By Dea Skourti, Nutritionist with a focus on Menopause & Midlife Wellness
When we talk about menopause, hot flashes, mood swings, and weight changes often take center stage. But there’s one hormone powerhouse that often goes under the radar- the thyroid. And during the menopausal transition, it can make all the difference to your quality of life.
Why Thyroid and Menopause are So connected?
Both Menopause and thyroid dysfunction can present with strikingly similar symptoms: fatigue, depression, anxiety, sleep disturbances, weight changes, even hair loss. This overlap can create diagnostic confusion and delay proper treatment- a concern emphasized in a 2024 position paper by the European Menopause and Andropause Society (EMAS)1
In fact, EMAS urges clinicians to keep a high index of suspicion for thyroid disorders in menopausal women, especially when symptoms seem “atypical” or more severe than expected.
Shared Symptoms: Is it Menopause, Thyroid..or Both?
| Symptom | Menopause | Hypothyroidism | Hyperthyroidism |
|---|---|---|---|
| Mood swings | ✅ | ✅ | ✅ |
| Weight gain | ✅ | ✅ | ❌ |
| Sweating/night sweats | ✅ | ❌ | ✅ |
| Sleep disturbances | ✅ | ✅ | ✅ |
| Low libido | ✅ | ✅ | ✅ |
As you can see, the overlap is real. This is why self-advocacy- asking your healthcare provider about thyroid testing- is so essential.
How Hormones Play into this
Estrogen levels drop during menopause, while thyroid hormones -TSH , T3, T4- may also fluctuate. Some women develop sub-clinical hypothyroidism, a mild but impactful form of low thyroid function that increases the risk for:
- High cholesterol
- Non-alcoholic fatty liver disease (NAFLD)
- Metabolic syndrome
- Depressive symptoms
In left untreated, these changes can seriously affect heart health and overall metabolic balance.
A word of Caution: Bone Health & Over- treatment
Here’s a lesser-known but critical insight: over-treating hypothyroidism, especially in postmenopausal women, can weaken bones and increase the risk of osteoporosis. With estrogen already declining, keeping thyroid replacement therapy (like levothyroxine) within optimal limits becomes essential for bone preservation.
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My nutritional Takeway
In my work with midlife women, I often see thyroid dysfunction being mistaken for “just menopause”. It’s not “just” anything. Your body is complex, and you deserve clarity- and the right treatrment.
I recommend:
- Bringing up persistent fatigue, hair loss, or weight changes with your doctor.
- Getting a full thyroid panel, not just TSH.
- Avoiding supplements like biotin before lab tests (they can skew thyroid results!)
- Working with a Nutritionist who sees you as a Whole person, not a hormone lab value.
Treatment: Thyroid, Menopause & Hormone Therapy
Here’s the good news: both Thyroid medication and menopausal hormone therapy (MHT) can be safely used- often together- to improve your quality life.
📌 MHT does not increase thyroid cancer risk.
📌 Transdermal (patch) estrogen doesn’t interfere with thyroid function.
📌 If you’re already on thyroid medication and start MHT, your dose might need adjusting.
And yes, lifestyle support- including a thyroid- supportive, anti-inflammatory diet- plays a critical role. That’s where nutritionists like me come in.
Final thoughts
This EMAS paper is a wake-up call for all of us: thyroid health needs to be part of every menopause conversation. If you’re feeling “off”, don’t brush it aside. Your body might be trying to tell you something.
Want help navigating your menopause journey with clarity and confidence? Let’s work together.
References
European Menopause and Andropause Society (EMAS). Position Statement: Thyroid Disease and Menopause. Maturitas. 2024. https://doi.org/10.1016/j.maturitas.2024.107991