Thyropause: When Menopause and Hypothyroidism Overlap

It’s no secret that peri-menopause can be a - let’s say just say - challenging time in a woman’s health journey - with a big part of that challenge coming from the fact that our very legitimate health concerns are commonly brushed off, dismissed, and trivialized. Because of this medical “shrug,” women suffer for years without being told about effective, research-based testing and treatment options, simply because their symptoms aren’t “bad” enough or life threatening. But the changes that occur in peri-menopause can reveal underlying physiological imbalances, weak spots, and risk factors that shouldn’t be ignored.

Enter: Thyropause.

This term describes the trifecta of common symptoms that often coincide with peri-menopause but have significant overlap with low thyroid function - and if you’re reading this, I bet you’re familiar with at least 2 of the three - I’m talking about fatigue, weight gain, and depression.

When female hormones decline, they rarely do so in a gentle, smooth slope. This is one of the reasons that peri-menopause can be such a confusing ordeal - those erratic hormone shifts can create some serious chaos on their way toward menopause and beyond! But, more importantly to our topic, the withdrawal or shutting down of reproductive hormone production by the ovaries, specifically progesterone, can trigger hypothyroidism, or low thyroid function.

I’m going to say that one more time, because I want to make sure you catch this: when your progesterone drops, it reduces your free or available thyroid hormone and can trigger the autoimmunity that is at the root of many cases of low thyroid function. In addition, high, erratic estrogen increases something called thyroid-binding globulin, which also reduces available thyroid hormone overall. And that is a big deal!

Why? Because most of the 60 million Americans with thyroid dysfunction don’t even know they have it. And, given how many options we have for addressing hypothyroid (more than you’d think), and given that catching this dysfunction early can prevent other diseases like type 2 diabetes, Raynaud’s, and cardiovascular issues, it’s important that thyropause symptoms are fully explored instead of ignored.

Your thyroid may have been functioning just fine, at least well enough to maintain a normal TSH or thyroid stimulating hormone, which is the first and often only thyroid lab that is used by conventional doctors. But during peri-menopause all of that can change!

So - if you’re a woman who starts gaining belly fat at age 45, despite no changes to your diet or exercise routine, how are you supposed to know if the weight gain is being caused by peri-menopause, chronic stress hormones, or low thyroid function?

Or, if you’re a 50 year old woman who feels sluggish, brain-foggy, burned out, and has no motivation, is it because your neurotransmitters are unbalanced? Or could it be because of underlying reproductive and thyroid problems?

What about symptoms like high cholesterol, a puffy face, hair loss or thinning, poor memory…why should be accept these kinds of changes as simply a sign of getting older, when they’re also signs of underlying dysfunction?

The short answer is, we shouldn’t. And neither should your trusted healthcare provider, in my humblest of opinions.

So, what’s a gal to do?

If you’re experiencing weight gain, depression, and fatigue, and you suspect it’s related to hormonal shifts, the first thing to do is get more data - more importantly, complete data - about the state of your thyroid function. This will help you rule out hypothyroidism or point you in the right direction for treatment.

This means going beyond that simple TSH (thyroid stimulating hormone) screen to check on the status of your actual thyroid hormones, otherwise known as T3 and T4, as well as thyroid antibodies that may be produced in the case of autoimmune thyroid dysfunction. These are not standard screening tests, but they are crucial to determining if your fatigue, weight gain, or depression are being caused by your thyroid. If your doctor can’t or won’t order these additional tests for you, or your insurance wants to charge an arm and a leg to cover them, don’t give up! You can order your own at-home thyroid testing kit over at my website, and I’ll even help you understand the results. Or I can help you determine exactly which tests you need, and order them at a tenth of the cost, as part of a one-on-one consultation with me. You’ve got options - click HERE for more information on Functional Lab Testing; click HERE to learn more about working with me one-on-one.

Once you determine how much of a role your thyroid function is or isn’t playing, you can address the other members of your hormonal team, too.

One of my favorite ways to do this is using the DUTCH test, which stands for DRIED URINE TEST FOR COMPREHENSIVE HORMONES. This at-home test kit reveals the big picture of your hormone network including adrenal hormones like cortisol and DHEA, testosterone, estrogen, progesterone, and even melatonin. My clients always have an “aha!” moment when we’re reviewing their results, because it truly lays out the story of your hormones in a way that is actionable, meaning that we know what steps to take to support better hormone balance AND how to help your body metabolize or detox your hormones in an anti-inflammatory, cancer-preventative, symptom minimizing way. Yep, it makes a BIG difference which pathway your hormones, specifically estrogen, use to detox…but that’s a topic for another day.

Once you’ve zeroed in on your own specific hormonal needs, you can actually DO something about it using Functional Medicine strategies. You might support waning progesterone levels with Chasteberry fruit extract, Wild Yam, Vitamin C, and caffeine reduction. You might address estrogen dominance with increased fiber and water intake, N-Acetyl-Cysteine, Indole-3-Carbinol, and reducing your alcohol consumption. You might decrease elevated cortisol levels with adaptogens like Ashwagandha, or by balancing your blood sugar levels, or SAMe. You can find more functional stress management strategies in my Stress Better Starter Kit.

Basically, once you know exactly what you’re treating and why, you can actively do something about it instead of shrugging off that thyropause exhaustion, belly fat, and low motivation as just another inevitable result of aging. You deserve better than that.

Click HERE to check out my favorite hormone balancing supplements.

Click HERE to look at my preferred thyroid support supplements.