the two apart, says endocrinologist Mary Vouyiouklis Kellis, MD.

Knowing what’s ailing you is the key to managing both conditions.

How your doctor can tell if you actually have a thyroid problem

Thyroid disorders are more common among women. Women with a family history of thyroid problems or autoimmune issues (like type 1 diabetes) are at higher risk, says Dr. Kellis. And as we get older, those risks increase.

“Thyroid disorders are often diagnosed around the time of menopause, or between the ages of 45 and 55,” says Dr. Kellis. “Many women pass off their thyroid issues for menopause because the symptoms are similar and it seems like they’re at the right age.”

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The good news: A simple blood test can help rule out a thyroid disorder. If the test doesn’t find irregular thyroid hormone levels, then menopause is probably your answer — and you’ll need to work with your doctor to manage it.

Overactive vs. underactive thyroid

The thyroid is a butterfly-shaped gland located at the front of your neck. It produces hormones that help regulate your body’s metabolism and keep your brain, heart, muscles and other organs working properly. But sometimes it does too much or too little, as seen in:

  • Hyperthyroidism: An overactive thyroid may make you feel nervous, irritable and shaky. You may notice a racing heart, excessive sweating, heat intolerance, frequent bowel movements, thinning hair, weight loss and irregular periods.
  • Hypothyroidism: An underactive thyroid gland may slow down your body functions. What to look for: slower thinking, depression, feeling cold, constipation, muscle weakness, abnormal periods and a slower metabolism leading to moderate weight gain.

Loss of memory, or “brain fog,” is another, often-overlooked, sign of a thyroid issue, adds Dr. Kellis. Though rare, losing hair around the ends of your eyebrows is another sign.

Thyroid disorders are more common than you may think

Over 20 million Americans have a thyroid disorder, Dr. Kellis says. In fact, thyroid problems are more common than asthma and chronic obstructive pulmonary disease. But since many of the signs are so common, it’s easy miss it.

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Dr. Kellis recommends getting a blood test if you’re experiencing irregularities in weight loss or gain, slowed thinking, memory loss, or anything that makes your body “not feel right.”

Ask your doctor to check for thyroid lumps (nodules) or an enlarged thyroid (goiter) during routine physical exams. Both thyroid nodules and goiter can make your thyroid underactive or overactive. Few nodules or goiters cause pain, but larger one can hamper swallowing and breathing, or make you hoarse.

Effective treatments are available for most thyroid disorders, ranging from medications to surgery. The right diagnosis and treatment will help you manage a thyroid disorder and its symptoms, says Dr. Kellis.

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