Transitions in life can be difficult but few can be as confusing and frustrating as perimenopause and menopause.
Typically, perimenopause, the precursor to menopause, develops in the late 30s and early to mid 40s. Women in this age group may be familiar with various symptoms associated with the condition such as discomfort, hot flashes, and difficult menstruation. Many believe that such symptoms are simply part of the aging process and cannot be alleviated or avoided. However, hormonal influence, specifically those regulated by the thyroid, have significant influence over menopause and its associated symptoms.
Knowing how the thyroid and menopause influence each other helps inform the importance of effective hormone treatment.
Menopause and Perimenopause
As women begin entering into middle age, their bodies start shifting focus away from reproduction and childbearing. Typically, in the five to ten years leading up to menopause, women develop perimenopause, signaling major hormonal transitions.
Perimenopause is indicative of the relationship between the brain and the ovaries deteriorating ending with the cessation of ovarian activity. While the ovaries begin to decline the brain expects them to maintain the same activity as previous years. This miscommunication results in a variety of symptoms that can range from mild to severe.
Symptoms of menopause and perimenopause include the following and will vary in intensity depending on the individual:
- Worsening of PMS symptoms
- Abnormal vaginal bleeding or “spotting” between periods
- Missed periods
- Heavier periods
- Brain fog
- Weight gain
The Mutual Influence of Menopause and the Thyroid
Most women going through menopause or perimenopause experience a significant decrease in progesterone production often resulting in deficiency. This causes imbalanced estrogen levels, known as estrogen dominance, leading to more intense PMS and menopausal symptoms. Furthermore, elevated estrogen levels may block thyroid hormone transport while inhibiting conversion of inactive thyroid hormone T4 into the active form T3.
A study in 2011 found that estrogen may also negatively impact thyroid receptor sites. This reduces the thyroid’s ability to influence not only menstrual function, but other areas of the body as well. Because of the interconnectivity of estrogen and thyroid functionality, it is common for perimenopausal and menopausal women to suffer some degree of thyroid dysfunction.
For how much influence menopause has over thyroid activity, the thyroid exercises a similar level of influence in the development and regulation of menopause. The ovaries and uterus rely on healthy thyroid function to get the thyroid hormones it needs to function properly and remain active. Reduced thyroid hormone availability can lead to issues ranging in severity from vaginal irritation to repeated miscarriages. The intensity of menopausal symptoms is heavily dependent on the production and availability of thyroid hormone. Decreased, or even borderline healthy, levels of thyroid hormone can cause an increase in menopausal symptoms.
Limited thyroid activity can result in atrophic vaginitis, which promotes the occurrence of symptoms such as itching, loss of estrogen, vaginal discharge, and painful intercourse. Typically, perimenopausal and menopausal women suffering from a thyroid condition will also experience increased dryness of the vagina, hair, skin and nails, as well as more frequent and severe hot flashes. As thyroid levels decrease, the intensity of these symptoms increases.
Recent studies have also shown that thyroid dysfunction may contribute to the long-term effects of menopause. Menopausal women with hypothyroidism may be at greater risk of osteoporosis and cardiovascular disease.
Fortunately, a 2007 study found that women who had a thyroid disorder, while also experiencing intense menopausal symptoms, saw improvement of their symptoms through treating and optimizing thyroid function. Ideally, thyroid and other hormonal imbalances are resolved to improve menopausal symptoms and decrease the risk of long-term damage.
Treating the Thyroid and Menopause with BHRT
Even though the thyroid is clearly associated with menopause and perimenopause, it is often overlooked and not properly treated. Worse still, thyroid dysfunction frequently goes undiagnosed.
By the age of 50, one in twelve women suffer from significant underactive thyroid and by the age of 60 this ratio shrinks to one out of every six. However, even if thyroid dysfunction is recognized, typical treatment may not be enough.
Symptomatic menopausal women often to do not respond to synthetic thyroid hormone therapies. Synthetic hormones are constructed substances that mimic thyroid hormones naturally produced in the body. These products are frequently ineffective at optimizing thyroid function in menopausal women. Fortunately, bioidentical hormone replacement therapy (BHRT) is proving to be an effective method of improving thyroid function normalizing menstruation.
In contrast to synthetics, bioidentical hormones, which are typically compounded from plants, are structurally identical to hormones found in the body. Therefore, bioidentical hormones such as progesterone, estrogen, and thyroid are more easily utilized by the body allowing for greater restoration and balance.
BHRT has been shown to provide early benefits including better hormone balance and reduced menopausal symptoms while also improving long-term wellness in the areas of bone density retention, reduced incidence of breast and uterine cancers, and lowered risk of heart disease, stroke, and dementia. Improving these areas of wellness are hugely beneficial for improving the quality of life among menopausal and hypothyroid patients.
In addition to improving menstrual symptoms and thyroid functionality, BHRT may be able to improve the following issues experienced by menopausal and perimenopausal women:
- Weight gain
- Mood swings
- Dry skin and hair
- Reduced libido
- Lack of interest in previously important subjects
- Brain fog
- Panic attacks and anxiety
- Hot flashes
- Hair loss
- Vaginal dryness
Working in Harmony
Optimizing the thyroid is perhaps the best method of improving symptomatic menopause. However, it is important to remember that it is not the only hormone that influences menopausal development and symptoms. Supporting total hormone balance is hugely beneficial in regulating and restoring healthy menstruation and overall bodily function.
By utilizing bioidentical hormones such as progesterone, estrogen and thyroid hormone, the transition into menopause can be made significantly easier and, in some cases, even comfortable.
1. Perimenopause and Your Thyroid. HypothyroidMom. https://hypothyroidmom.com/peri-menopause-and-your-thyroid/
2. What’s the Link Between Thyroid Disease and Menopause? VeryWell. https://www.verywell.com/breaking-news-estrogen-menopause-and-thyroid-3231797
3. What You Should Know About Your Thyroid and Menopause. HealthLine. https://www.healthline.com/health/menopause/thyroid-and-menopause